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基于循证医学指导下“痰瘀”理论的中医药防治冠心病稳定型心绞痛患者的前瞻性队列研究。

Traditional Chinese Medicine in the prevention and treatment of stable angina pectoris in patients with coronary heart disease based on the theory of "phlegm and blood stasis" under guidance of evidence-based medicine: a prospective cohort study.

机构信息

Department of Cardiology, the Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China.

Research Center of Traditional Chinese Medicine, the Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China.

出版信息

J Tradit Chin Med. 2021 Feb;41(1):150-156. doi: 10.19852/j.cnki.jtcm.2021.01.017.

Abstract

OBJECTIVE

To ascertain whether continuous treatment with Traditional Chinese Medicine (TCM) combined with standardized drug therapy from Western Medicine can further reduce the incidence of cardiovascular events in patients with coronary heart disease and angina and reduce the incidence of angina pectoris in patients with coronary heart disease.

METHODS

A multicenter, prospective cohort study of 1042 patients in 22 hospitals was conducted. A total of 423 patients with angina pectoris were treated with standardized Western Medicine alone (control group) and 619 with a combination of Chinese and Western Medicine (exposure group). The two groups underwent follow-up for 1 year to establish whether there was any improvement in the incidence of cardiovascular events or change in the curative effect.

RESULTS

The incidence of primary endpoint events in the combined-exposure group decreased by 0.45% (P > 0.05) and the incidence of secondary terminal events decreased by 5.25% in comparison with the control group (P < 0.05). The total angina pectoris score clearly decreased in the Western Medicine group over the first 6 months, but the decline was more apparent in the combined-exposure group.

CONCLUSION

Compared with treatment using standardized Western Medicine alone, providing TCM combined with Western medical treatment reduced the incidence of cardiovascular events in patients with stable angina pectoris (grade Ⅱ endpoint) and effectively improved the curative effect.

摘要

目的

确定中药(TCM)的连续治疗与西药的标准化药物治疗相结合是否可以进一步降低冠心病和心绞痛患者的心血管事件发生率,并降低冠心病患者的心绞痛发生率。

方法

对 22 家医院的 1042 例患者进行了多中心前瞻性队列研究。423 例心绞痛患者单独接受标准化西药治疗(对照组),619 例接受中西药联合治疗(暴露组)。两组均进行了 1 年的随访,以确定心血管事件的发生率是否有所改善或疗效是否有所变化。

结果

与对照组相比,联合暴露组的主要终点事件发生率降低了 0.45%(P>0.05),次要终点事件发生率降低了 5.25%(P<0.05)。在最初的 6 个月中,西药组的总心绞痛评分明显下降,但联合暴露组的下降更为明显。

结论

与单独使用标准化西药治疗相比,提供中药联合西药治疗可降低稳定性心绞痛患者(二级终点)的心血管事件发生率,并有效改善疗效。

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