老年射血分数保留性心力衰竭患者中西医结合居家运动康复专家共识

doi:10.12114/j.issn.1007-9572.2026.0151

中国全科医学 ›› 2026, Vol. 29 ›› Issue (35): 5153-5160.DOI: 10.12114/j.issn.1007-9572.2026.0151

• 指南·共识 • 下一篇

老年射血分数保留性心力衰竭患者中西医结合居家运动康复专家共识

刘艳萍¹^,^*(), 唐荣欣¹, 刘姝², 梁闪¹, 张岩¹, 李梦¹, 彭广操¹, 游桂英³, 孙国珍⁴, 唐海玉⁵, 丁艳丽¹, 杨红蕾¹, 孟玉璞¹, 杨永婷¹

1．450000　河南省郑州市，河南中医药大学第一附属医院心脏中心
2．450000　河南省郑州市，河南中医药大学第一附属医院护理部
3．610041　四川省成都市，四川大学华西医院心脏内科
4．210029　江苏省南京市，南京医科大学第一附属医院心血管内科
5．518033　广东省深圳市中医院老年医学科

收稿日期:2026-05-14 修回日期:2026-08-20 出版日期:2026-12-15 发布日期:2026-10-26
通讯作者: 刘艳萍
基金资助:
国家中医优势专科建设项目(国中医药医政函〔2024〕90号); 河南省中医药重点学科建设项目(豫卫中医药科教〔2024〕1号); 河南省中医智慧护理工程研究中心(豫发改高技〔2022〕948号); 深圳市"医疗卫生三名工程"项目资助(SZZYSM202411009); 河南省卫生健康委员会国家中医药传承创新中心联合共建科研专项(2024ZXZX1138，2024ZXZX1146，2024ZXZX1142)

Expert Consensus on Home-based Exercise Rehabilitation with Integrated Traditional Chinese and Western Medicine for Elderly Patients with Heart Failure with Preserved Ejection Fraction

LIU Yanping¹^,^*(), TANG Rongxin¹, LIU Shu², LIANG Shan¹, ZHANG Yan¹, LI Meng¹, PENG Guangcao¹, YOU Guiying³, SUN Guozhen⁴, TANG Haiyu⁵, DING Yanli¹, YANG Honglei¹, MENG Yupu¹, YANG Yongting¹

1. Heart Center, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China
2. Department of Nursing, the First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China
3. Department of Cardiology, West China Hospital, Sichuan University, Chengdu 610041, China
4. Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
5. Department of Geriatrics, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518033, China

Received:2026-05-14 Revised:2026-08-20 Published:2026-12-15 Online:2026-10-26
Contact: LIU Yanping

摘要/Abstract

摘要： 居家运动康复是降低老年射血分数保留性心力衰竭（HFpEF）患者再住院率及失能风险的关键手段，但目前缺乏规范化的中西医结合居家运动康复管理路径，临床实践中存在康复认知不足、运动方案个体化欠缺、居家监测体系不完善、跨学科协作机制薄弱等问题。本共识基于循证方法，通过文献筛选、质量评价、证据提取与综合形成初稿，经专家论证会及2轮德尔菲专家函询完成证据分级和推荐意见制定。共识明确了老年HFpEF患者中西医结合居家运动康复核心概念，构建涵盖居家运动康复组织管理、运动原则、评估与监测及运动方案的标准化流程，并制定了居家运动康复管理策略。本共识旨在建立老年HFpEF患者中西医结合居家运动康复管理路径，规范居家运动康复流程，通过系统化康复体系降低患者再住院率及失能风险，改善其生活质量，为临床提供标准化指导。

关键词: 心力衰竭, 射血分数保留性心力衰竭, 中西医结合, 居家运动, 心脏康复

Abstract:

Home-based exercise rehabilitation is a key intervention for reducing readmission rates and disability risk in elderly patients with heart failure with preserved ejection fraction (HFpEF). However, a standardized home-based exercise rehabilitation management pathway integrating traditional Chinese and Western medicine is currently lacking, and clinical practice face problems such as insufficient awareness of rehabilitation, inadequate individualization of exercise protocols, incomplete home monitoring systems, and weak interdisciplinary collaboration mechanisms. This consensus was developed using an evidence-based approach, with an initial draft created through literature screening, quality assessment, evidence extraction, and synthesis of evidence. The draft was then refined through expert panel discussions and two rounds of Delphi expert consultations to establish evidence grading and formulate recommendations. The consensus clarifies the core concepts of home-based exercise rehabilitation with integrated traditional Chinese and Western medicine for elderly HFpEF patients, constructs a standardized process covering organizational management, exercise principles, assessment and monitoring, and exercise protocols, and establishes management strategies for home-based exercise rehabilitation. This consensus aims to establish a management pathway for home-based exercise rehabilitation with integrated traditional Chinese and Western medicine for elderly patients with HFpEF, standardize home-based exercise rehabilitation procedures, reduce readmission rates and disability risk through a systematic rehabilitation system, improve quality of life, and provide standardized guidance for clinical practice.

Key words: Heart failure, Heart failure with preserved ejection fraction, Integrated traditional Chinese and Western medicine, Home-based exercise, Cardiac rehabilitation

刘艳萍,唐荣欣,刘姝,等. 老年射血分数保留性心力衰竭患者中西医结合居家运动康复专家共识[J]. 中国全科医学, 2026, 29(35): 5153-5160. DOI: 10.12114/j.issn.1007-9572.2026.0151.
LIU Yanping,TANG Rongxin,LIU Shu, et al. Expert Consensus on Home-based Exercise Rehabilitation with Integrated Traditional Chinese and Western Medicine for Elderly Patients with Heart Failure with Preserved Ejection Fraction[J]. Chinese General Practice, 2026, 29(35): 5153-5160. DOI: 10.12114/j.issn.1007-9572.2026.0151.

图/表 2

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证据等级	研究设计类型	具体定义
1级	实验性设计	1a：多项随机对照试验（RCT）的系统评价/Meta分析 1b：RCT与其他研究设计的系统评价 1c：单个RCT 1d：准随机对照试验（Pseudo-RCT）
2级	类实验性设计	2a：多项类实验研究的系统评价 2b：类实验研究与其他较低级别研究设计的系统评价 2c：前瞻性对照类实验研究 2d：前后对照或历史/回顾性对照研究
3级	观察性-分析性设计	3a：多项可比性队列研究的系统评价 3b：可比性队列研究与其他较低级别研究设计的系统评价 3c：有对照组的队列研究 3d：病例对照研究 3e：无对照组的观察性研究
4级	观察性-描述性设计	4a：多项描述性研究的系统评价 4b：横断面研究 4c：病例系列研究 4d：个案研究
5级	专家意见与基础研究	5a：专家意见的系统评价 5b：专家共识 5c：基础研究/单个专家意见

证据等级	研究设计类型	具体定义
1级	实验性设计	1a：多项随机对照试验（RCT）的系统评价/Meta分析 1b：RCT与其他研究设计的系统评价 1c：单个RCT 1d：准随机对照试验（Pseudo-RCT）
2级	类实验性设计	2a：多项类实验研究的系统评价 2b：类实验研究与其他较低级别研究设计的系统评价 2c：前瞻性对照类实验研究 2d：前后对照或历史/回顾性对照研究
3级	观察性-分析性设计	3a：多项可比性队列研究的系统评价 3b：可比性队列研究与其他较低级别研究设计的系统评价 3c：有对照组的队列研究 3d：病例对照研究 3e：无对照组的观察性研究
4级	观察性-描述性设计	4a：多项描述性研究的系统评价 4b：横断面研究 4c：病例系列研究 4d：个案研究
5级	专家意见与基础研究	5a：专家意见的系统评价 5b：专家共识 5c：基础研究/单个专家意见

推荐等级	具体标准
A级推荐（强推荐）	明确利大于弊；有充分质量的证据支持其使用；对资源使用有益或无负面影响；已充分考虑价值观、偏好及患者体验
B级推荐（弱推荐）	似乎利大于弊，但尚不够明确；有证据支持其使用，但证据质量可能不高；对资源使用有益、无影响或影响最小；价值观、偏好及患者体验可能已考虑，也可能未考虑

推荐等级	具体标准
A级推荐（强推荐）	明确利大于弊；有充分质量的证据支持其使用；对资源使用有益或无负面影响；已充分考虑价值观、偏好及患者体验
B级推荐（弱推荐）	似乎利大于弊，但尚不够明确；有证据支持其使用，但证据质量可能不高；对资源使用有益、无影响或影响最小；价值观、偏好及患者体验可能已考虑，也可能未考虑

老年射血分数保留性心力衰竭患者中西医结合居家运动康复专家共识

Expert Consensus on Home-based Exercise Rehabilitation with Integrated Traditional Chinese and Western Medicine for Elderly Patients with Heart Failure with Preserved Ejection Fraction

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