[中药可能降低类风湿关节炎合并血小板计数升高患者的再入院风险：一项匹配队列研究]
[Traditional Chinese medicine may reduce the risk of readmission in patients with rheumatoid arthritis complicated with elevated platelet count: a matched cohort study].
作者信息
Wang F, Liu J, Fang Y, Wen J, He M, Han Q, Li X
机构信息
First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China.
出版信息
Nan Fang Yi Ke Da Xue Xue Bao. 2023 Sep 20;43(9):1548-1557. doi: 10.12122/j.issn.1673-4254.2023.09.12.
OBJECTIVE
To evaluate the association of traditional Chinese medicine (TCM) treatment with the risk of readmission in patients with rheumatoid arthritis (RA) complicated with elevated platelet count.
METHODS
We retrospectively collected the data of inpatients diagnosed with RA in our hospital from 2013 to 2021. The patients with elevated platelet count receiving TCM treatment were matched to those without TCM treatment using propensity score matching at the 1∶1 ratio, and the confounding factors were adjusted including gender, age, Chinese patent medicine, and external application. A Cox proportional hazard model was used to evaluate the hazard ratio (HR) of the risk of readmission, and a Kaplan-Meier curve was generated to assess the incidence of readmission in these patients.
RESULTS
A total of 1176 RA patients with elevated platelet count were included in this study, including 842 patients in the TCM group and 334 patients in the non-TCM group, and after 1∶1 propensity score matching, 334 patients were included in each group. The Cox proportional hazards model showed that the readmission rate was significantly lower in TCM group than in non-TCM group (HR=0.59, 95% : 0.48-0.73, <0.001), and TCM was a protective factor against readmission in RA patients with elevated platelet count. Kaplan-Meier curves demonstrated that long-term use of TCM helped to decrease the risk of readmission (Log-rank <0.001). Association rules showed that the use of several Chinese herbal medicines and the Chinese patent medicine Xinfeng Capsule had a strong correlation with improvement of such clinical indicators as rheumatoid factor, erythrocyte sedimentation rate, and C-reactive protein.
CONCLUSION
In RA patients with elevated platelet count, the use of TCM, as a protective factor against readmission, is strongly associated with a lowered risk of readmission with a long-term association.
目的
评估中医（TCM）治疗与类风湿关节炎（RA）合并血小板计数升高患者再入院风险的相关性。
方法
我们回顾性收集了2013年至2021年在我院诊断为RA的住院患者的数据。采用倾向评分匹配法按1∶1的比例将接受中医治疗的血小板计数升高患者与未接受中医治疗的患者进行匹配，并对性别、年龄、中成药和外用药物等混杂因素进行了调整。使用Cox比例风险模型评估再入院风险的风险比（HR），并生成Kaplan-Meier曲线以评估这些患者的再入院发生率。
结果
本研究共纳入1176例血小板计数升高的RA患者，其中中医组842例，非中医组334例，经1∶1倾向评分匹配后，每组各纳入334例。Cox比例风险模型显示，中医组的再入院率显著低于非中医组（HR = 0.59，95%：0.48 - 0.73，<0.001），中医是血小板计数升高的RA患者再入院的保护因素。Kaplan-Meier曲线表明，长期使用中医有助于降低再入院风险（对数秩检验<0.001）。关联规则显示，几种中药和中成药新癀片的使用与类风湿因子、红细胞沉降率和C反应蛋白等临床指标的改善有很强的相关性。
结论
在血小板计数升高的RA患者中，中医作为再入院的保护因素，与长期降低再入院风险密切相关。
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