Fan Guohui, Wang Dingyi, Wu Sinan, Li Demin, Ren Xiaoxia, Dong Fen, Huang Kewu, Chen Yahong, Zhang Hongchun, Wang Chen, Yang Ting
Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing, China.
Department of Traditional Chinese Medicine for Pulmonary Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Center for Respiratory Medicine, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, National Clinical Research Center for Respiratory Diseases, Beijing, China.
Front Pharmacol. 2023 Mar 16;14:1118143. doi: 10.3389/fphar.2023.1118143. eCollection 2023.
Our aim was to systematically investigate the efficacy of Tanreqing (TRQ) injection on in-hospital outcomes among inpatients with frequent or infrequent AECOPD. In this ongoing, nationwide multicenter registry designed to investigate clinical characteristics, management, and prognoses of Chinese patients admitted for AECOPD in real-world settings, we collected characteristics, comorbidities, in-hospital prognoses, and information on the COPD assessment test (CAT) questionnaire, PEACE questionnaire, and modified British Medical Research Council (mMRC) questionnaire from each enrolled patient. Frequent AECOPD was determined as being admitted to the hospital ≥1 time or visiting the emergency room (ER) ≥ 2 times due to AECOPD within a year. A propensity match method and univariable and multivariable regression models were performed to analyze the efficacy of TRQ on clinical outcomes for inpatients with frequent AECOPD. A total of 4135 inpatients were involved in the analysis, including 868 administered with TRQ and 3267 not administered with TRQ. After propensity score match, among those administered with TRQ, 493 had frequent AECOPD and 358 had infrequent AECOPD. A significant reduction of CAT score at discharge (TRQ median 12, IQR 8.0-16.0; non-TRQ median 13, IQR 9.0-18.0, = 0.0297), a lower rate of ICU admission (TRQ 0.8% vs. non-TRQ 2.6%, = 0.0191), and a shorter length of stay (LOS) (TRQ median 11, IQR 9.0-14.0; non-TRQ median 11, IQR 8.0-14.0, = 0.004) were observed in the TRQ group, compared with the non-TRQ group among frequent AECOPD patients. In the subgroup analysis, for those with a PEACE score >7 on admission, TRQ contributed to a significantly lower CAT score at discharge ( = 0.0084) and a numerically lower ICU admission rate with a marginal statistical significance. Among those with phlegm-heat symptom complex on admission ≥2, a lower CAT score at discharge and a lower ICU admission were also observed in the TRQ group. TRQ injection had better efficacy in patients with frequent AECOPD in reducing ICU admission and alleviating respiratory symptoms, especially for those with higher severity on admission or more phlegm-heat symptoms.
我们的目的是系统研究痰热清（TRQ）注射液对频繁或不频繁发生慢性阻塞性肺疾病急性加重（AECOPD）住院患者院内结局的疗效。在这项正在进行的全国多中心登记研究中，旨在调查现实环境中因AECOPD入院的中国患者的临床特征、管理和预后，我们收集了每位入选患者的特征、合并症、院内预后以及慢性阻塞性肺疾病评估测试（CAT）问卷、PEACE问卷和改良英国医学研究委员会（mMRC）问卷的信息。频繁AECOPD定义为一年内因AECOPD住院≥1次或就诊于急诊室（ER）≥2次。采用倾向匹配法以及单变量和多变量回归模型分析TRQ对频繁AECOPD住院患者临床结局的疗效。共有4135名住院患者参与分析，其中868名接受了TRQ治疗，3267名未接受TRQ治疗。倾向评分匹配后，接受TRQ治疗的患者中，493例为频繁AECOPD，358例为不频繁AECOPD。与非TRQ组相比，TRQ组频繁AECOPD患者出院时CAT评分显著降低（TRQ中位数12，四分位数间距8.0 - 16.0；非TRQ中位数13，四分位数间距9.0 - 18.0，P = 0.0297），入住重症监护病房（ICU）的比例较低（TRQ为0.8% vs.非TRQ为2.6%，P = 0.0191），住院时间（LOS）较短（TRQ中位数11，四分位数间距9.0 - 14.0；非TRQ中位数11，四分位数间距8.0 - 14.0，P = 0.004）。在亚组分析中，对于入院时PEACE评分>7的患者，TRQ导致出院时CAT评分显著降低（P = 0.0084），ICU入院率在数值上较低且具有边缘统计学意义。在入院时痰热证候≥2的患者中，TRQ组出院时CAT评分也较低，ICU入院率也较低。痰热清注射液对频繁AECOPD患者在降低ICU入院率和缓解呼吸道症状方面具有更好的疗效，尤其是对于入院时病情较重或痰热症状较多的患者。
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