Zhou Qin, Liu Jian, Sun Yan-Qiu, Chen Xiao-Lu, Zhang Xian-Heng, Ding Xiang
the First Affiliated Hospital of Anhui University of Chinese Medicine Hefei 230012, China.
Zhongguo Zhong Yao Za Zhi. 2023 Apr;48(8):2241-2248. doi: 10.19540/j.cnki.cjcmm.20221130.501.
This study aimed to explore the correlation between traditional Chinese medicine(TCM) and reduced risk of readmission in patients having rheumatoid arthritis with hypoproteinemia(RA-H). A retrospective cohort study was conducted on 2 437 rheumatoid arthritis patients in the information system database of the First Affiliated Hospital of Anhui University of Chinese Medicine from 2014 to 2021, and 476 of them were found to have hypoproteinemia. The patients were divided into TCM users and non-TCM users by propensity score matching. Exposure was defined as the use of oral Chinese patent medicine or herbal decoction for ≥1 month. Cox regression analysis was performed to explore the risk factors of clinical indicators of rheumatoid arthritis. Additionally, the use of TCM during hospitalization was analyzed, and analysis of association rules was conducted to investigate the correlation between TCM, improvement of indicators and readmission of patients. Kaplan-Meier survival curve was plotted to compare the readmission rate of TCM users and non-TCM users. It was found the readmission rate of RA-H patients was significantly higher than that of RA patients. By propensity score matching, 232 RA-H patients were divided into TCM group(116 cases) and non-TCM group(116 cases). Compared with the conditions in the non-TCM group, the readmission rate of the TCM group was lowered(P<0.01), and the readmission rate of middle-aged and elderly patients was higher than that of young patients(P<0.01). Old age was a risk factor for readmission of RA-H patients, while TCM, albumin(ALB) and total protein(TP) were the protective factors. During hospitalization, the TCMs used for RA-H patients were mainly divided into types of activating blood and resolving stasis, relaxing sinew and dredging collaterals, clearing heat and detoxifying, and invigorating spleen and resolving dampness. The improvement of rheumatoid factor(RF), immunoglobulin G(IgG), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and ALB was closely related to TCM. On the basis of western medicine treatment, the application of TCM could reduce the readmission rate of RA-H patients, and longer use of TCM indicated lower readmission rate.
本研究旨在探讨中医与类风湿关节炎合并低蛋白血症(RA-H)患者再入院风险降低之间的相关性。对2014年至2021年安徽中医药大学第一附属医院信息系统数据库中的2437例类风湿关节炎患者进行回顾性队列研究,发现其中476例患有低蛋白血症。通过倾向得分匹配将患者分为中医使用者和非中医使用者。暴露定义为使用口服中成药或中药汤剂≥1个月。进行Cox回归分析以探讨类风湿关节炎临床指标的危险因素。此外,分析了住院期间中医的使用情况,并进行关联规则分析以研究中医、指标改善与患者再入院之间的相关性。绘制Kaplan-Meier生存曲线以比较中医使用者和非中医使用者的再入院率。结果发现,RA-H患者的再入院率显著高于类风湿关节炎患者。通过倾向得分匹配,将232例RA-H患者分为中医组(116例)和非中医组(116例)。与非中医组相比,中医组的再入院率降低(P<0.01),中老年患者的再入院率高于年轻患者(P<
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