基于真实世界研究探讨“三辨三期三调”针药联合对COPD患者EOS、CRP的影响  

A Real-World Study on the Influence of Combination of Acupuncture and Medicine on EOS and CRP in Patients with COPD Based on"Three Discrimination,Three Phases and Three Adjustments"

作　　者：何喆 余顺 董芹作 邢利威 杨彦斌[2] 赵荣 钱锐[2] HE Zhe;YU Shun;DONG Qingzuo;XING Liwei;YANG Yanbin;ZHAO Rong;QIAN Rui(Yunnan University of Chinese Medicine,Kunming 650500,China;Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming 650021,China)

机构地区：[1]云南中医药大学,云南昆明650500 [2]云南省中医医院,云南昆明650021

出　　处：《云南中医药大学学报》2023年第1期29-36,共8页Journal of Yunnan University of Chinese Medicine

基　　金：国家自然科学基金项目(82060895,81760896);吕光荣全国名老中医药专家传承工作室;区域中医诊疗中心(老年病);云南省科技厅应用基础研究联合重点项目(2019FF002-004);云南省中医药科技资源开放共享公共科技服务平台。

摘　　要：目的探索真实世界中“三辨三期三调”指导下针刺中药联合对慢性阻塞性肺疾病EOS、CRP的影响。方法采用回顾性队列研究方法,以云南中医药大学第一附属医院/云南省中医医院HIS系统数据库为依托,采集2019年8月-2022年8月所有出院诊断为慢性阻塞性肺疾病患者病例,共纳入3357例。以是否接受“三辨三期三调”指导下针刺中药联合治疗分为“三辨三期三调”针药联合组(1696例,简称针药组)和“三辨三期三调”中药治疗组(1661例,简称中药组)。以倾向评分法(回归法、匹配法、调整法、分层法、加权法)分析2组患者EOS、CRP的变化。结果倾向评分法处理前后均显示针药组总有效率明显优于中药组(P<0.05)。结论基于“三辨三期三调”的针药联合治疗在降低慢性阻塞性肺疾病带病期、发病期、重病期患者的EOS与CRP水平方面的效果明显优于单纯中药疗法。Objective To explore the effect of acupuncture combined with traditional Chinese medicine on EOS and CRP of chronic obstructive pulmonary disease in the real world based on"three discrimination,three phases and three adjustments".Methods Based on the HIS system database of Yunnan provincial hospital of traditional Chinese medicine,a retrospective cohort study was conducted to collect 3357 patients diagnosed as chronic obstructive pulmonary disease patients in the period of illness and serious illness from August 2019 to August 2022.According to whether or not to receive ATCM treatment,1696 cases were divided into traditional Chinese medicine group and 1661 cases were divided into traditional Chinese medicine treatment group.The effects of EOS and CRP in the two groups were analyzed by propensity score(PS)(Logistic regression,PS matching,PS adjustment,PS stratification,PS weighting).Results The total effective rate of the ATCM group was significantly better than that of the traditional Chinese medicine group before and after PS treatment(P<0.05).Conclusion The traditional Chinese medicine based on"three discrimination,three phases and three adjustments"can significantly reduce the EOS and CRP levels of patients with COPD in the disease stage,onset stage and severe disease stage,which is better than that of traditional Chinese medicine alone.

关 键 词：COPD 针药结合 EOS CRP 三辨三期三调 

分 类 号：R256.1[医药卫生—中医内科学] R246.1[医药卫生—中医学]