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在哮喘患者中,常规护理添加中药与类风湿关节炎风险降低相关:一项基于人群的回顾性队列研究。

Adding Chinese Herbal Medicine to Routine Care is Associated With a Lower Risk of Rheumatoid Arthritis Among Patients With Asthma: A Population-Based Retrospective Cohort Study.

作者信息

Chang Wei-Chiao, Livneh Hanoch, Chen Wei-Jen, Hsieh Chang-Cheng, Wang Yu-Han, Lu Ming-Chi, Guo How-Ran, Tsai Tzung-Yi

机构信息

Department of Chinese Medicine, Dalin Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Chiayi, Taiwan.

Rehabilitation Counseling Program, Portland State University, Portland, OR, United States.

出版信息

Front Pharmacol. 2022 Aug 17;13:895717. doi: 10.3389/fphar.2022.895717. eCollection 2022.

Abstract

Due to the shared pathogenesis of asthma and rheumatoid arthritis (RA), patients with asthma were found to have a higher risk of RA. While the benefits and safety of Chinese herbal medicine (CHM) for asthma have been reported, the scientific evidence regarding its effect on RA is limited. This longitudinal cohort study aimed to determine the relation between CHM use and RA risk in patients with asthma. Using the nationwide claims data, we enrolled 33,963 patients 20-80 years of age who were newly diagnosed with asthma and simultaneously free of RA between 2000 and 2007. From this sample, we utilized propensity score matching to create sets of participants as treatment and control groups, which comprised 13,440 CHM users and 13,440 non-CHM users. The incidence rate and hazard ratio (HR) for RA between the two groups were estimated at the end of 2013. A Cox proportional hazards model was constructed to examine the impact of the CHM use on the risk of RA. The cumulative incidence of RA was substantially lower in the CHM user group. In the follow-up period, 214 patients in the CHM user group (1.92 per 1,000 person-years) and 359 patients in the non-CHM user group (2.92 per 1,000 person-years) developed RA (adjusted HR = 0.63, 95% confidence interval: 0.54-0.75). Of the commonly-prescribed formulae, nine CHM products were associated with a lower RA risk: Xiao-Qing-Long-Tang, Ma-Xing-Gan-Shi-Tang, Ding-Chuan-Tang, Xin-Yi-Qing-Fei-Tang, Bei Mu, Jie Geng, Xing Ren, Da Huang, and San Chi. This study found that patients with asthma who received CHM treatment, in addition to the conventional therapy, had a lower risk of RA. Use of CHM treatment may be integrated into conventional therapy to reduce subsequent RA risk among asthma patients.

摘要

由于哮喘和类风湿关节炎(RA)具有共同的发病机制,研究发现哮喘患者患RA的风险更高。虽然已有关于中药(CHM)治疗哮喘的益处和安全性的报道,但其对RA影响的科学证据有限。这项纵向队列研究旨在确定哮喘患者使用中药与患RA风险之间的关系。利用全国性医保理赔数据,我们纳入了2000年至2007年间新诊断为哮喘且同时无RA的33963名20至80岁患者。从该样本中,我们采用倾向得分匹配法创建了治疗组和对照组,每组各有13440名中药使用者和13440名非中药使用者。在2013年底估算了两组之间RA的发病率和风险比(HR)。构建Cox比例风险模型以检验使用中药对RA风险的影响。中药使用者组中RA的累积发病率显著更低。在随访期内,中药使用者组有214名患者(每1000人年1.92例)发生RA,非中药使用者组有359名患者(每1000人年2.92例)发生RA(校正HR = 0.63,95%置信区间:0.54 - 0.75)。在常用方剂中,9种中药产品与较低的RA风险相关:小青龙汤、麻杏甘石汤、定喘汤、辛夷清肺汤、贝母、桔梗、杏仁、大黄和三七。本研究发现,哮喘患者在接受常规治疗之外还接受中药治疗,其患RA的风险更低。中药治疗可纳入常规治疗,以降低哮喘患者后续患RA的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d57c/9431954/8cfe063f0815/fphar-13-895717-g001.jpg

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