健脾化湿通络方药对3 449例风湿病患者终点事件影响的队列研究
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安徽省科技攻关项目(1604a0802085);中央引导地方科技发展专项(财教〔2016〕1188);现代中医内科应用基础与开发研究安徽省重点实验室(财教〔2016〕518)


Effect of the Drugs Based on Jianpi Huashi Tongluo Prescription on the Outcome Events of Patients with Rheumatic Diseases: A Cohort Study of 3 449 Cases
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    摘要:

    目的 通过随访风湿病出院患者健脾化湿通络方药的应用情况,观察中医药治疗风湿病的效应。方法 采用队列研究方法,电话随访风湿病住院患者出院后服用中成药和中药汤剂的时间(<28 d者定义为非暴露组,>28 d、且≤90 d者为低暴露组,>90 d、且<180 d者为中暴露组,≥180 d者为高暴露组)。采用χ2检验、Logistic回归法分析健脾化湿通络方药治疗与终点事件发生的相关性。结果 3 449例患者完成随访,失访率16.18%(666/4 115)。出院后应用中成药、中药汤剂时间≥28 d的风湿病患者共2 877例,应用频次较高的中成药依次为新风胶囊、新癀片、黄芩清热除痹胶囊、雷公藤多苷片、杜仲壮骨丸、颈椎活血胶囊等。终点事件发生185例,其中高暴露组发生18例(9.73%),中暴露组31例(16.76%),低暴露组48例(25.95%),非暴露组88例(47.57%),终点事件发生率差异有统计学意义(P<0.05)。Logistic回归分析结果表明,暴露强度、新风胶囊、雷公藤多苷片、黄芩清热除痹胶囊为终点事件的保护因素。结论 终点事件的发生与中医药治疗的强度相关,以新风胶囊为代表的健脾化湿通络方药能减少风湿病患者终点事件的发生。

    Abstract:

    Objective To investigate the effect of traditional Chinese medicine in the treatment of rheumatic diseases by following up the application of the drugs based on Jianpi Huashi Tongluo Prescription in discharged patients with rheumatic diseases. Methods A cohort study was performed, and telephone followup was performed for hospitalized patients with rheumatic diseases to record the medication time of Chinese patent drugs and traditional Chinese medicine decoction after discharge. The patients with a medication time of <28 days were enrolled as nonexposure group, those with a medication time of >28 days and ≤90 days were enrolled as low exposure group, those with a medication time of >90 days and <180 days were enrolled as moderate exposure group, and those with a medication time of ≥180 days were enrolled as high exposure group. The chisquare test and the logistic regression method were used to investigate the association between Jianpi Huashi Tongluo Prescription treatment and outcome events. Results A total of 3 449 patients completed the followup, and the loss to followup rate was 16.18% (666/4 115). A total of 2 877 patients with rheumatic diseases had a medication time of ≥28 days after discharge, and Xinfeng Capsule had the highest frequency, followed by Xinhuang Tablet, Huangqin heatclearing and arthralgiaremoving Capsule, Tripterygium wilfordii polyglycoside Tablet, Duzhong Zhuanggu Pill, and Jingzhui Huoxue Capsule. A total of 185 patients experienced outcome events, with 18 patients (9.73%) in the high exposure group, 31 (16.76%) in the moderate exposure group, 48 (25.95%) in the low exposure group, and 88 (47.57%) in the nonexposure group, and there was a significant difference in the incidence rate of outcome events between groups (P<0.05). The logistic regression analysis showed that degree of exposure, Xinfeng Capsule, Tripterygium wilfordii polyglycoside Tablet, and Huangqin heatclearing and arthralgiaremoving Capsule were protective factors against outcome events. Conclusion The occurrence of outcome events is associated with the intensity of traditional Chinese medicine treatment. The drugs based on Jianpi Huashi Tongluo Prescription, represented by Xinfeng Capsule, can reduce the occurrence of outcome events in patients with rheumatic diseases.

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刘 健,方妍妍,董文哲,文建庭,孙广瀚,鲍丙溪.健脾化湿通络方药对3 449例风湿病患者终点事件影响的队列研究[J].安徽中医药大学学报,2019,38(6):6-9

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  • 在线发布日期: 2019-11-25