Park Jeongsu, Bak Seongjun, Chu Hongmin, Kang Sukjong, Youn Inae, Jun Hyungsun, Sim Daeun, Leem Jungtae
Wonkwang University Gwangju Korean Medicine Hospital, Gwangju 61729, Republic of Korea.
College of Korean Medicine, Wonkwang University, Iksan 54538, Republic of Korea.
Healthcare (Basel). 2023 Dec 27;12(1):61. doi: 10.3390/healthcare12010061.
This study used real-world data (RWD) to explore the long-term effects of East Asian traditional medicine (EATM) on heart failure (HF). A comprehensive search was conducted across five databases to identify relevant studies, which were then reviewed using the Arksey and O'Malley scoping review framework. The analysis focused on a descriptive examination of the long-term outcomes associated with EATM intervention. Methodologically, the study explored various aspects, including study subjects, interventions, applied clinical outcomes, and statistical methods. Out of 258 studies, 12 were selected. Eight studies involved patients with HF, while the others used HF as an outcome. Datasets from the National Health Insurance Research Database were used in Taiwan, while electronic medical record data were used in China and Japan. EATM interventions have been found to be associated with lower mortality and readmission rates. One study indicated that an increased dose of Fuzi, a botanical drug, or prompt use of Fuzi after diagnosis led to a decreased mortality hazard ratio. In two studies examining readmission rates, a significant increase was observed in the non-exposed group, with odds ratios of 1.28 and 1.18. Additionally, in patients with breast cancer, the subdistribution hazard ratio for the occurrence of doxorubicin-induced HF was reduced to 0.69. Although cohort studies with survival analysis were common, methodological flaws, such as issues with statistical methods and HF diagnosis, were identified. Despite these challenges, the study observed an association between EATM and improved clinical outcomes in patients with HF, emphasizing the potential of RWD studies to complement randomized controlled trials, especially for longer-term follow-ups. These results provide foundational data for future RWD research.
本研究使用真实世界数据(RWD)来探究东亚传统医学(EATM)对心力衰竭(HF)的长期影响。在五个数据库中进行了全面检索以识别相关研究,然后使用阿克斯和奥马利的范围综述框架对这些研究进行了审查。分析重点在于对与EATM干预相关的长期结局进行描述性考察。在方法学上,该研究探讨了多个方面,包括研究对象、干预措施、应用的临床结局和统计方法。在258项研究中,选取了12项。其中8项研究涉及HF患者,其他研究则将HF作为结局。台湾使用了国民健康保险研究数据库中的数据集,而中国和日本使用了电子病历数据。已发现EATM干预与较低的死亡率和再入院率相关。一项研究表明,增加附子(一种植物药)的剂量或在诊断后及时使用附子会导致死亡风险比降低。在两项考察再入院率的研究中,未暴露组观察到显著增加,优势比分别为1.28和1.18。此外,在乳腺癌患者中,阿霉素诱导的HF发生的亚分布风险比降至0.69。尽管生存分析的队列研究很常见,但也发现了方法学缺陷,如统计方法和HF诊断方面的问题。尽管存在这些挑战,该研究观察到EATM与HF患者临床结局改善之间存在关联,强调了RWD研究对补充随机对照试验的潜力,特别是对于长期随访。这些结果为未来的RWD研究提供了基础数据。