摘要
目的探讨中医疗法对慢性心力衰竭患者利尿剂抵抗的影响,为该病患者利尿剂抵抗的预防及诊疗提供参考。方法回顾性收集2020年1月—2022年12月在上海市浦东新区光明中医医院住院的慢性心力衰竭患者资料,将患者分为发生利尿剂抵抗组和未发生利尿剂抵抗组,比较2组一般资料、中医治疗情况,采用Lasso回归和Logistic回归分析中医疗法预防利尿剂抵抗的效果及影响因素。结果符合入组标准慢性心力衰竭患者419例,其中发生利尿剂抵抗组154例,未发生利尿剂抵抗组265例,2组均使用中西医标准治疗。2组患者使用中药涂擦、耳针疗法、灸法、手指点穴、穴位敷贴、中药包熨烫和中医定向透药疗法的比例差异均有统计学意义(P均<0.05),应用耳穴压丸、推拿和中药塌渍疗法的比例差异均无统计学意义(P均>0.05)。Logistic回归(模型3)分析结果显示,中药涂擦(OR=0.608,95%CI:0.377~0.979)、耳针疗法(OR=0.458,95%CI:0.268~0.782)、灸法疗法(OR=0.621,95%CI:0.403~0.956)、手指点穴疗法(OR=0.624,95%CI:0.405~0.962)、穴位敷贴疗法(OR=0.612,95%CI:0.399~0.938)、中药包熨烫疗法(OR=0.599,95%CI:0.373~0.961)和中医定向透药疗法(OR=0.552,95%CI:0.349~0.873)是利尿剂抵抗发生的保护因素,与模型1和模型2结果一致。结论中医疗法能够有效预防慢性心力衰竭患者利尿剂抵抗的发生,应积极发挥中医优势,为慢性心力衰竭的临床研究提供循证医学证据。
Objective It is to explore the effect of traditional Chinese medicine on diuretic resistance in patients with chronic heart failure,and to provide reference for the prevention,diagnosis and treatment of diuretic resistance in patients with this disease.Methods The data of chronic heart failure patients hospitalized in Guangming Hospital of Traditional Chinese Medicine from January 2020 to December 2022 was retrospectively collected,the patients were divided into the group with diuretics resistance and the group without diuretics resistance,the general information,Chinese medicine treatment of the two groups were compared,and the effect and its influencing factors of Chinese medicine treatment in the prevention of diuretic resistance were analyzed by Lasso regression analysis and Logistic regression analysis.Results There were 419 patients with chronic heart failure who met the enrollment criteria,including 154 patients in the diuretic resistance group and 265 patients in the non-diuretic resistance group,and both groups were treated with Chinese and western medicine standard therapy.The differences in the proportions of patients treated with traditional Chinese medicine rubbing,auricular acupuncture,moxibustion,finger pointing manipulation,acupoint application,Chinese medicine pack ironing and Chinese medicine target transdermal drug delivery were all statistically significant(all P<0.05),and the differences in the proportions of patients treated with auricular pressure pills,manipulation and Chinese medicine external medicinal liquid application were not statistically significant(all P>0.05).Logistic regression(model 3)analysis showed that traditional Chinese medicine rubbing(OR=0.608,95%CI:0.377-0.979),auricular acupuncture(OR=0.458,95%CI:0.268-0.782),moxibustion(OR=0.621,95%CI:0.403-0.956),finger pointing manipulation(OR=0.624,95%CI:0.405-0.962),acupoint application(OR=0.612,95%CI:0.399-0.938),Chinese medicine pack ironing(OR=0.599,95%CI:0.373-0.961),and Chinese medicine target transdermal drug delivery(OR=0.5
作者
杨娅鸿
李萍
卫晓霞
陈燕丽
施静
YANG Yahong;LI Ping;Wei Xiaoxia;CHEN Yanli;SHI Jing(School of Public Health,Guizhou Medical University,Guiyang 561113,Guizhou,China;Guangming Hospital of Traditional Chinese Medicine,Shanghai 201200,China)
出处
《现代中西医结合杂志》
CAS
2024年第5期614-618,645,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
上海市浦东新区科技与经济委员会医疗卫生项目(PKJ2022-Y65)。
