Dai Guohua, Gao Wulin, Bi Dongxue, Liu Chunhua, Liu Yuhan, Wang Ning, Zhao Chen
Department of Cardiology, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250000, China.
First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250000, China.
J Tradit Chin Med. 2018 Jun;38(3):412-418.
To investigate the ""real world"" effectiveness of Traditional Chinese Medicine (TCM) in patients with acute myocardial infarction suffering from diabetes mellitus (AMI+DM patients).
This was a retrospective cohort study. During hospitalization, the ""exposure group"" was defined as patients who had a TCM injection for ≥ 7 d. During follow-up, the definition of the exposure group was application of a Chinese patent medicine or decoction of Chinese medicine for ≥ 28 d. General information (age, sex, contact details), TCM use and endpoint events of AMI+DM patients during hospitalization and follow-up were collected. The correlation between TCM and the end-point events of AMI + DM patients was analyzed using a multiple logistic regression method.
A total of 479 AMI + DM patients were enrolled and 345 cases were followed up. During hospitalization, TCM, age, hypertension and use of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) were associated with cardiac death. During follow-up, TCM was associated with cardiac death. TCM was a relevant factor for a composite endpoint of re-infarction and stroke. TCM, anti-thrombotic therapy and lipid-lowering therapy were related to acute heart failure. TCM, anti-thrombotic therapy, anti-MI therapy and ACEI/ARB use exhibited a strong correlation with re-hospitalization due to cardiovascular disease.
TCM reduced the prevalence of cardiac death during hospitalization, and cardiac death, a composite endpoint of re-infarction and stroke, acute heart failure and re-hospitalization due to cardiovascular disease during follow-up.
探讨中药对急性心肌梗死合并糖尿病患者（AMI+DM患者）的“真实世界”疗效。
这是一项回顾性队列研究。住院期间，“暴露组”定义为接受中药注射≥7天的患者。随访期间，暴露组定义为服用中成药或中药汤剂≥28天的患者。收集AMI+DM患者住院期间及随访期间的一般信息（年龄、性别、联系方式）、中药使用情况及终点事件。采用多因素logistic回归方法分析中药与AMI+DM患者终点事件的相关性。
共纳入479例AMI+DM患者，345例进行了随访。住院期间，中药、年龄、高血压以及使用血管紧张素转换酶抑制剂（ACEI）或血管紧张素受体阻滞剂（ARB）与心源性死亡相关。随访期间，中药与心源性死亡相关。中药是再梗死和中风复合终点的相关因素。中药、抗血栓治疗和降脂治疗与急性心力衰竭有关。中药、抗血栓治疗、抗心肌梗死治疗以及ACEI/ARB的使用与心血管疾病再住院密切相关。
中药降低了住院期间心源性死亡的发生率，以及随访期间心源性死亡、再梗死和中风复合终点、急性心力衰竭和心血管疾病再住院的发生率。
