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[中国二级医院住院急性冠脉综合征患者使用中医药相关因素的横断面研究]

[A cross-sectional study of factors related to traditional Chinese medicine use for hospitalized acute coronary syndrome patients in China's level 2 hospitals].

作者信息

Zhao Yifei, Li Shenshen, Ma Lihong, Sun Yihong, Du Xin, Huo Yong, Hu Dayi, Gao Runlin, Wu Yangfeng

机构信息

School of Public Health, Peking University Health Science Centre, Beijing 100191, China.

Email:

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Feb;42(2):156-60.

PMID:24735629
Abstract

OBJECTIVE

To explore the current status on traditional Chinese medicine (TCM) use for hospitalized acute coronary syndrome patients in China's level 2 hospitals, and to explore associated factors of TCM use for these patients.

METHODS

This survey was performed in 102 level 2 hospitals from 15 provinces or autonomous region in China. Patients admitted to these hospitals with acute coronary syndrome during September 2011 to May 2012 were eligible for this study. Information on TCM use was obtained from their medical records. Chi-square test and logistic regression analysis were used to explore the related factors of TCM use in these patients.

RESULTS

We recruited 5 432 acute coronary syndrome patients in this study, TCM was applied to 3 503 patients (64.5%). Multivariable logistic regression showed that pre-hospital TCM use was positively related with in-hospital TCM use (OR = 2.08, P < 0.01) , while pre-hospital use of 4 medicines recommended by the guidelines(including aspirin/clopidogrel, β acceptor blocker, stain and angiotensin converting enzyme inhibitor/angiotensin converting enzyme receptor blocker ), being a smoker and diagnosis of myocardial infarction rather than unstable angina at hospital discharge were negatively related with in-hospital TCM use (the ORs were 0.58, 0.78 and 0.71, respectively, all P < 0.01). The TCM use varied significantly between regions. Taking southwest region as a reference, the ORs varied between 2.98-13.37 (all P < 0.01) in eastern China, south China, central China, north China, northwest and northeast regions.

CONCLUSIONS

TCM is widely used in hospitalized acute coronary syndrome patients in China's resource-constrained level 2 hospitals. Pre-hospital TCM use is positively correlated with in-hospital TCM use for these patients.

摘要

目的

探讨中国二级医院住院急性冠状动脉综合征患者使用中药的现状,并探究这些患者使用中药的相关因素。

方法

本调查在中国15个省或自治区的102家二级医院开展。2011年9月至2012年5月期间入住这些医院的急性冠状动脉综合征患者符合本研究条件。从他们的病历中获取中药使用信息。采用卡方检验和逻辑回归分析来探究这些患者使用中药的相关因素。

结果

本研究共纳入5432例急性冠状动脉综合征患者,其中3503例(64.5%)使用了中药。多变量逻辑回归显示,院前使用中药与院内使用中药呈正相关(OR = 2.08,P < 0.01),而院前使用指南推荐的4种药物(包括阿司匹林/氯吡格雷、β受体阻滞剂、他汀类药物和血管紧张素转换酶抑制剂/血管紧张素转换酶受体阻滞剂)、吸烟以及出院诊断为心肌梗死而非不稳定型心绞痛与院内使用中药呈负相关(OR分别为0.58、0.78和0.71,均P < 0.01)。中药使用在不同地区之间存在显著差异。以西南地区为参照,华东、华南、华中、华北、西北和东北地区的OR值在2.98 - 13.37之间(均P < 0.01)。

结论

在中国资源有限的二级医院中,中药在住院急性冠状动脉综合征患者中广泛使用。这些患者院前使用中药与院内使用中药呈正相关。

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