CCTV Tianjin January 27th (Reporter Chu Fuqing) In order to do a good job of comprehensive rehabilitation of patients with new crown pneumonia in Tianjin, and give full play to the advantages of combining rehabilitation of Chinese and Western medicine, on January 26, the Tianjin Health Committee issued “Tianjin City The new crown pneumonia recovery period of traditional Chinese and western medicine (trial) “, under the guidance of Academician Zhang Boli, according to the actual situation of Tianjin, it was jointly studied by experts from Tianjin New Crown Pneumonia Traditional Chinese Medicine Prevention and Treatment Expert Group.
The following is the “Tianjin New Crown Pneumonia’s Recovery Plan (Trial)”: “
1. Rehabilitation goals
Promote the comprehensive recovery of physiological and psychological patients with new crown pneumonia, improve related clinical symptoms, improve the quality of life, promote physical and mental health, and restore daily life, study and work ability to the greatest extent.
2. Rehabilitation object
In line with the General Office of the National Health and Health Commission and the Office of the State Administration of Traditional Chinese Medicine, the diagnosis criteria of the “New Coronary Virus Pneumonia Diagnosis and Treatment Plan (Trial Eighth Edition Revised Edition)”, patients who have been cured, and have reached the standard of discharge of centralized medical isolation observation observation standards Asymptomatic infection. This plan is suitable for adults and children with new coronary pneumonia.
3. Rehabilitation process
(1) Perform functional assessment, formulate rehabilitation plans, carry out rehabilitation guidance, and supervise and implement;
(2) Comprehensive evaluation of rehabilitation treatment 2 weeks, formulate home rehabilitation plans for home rehabilitation;
(3) Establish a follow -up mechanism, and evaluate the 2 weeks, 1 month, 3 months, 6 months, 12 months, and 24 months after the healing, and dynamically track the recovery.
Fourth, rehabilitation assessment
(1) Respiratory dysfunction
1. Main manifestations: can be manifested as pharyngeal discomfort, cough, sputum weakness, shortness of breath, shortness of breath after activity, chest tightness, palpitations, etc.
2. Functional evaluation: Evaluate the degree of dyspnea, fatigue, activity endurance, non -invasive pulse oxygen saturation monitor and portable pulmonary functional instrument.
2.1 Consciousness of Breathing Difficulty: Adopt the Division of Medicine Research Council (MMRC). The score of this scale is divided into level 5 (0 ~ 4 points), 0 ~ 1 point as a mild symptom, ≥2 points into severe symptoms.
2.2 Fatigue: Use BORG conscious fatigue scale. The scale is 6-20 points, divided into 7 grades, usually greater than 13 points to have obvious symptoms of breathing and fatigue, which is more than or equal to 17 points.
2.3 Event endurance: Use a 6 -minute walking test (6MWT) or 30 seconds to squat the number of times to guide the patient’s rehabilitation exercise intensity for the patient.
2.4 Use a vein oxygen saturation: Use a portable blood oxygen saturation monitor to evaluate the degree of hypoxia of patients.
2.5 Pulmonary function: Use a portable lung function monitor to evaluate the patient’s lung function.
(2) Psychological dysfunction
1. Main manifestations: emotional reactions such as anxiety and fear of fear, emotional instability, depression and sadness, helplessness and anger, etc.; Cognitive changes, such as some patients, will feel distorted, not concentrate, hesitate, self -blame, etc.; Behavior; behavior, etc. Obstacles such as insomnia, avoidance behavior, excessive food, self -injury, and even suicide behavior; physiological reactions such as heart panic, headache, muscle soreness, indigestion, nausea, and decreased appetite caused by emotional reactions.
2. Functional evaluation: Evaluate whether the patient has anxiety, depression and other performances, the following evaluation table can be used:
2.1 Depression: PatientHealthquestInaire-9 (PHQ-9) is used. This volume table consists of 9 items and uses a 0-3-point 4-level scoring method. The total score is 0 ~ 4 points for depression -free symptoms, 5 ~ 9 points are mild depression, 10 ~ 14 points are moderate depression, and more than 15 points are severe depression.
2.2 Anxiety: The GAD-7 (GAD-7) can be adopted with a broad anxiety dysfunction table (GAD-7). The total score is 0 ~ 4 points into non -anxiety symptoms, 5 ~ 9 points are mild anxiety, 10 ~ 14 points are moderate anxiety, and more than 15 points are severe anxiety.
2.3 Pressure: Adopt a Chinese pressure perception table (CPSS), which consists of 14 projects, with 0 to 4 points of 5 -level scores, with a low pressure of 14 ~ 28 points, moderate pressure in 29 ~ 42, 43 43, 43, 43, 43, 43, 43, 43. ~ 56 pressure is high, 57 ~ 70 is very high.
2.4 Pain: Subjectiveunitsofdistress, SUD)
(3) Evaluation of other dysfunction
Including the evaluation of dysfunction such as digestive systems, circulation systems, nervous systems, skin systems, skeletal systems, and endocrine systems based on the actual situation of the patient and records and follow -up.
5. Rehabilitation of isolation points
(1) Rehabilitation of Chinese Medicine
Qingjin Yiqi granules
Efficacy: Yiji to nourish yin, strengthen the spleen and medium, clear heat and dampness.
Indications: The recovery period of new crown pneumonia, seeing upset, dry cough and less sputum, unfavorable throat, shortness of breath after movement, fatigue and weakness of burnout, full chest and abdomen, dull and soft, heavy limbs, light tongue and less Jinjin.
Usage and dosage: Oral, 1 bag (15g) at a time, 2 times/day, children halved. The treatment is 14 days or obeys the doctor’s order.
(2) Aerobic exercise
“Victory of Crown Rehabilitation” or the eight paragraphs of the traditional method, Taijiquan, etc.
Exercise intensity: Patients should follow the principle of gradual progress and gradually advance from low intensity to medium intensity. Apply the BORG conscious fatigue table for self -assessment, so that the score of the BORG conscious fatigue table during exercise is controlled at 13 ~ 16 points; if there is a medical grade pulse oxygen monitor, blood oxygen can be performed. The blood oxygen is not less than 93 %Can. Such as any situation of chest tightness, shortness of breath, fatigue, dizziness, dizziness, headache, palpitations, sweat, unstable standing, pain, etc., stop exercise immediately and rest.
Exercise time: According to individual conditions, “victory and rehabilitation” once a day in the afternoon, one to 3 times each time, step by step, 5 ~ 10 minutes each time; Practice 1 to 2 times. The eight -segment Jin practice time is about 10-15 minutes, and it is recommended to 1 to 2 times a day. Taijiquan recommends once a day, 30 ~ 50 minutes each time. The time of aerobic exercise must be based on personal constitution, which is advisable to bear.
(3) Appropriate technology of traditional Chinese medicine
1. Acupoint application therapy
You can choose “New Cross -Grade Patch”, which are commonly selected: Dazhui, Dingchong, Feishu, Tiantu, and Cycles.
2. massage therapy
Foundation: Taiyuan, Langzhong, Zhongfu, Feishu, Shenshu, Esseuma, List, List, Zhongli, Zusanli, etc., cough, itching, dry cough, can add young businessmen, rulerze, etc.
Meridian massage: hand Taiyin lung meridian, hand Yangming large intestine meridian, foot Yangming stomach meridian, foot Taiyin spleen meridians, Renmai, Du vein, etc.
Foundation: Push the lung meridian, spleen meridian, kidney meridian, abdomen.
Syndrome extraction and subtraction: those who are fatigue, press the sea of Qi and Zusanli; those who are hot and night sweats, press and rub the Sanyinjiao; those who are cold are afraid of cold, push the three levels, press and rub the Guanyuan; ; Poor stools, stagnation, clearing the river and clear intestine, each acupuncture operation for 2 minutes.
3. Ear acupoint press bean therapy
Selection points: lung, endocrine, god door, spleen, large intestine, intercourse.
4. Saver therapy
Framelon formula: Huoxiang, Peilan, Ai Ye, Qiaohuo, Bupleurum, ostelastial, Asarum, Evodia, Xinyi and other points. Precautions for drug allergies to use it with caution; the sachets should not be dipped in water, please replace it in time when you encounter water.
Note: The appropriate technology of traditional Chinese medicine and Chinese medicine should be used under the guidance of doctors.
(4) Rehabilitation of respiratory function
1. Lip shrinkage breathing training: The patient takes the seat, and the lips are shrunk into a “blow whistle” shape; the gas enters from the nostrils when inhaled, and the lips are tightened when exhaling Blow out between the two lips. The time ratio between inhalation and exhalation is 1: 2. Practice 3 to 4 times a day, 15-30 minutes each time, gradually extend the exhalation time and reduce the frequency of breathing.
2. Abdominal respiratory training: Patients take their supine, stand or sit, put them in the abdomen with one hand, and put them in the chest with one hand; the abdomen is bulged upward when inhaling, and the chest is not moved; Breathe 7 to 8 times per minute during training, 10 to 30 minutes each time, exercise twice a day, master the abdominal breathing, you should blend your lip breathing in it. potential.
3. Adjustment of breathing rhythm: You can use the way to breathe in the nose. When exhaling, you can use your lip to exhale. In the process, you can put your hands on the abdomen. Feel the abdomen upward when inhaling. Relax when exhaling. ; Breathing frequency should generally be controlled at about 1: 2 or 1: 3.
(5) Psychological rehabilitation
1. Self -regulation
① Objectively understand the new crown epidemic, take scientific protection measures, increase security, and relieve your fear.
② identify and accept their own emotions. Feelings, nervousness, and fear are the normal reactions of most people in the face of the epidemic, accept their negative emotions, re -establish new laws of life, and gradually resolve negative emotions.
③ Accept the support and care of family members, friends and society, and gradually return to normal social relations.
④ Take the initiative to obtain psychological health knowledge and psychological health skills, and actively seek professional help if necessary.
⑤ Music therapy. Listen to the music of the five organs and the five chronches. Emotional depression can appreciate the rhythm and cheerful tracks, and those with emotional anxiety and impetuousness can appreciate the gentle tracks of the rhythm.
⑥ Emotional Easy Law. Change the living environment and methods, transfer or disperse a concentration point of a certain thinking of patients, avoid bad stimuli, and get rid of bad emotions.
2. Professional psychological intervention
① Professional psychologists formulate targeted psychological intervention solutions based on the characteristics of different periods and different types of patients in different periods and different types of patients.
② Psychological assessment must be performed before psychological intervention. If necessary, a psychiatrist has performed diagnosis and professional scale evaluation, and corresponding intervention plans are formulated based on the evaluation results.
③ Professional psychological intervention treatment for patients with insomnia, anxiety, and depression, and related drug intervention should be given if necessary.
④ Patients with psychiatric problems such as impulse, anxiety, and suicide tend to provide psychiatric consultation in time, and formulate professional psychological-psychological combined treatment plans.
⑤ For those with emotional instability, one -on -one cognitive behavior therapy can be adopted for psychological support to help emotional management.
(6) Dietary therapy
The diet should be light and balanced, and the food is diverse. Pay attention to drinking water, vegetables, fruits, meat egg milk and soy products. Pay attention to the use of spleen and stomach, as well as the use of dietary methods such as lungs, soothe, and laxative.
(7) Rehabilitation management
Formulate daily rehabilitation schedule, including: learning, rehabilitation treatment, exercise of traditional Chinese medicine exercise, eye exercises, and self -massage. Children can interact with parent -child interaction, lunch break and late break. Standardize rehabilitation management and improve the effect of rehabilitation.
6. Home recovery
(1) Keep the indoor air fresh, the temperature and humidity are appropriate, and the windows are opened regularly.
(2) Timely increase and decrease clothing according to changes in temperature to prevent colds.
(3) Regular disinfection to ensure the hygiene in the family; pay attention to personal hygiene, wash hands frequently, prevent infection and infection.
(4) Keep home isolation in accordance with relevant regulations to avoid densely personnel public places and reduce mutual contact.
(5) In accordance with the home rehabilitation plan formulated by a professional rehabilitation physician, rehabilitation treatment is performed step by step. Encourage to insist at the victory 1-2 times a day. There are discomfort symptoms, consult or seek medical treatment in time.
(6) Ensure reasonable diet and sufficient sleep time. Adjust your psychological state, restore physical fitness, and gradually return to society.
(7) Regular follow -up, and formulate targeted rehabilitation measures according to the specific situation.
(1) Through physical examination, questionnaire table, auxiliary inspection and other methods, comprehensively and detailed evaluation of patient respiratory function, psychological state, and other obstacles and severity of patients provide a basis for formulating rehabilitation schemes.
(2) Master the indications and contraindications of rehabilitation treatment, and follow the principles of personalization. Especially for patients with children, age, and various basic diseases, strengthen treatment safety.
(3) Rehabilitation treatment should pay attention to the monitoring of life signs, ensure the safety and effectiveness of treatment, and adjust the treatment cycle appropriately. It is recommended that those who have conditions to wear wearable devices for relevant evaluation and treatment.
(4) Patients should be paid attention to protection during the recovery treatment of patients discharged to avoid cross -infection.
(5) If the patient is a weak physique, the stimulus should not be too strong. The rehabilitation movement is based on the degree of sweat. Any discomfort immediately terminates the treatment.