摘要
目的通过随访强直性脊柱炎(ankylosing spondylitis, AS)出院患者健脾化湿益肾通络方药的应用情况,分析中医药治疗与终点事件发生的相关性。方法采用队列研究设计。电话随访安徽中医药大学第一附属医院2012年1月1日—2016年6月30日AS住院患者399例,依据出院后服用中成药、中药汤剂的时间,将随访成功323例患者分为高暴露组(159例),中暴露组(38例),低暴露组(70例),非暴露组(56例),采用χ~2检验、Logistic回归分析(健脾化湿代表药:茯苓、薏苡仁、陈皮,祛风益肾代表药:威灵仙、川芎、桑寄生,活血通络代表药:丹参、桃仁、红花)治疗与终点事件(全因死亡、手术治疗、再发入院、关节外病变)发生的相关性。结果失访率19.05%(76/399);出院后应用中成药、中药汤剂≥28天的AS患者共267例,应用频次较高的口服中成药依次为杜仲壮骨丸、新风胶囊、黄芩清热除痹胶囊、雷公藤多苷片等,中药汤剂依次为四妙散、独活寄生汤、身痛逐瘀汤、桃红四物汤等。终点事件共发生6例,其中高暴露组发生0例,中暴露组1例(26.32%),低暴露组2例(28.57%),非暴露组3例(53.57%),发生率差异有统计学意义(P<0.05)。结论终点事件的发生与中医药治疗的强度相关,以陈皮、桑寄生等为代表的健脾化湿益肾方药能减少AS患者终点事件的发生。
Objective To analyze the correlation between TCM treatment and endpoint events by follow-ups of the application of Chinese herbs for Pi invigorating,dampness resolving,Shen benefiting,and collaterals dredging(CHs-PIDSSBCD)for treating ankylosing spondylitis(AS)patients.Methods A cohort study design was used.Totally 399 AS inpatients were followed-up at First Affiliated Hospital,Anhui University of Traditional Chinese Medicine from January 1,2012 to June 30,2016 by telephone.According to the time points of taking Chinese patent medicine and Chinese medicine decoction after discharge,patients successfully followed-up were assigned to high exposure group(159 cases),middle exposure group(38 cases),low exposure group(70 cases),and non-exposure group(56 cases).Usingχ~2 test and Logistic regression analysis(representative drugs of Pi invigorating and dampness resolving:poria,coix seed,tangerine peel;representative drugs of wind removing and Shen invigorating:Radix et Rhizoma Clematidis,Ligusticum Chuanxiong,Taxillus Chinensis;representative drugs of blood activating and collaterals dredging:Salvia Miltiorrhiza,peach kernel,safflower),the correlation between treatment and endpoint events(all-cause death,surgical treatment,re-admission,extra-articular lesions)were analyzed.Results A total of 323 patients completed follow-ups,and the follow-ups loss rate was 19.05%(76/399).There were 267 AS patients who took Chinese patent medicine and Chinese medicine decoction for at least 28 days after discharge.Chinese patent medicines with higher frequency of application were sequenced as Duzhong Zhuanggu Pill,Xinfeng Capsule,Huangqi Qingre Chubi Capsule and Tripterygium Polyglycosides Tablet,and so on.Traditional Chinese medicine decoctions with higher frequency of application were sequenced as Simiao Powder,Duhuo Jisheng Decoction,Shentong Zhuyu Decoction,Taohong Siwu Decoction,and so on.End point event occurred in 6 cases,including 0 cases in the high exposure group,1 case(26.32%)in the middle exposure group,2 cases(28.57%)in the
作者
方妍妍
刘健
万磊
忻凌
董文哲
文建庭
FANG Yan-yan;LIU Jian;WAN Lei;XIN Ling;DONG Wen-zhe;WEN Jian-ting(Graduate School,Anhui University of Traditional Chinese Medicine,Hefei(230038);Department of Rheumatology,First Affiliated Hospital,Anhui University of Traditional Chinese Medicine,Hefei(230031))
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2019年第5期553-556,共4页
Chinese Journal of Integrated Traditional and Western Medicine
基金
国家中医药重点学科中医痹病学建设项目(No.国中医药发[2009]30号)
国家临床重点专科中医风湿病科建设项目(No.财社[2013]239号)
安徽省重点实验室建设项目(No.1306c083035)
国家科技支撑计划课题(No.2012BA126B02)
安徽省重点实验室:现代中医内科应用基础与开发研究(No.1606c08238)
关键词
强直性脊柱炎
健脾化湿益肾通络药
终点事件
队列研究
ankylosing spondylitis
Chinese herbs for Pi invigorating,dampness resolving,Shen benefiting,and collaterals dredging
endpoint event
cohort study
