广东地区冠心病PCI术后患者长期中医药疗效评价及临床随访研究  

Clinical Follow-up Study of Long-term Efficacy of Chinese Medicine Intervention for Treatment of Coronary Heart Disease after Percutaneous Coronary Intervention in Guangdong Region

作　　者：唐娜 褚庆民[2] 李荣[2] TANG Na;CHU Qing-Min;LI Rong(Sanyuanli Street Community Health Service Center of Baiyun District,Guangzhou 510406 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州市白云区三元里街社区卫生服务中心,广东广州510406 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2020年第10期1854-1860,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省自然科学基金项目(编号:2017A030313745);广东省中医药局科研项目(编号:20181087);广东省医学科学技术研究基金项目(编号:A2018222)。

摘　　要：【目的】探讨广东地区冠心病冠状动脉支架植入(PCI)术后患者5年内心血管事件发生情况,评价中医药干预对冠心病PCI术后患者长期临床疗效的影响,同时进一步探讨清热活血方对该类患者的临床疗效和安全性,为中医药长期治疗冠心病PCI术后患者提供理论依据。【方法】采用回顾性调查分析方法,基于课题组既往研究资料数据库,对广州中医药大学第一附属医院2010年1月至2013年12月收治的广东地区冠心病PCI术后患者的病例资料进行检索,共收集695例。期间住院死亡21例,出院674例,其中合并恶性肿瘤予以排除7例以及随访期间失访50例,实际完成随访617例。在完成随访观察的病例中,根据术后是否服用中药分为中药+西药治疗组(简称中药+西药组)316例和单纯西药治疗组(简称单纯西药组)301例,统计2组患者5年内心血管事件发生情况(包括再发心绞痛情况、再发心肌梗死情况、再次因心血管病入院情况、再次PCI情况和死亡情况等)。根据所服用中药是否为清热活血方将中药+西药组患者分为清热活血方治疗组(简称清热组)160例和非清热活血方治疗组(简称非清热组)156例,进一步观察2组患者5年内心血管事件发生情况,从而进一步评价清热活血方治疗广东地区冠心病PCI术后患者的长期临床疗效和安全性,随访终止时间为2017年12月31日。【结果】(1)本研究对广东地区冠心病PCI术后患者的平均随访时间为4.01年。(2)中药+西药组的累积总心血管事件发生率为16.1%(51/316),明显低于单纯西药组的28.2%(85/301),差异有统计学意义(P<0.01)。其中,中药+西药组的累积主要心血管事件发生率为6.3%(20/316),单纯西药组为11.0%(33/301),差异无统计学意义(P>0.05);中药+西药组的累积次要心血管事件发生率为9.8%(31/316),明显低于单纯西药组的17.3%(52/301),差异有统计学意义(P<0.05)。(3)在中药+西药组的316例患�Objective The incidence of 5-year cardiovascular events in coronary heart disease(CHD)patients after percutaneous coronary intervention(PCI)in Guangdong region was investigated for the evaluation of long-term efficacy of Chinese medicine intervention for CHD patients after PCI and for the further exploration of clinical efficacy and safety of Qingre Huoxue Prescription for CHD patients after PCI, so as to provide the theoretical evidence for the long-term treatment of CHD patients after PCI with Chinese medicine. Methods The retrospective investigation method was used for the collection of case information from our previous research data database covering a total of 695 cases of the CHD patients after PCI in Guangdong region who admitted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January of 2010 to December of 2013. During the hospitalization,21 cases of the 695 included patients were dead,and the left 674 were discharged. Seven cases complicated with malignant tumors were excluded,50 cases lost follow-up during the period of follow-up,and a total of 617 cases completed the investigation. Of the 617 cases,according to the medication of Chinese medicine or not, 316 cases receiving Chinese medicine plus western medicine treatment after PCI served the combined therapy group,and 301 cases receiving western medicine treatment alone after PCI served the western medicine group. Within the 5 years after PCI,we calculated the incidence of cardiovascular events including recurrence of angina pectoris, recurrence of myocardial infarction, re-admission for cardiovascular events, re-PCI, and mortality in the two groups. By following the medication of Qingre Huoxue Prescription(QHP)or not,the 316 cases were divided into QHP group(160 cases) and non-QHP group(156 cases). And the incidence of 5-year cardiovascular events in the QHP group and non-QHP group was also analyzed,so as to investigate the clinical efficacy and safety of QHP for CHD patients after PCI in Guangdong region. The follow

关 键 词：广东地区 冠心病 冠状动脉支架植入术后 中医药干预 清热活血法 临床随访 

分 类 号：R259.433[医药卫生—中西医结合]