| 赖润民;林骞;张贺;王彤歆3鞠建庆;刘启予;石榴3贾君迪3徐浩.活血解毒中药对稳定性冠心病再发心血管事件影响的真实世界研究[J].中国中西医结合杂志,2023,43(9):1069-1074 |
| 活血解毒中药对稳定性冠心病再发心血管事件影响的真实世界研究 |
| Effect of Promoting Blood Circulation and Detoxification on Recurrent Cardiovascular Events in Stable Coronary Artery Disease Patients： A Real-World Study |
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| DOI：10.7661/j.cjim.20230816.245 |
| 中文关键词: 稳定性冠心病 活血解毒 心血管事件 真实世界研究 中医 |
| 英文关键词:stable coronary artery disease promoting blood circulation and detoxifying cardiovascular event real-world study Chinese medicine |
| 基金项目:国家重点研发计划项目（No.2018YFC2002502）;中国中医科学院科技创新工程项目（No.CI2021A00917） |
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| 中文摘要: |
| 目的 基于真实世界数据，探索中药处方中应用活血解毒中药与稳定性冠心病患者1年内再发心血管事件的相关性。方法 收集全国10家三级甲等医院共1 220例基线资料齐全、有完整中药处方信息的稳定性冠心病患者临床诊疗与随访数据，将处方中含有兼具活血、解毒功效中药的患者归为活血解毒中药组，处方中含有活血中药和解毒中药配伍的患者归为活血解毒处方组，其余患者归为对照组。采用Cox回归方法比较三组患者在1年随访期时再发心血管事件情况。结果 经校正的Cox回归分析结果显示，与对照组比较，活血解毒中药组的患者发生主要复合终点事件（心源性死亡、卒中、非致死性心肌梗死和血运重建）和硬终点事件（心源性死亡、卒中和非致死性心肌梗死）的风险分别降低了69%（P<0.01）和58%（P<0.05）；活血解毒处方组的患者发生主要复合终点事件的风险降低了42%（P<0.01），而硬终点事件的发生风险差异无统计学意义（P>0.05）。结论 在中药处方中应用活血解毒中药，或将活血中药与解毒中药配伍使用，可显著改善稳定性冠心病患者的短期心血管预后。 |
| 英文摘要: |
| Objective To explore the association between practice of promoting blood circulation and detoxification in Chinese medicine（CM） prescription and recurrent cardiovascular events in stable coronary artery disease（SCAD） patients based on real-world clinical data. Methods Clinical and follow-up data from 1 220 SCAD patients with complete information on baseline characteristics and CM prescriptions were collected from 10 Grade-A tertiary hospitals around the country. Patients with CM prescriptions containing herbs that have both the effect of promoting blood circulation and detoxifying were labelled promoting blood circulation and detoxifying herbs group；patients with CM prescriptions containing herbs that promote blood circulation and herbs that detoxify were labelled promoting blood circulation and detoxifying prescription group；the rest of the patients were labelled as control group. Cox proportional hazard regression was adopted to compare the incidence of cardiovascular events at the time of 1-year follow-up. Results Adjusted results of Cox regression showed that，compared with control group，the risk of incidence of primary composite endpoint and cardiovascular hard event were lowered 69%（P<0.01） and 58%（P<0.05） in the promoting blood circulation and detoxifying herbs group； the risk of incidence of primary composite endpoint was lowered 42%（P<0.01） in the promoting blood circulation and detoxifying prescription group，while the decrease in risk of major adverse cardiovascular event was not significant（P>0.05）. Conclusion Applying herbs that promotes blood circulation and detoxifies or combining herbs that promotes blood circulation and herbs that detoxifies in CM prescriptions could significantly improve the short-term cardiovascular prognosis of SCAD patients. |
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