基于倾向性评分的真实世界生脉注射液治疗心肌梗死有效性研究  

Study on Efficacy of Real-World Shengmai Injection in Treatment of Myocardial Infarction Based on Propensity Score

作　　者：赵晓晓 孙春全 刘福梅[1] 谢雁鸣[1] 王连心[1] 陈澍 ZHAO Xiaoxiao;SUN Chunquan;LIU Fumei;XIE Yanming;WANG Lianxin;CHEN Shu(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Renmin University of China,Beijing 100872,China)

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]天津中医药大学,天津301617 [3]中国人民大学,北京100872

出　　处：《中国中医基础医学杂志》2023年第6期960-965,共6页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号);2021年岐黄学者支持项目(国中医药人教函[2022]6号);中国中医科学院科技创新工程项目(CI2021A00702);国家重点研发计划项目(2018YFC1707400)。

摘　　要：目的探索真实世界生脉注射液治疗心肌梗死的有效性。方法提取中国中医科学院中医临床基础医学研究所建立的患者数据库中2001—2016年使用生脉注射液治疗心肌梗死的患者作为暴露组(1848例),同时按年龄、性别、入院病情在数据库中匹配未使用生脉注射液的心肌梗死患者作为对照组(1782例),利用倾向性评分对两组混杂因素进行稳健处理,采用多种logistic回归方法分析其有效性。结果①卡方检验表明两组治疗结果存在差异(P<0.05),且暴露组的有效率65.4%(好转+治愈)要优于对照组47.0%(好转+治愈)。②无倾向性评分加权及也未对协变量进行调整的单纯logistic回归分析、倾向性评分加权但无协变量调整的logistic回归分析、带协变量调整的倾向性评分加权logistic回归分析均表明暴露组的有效性优于对照组。结论倾向性评分的加权,提高了研究结果的真实性。通过多种检验方式证明生脉注射液治疗心肌梗死的疗效优于对照组,值得临床推广使用。Objective To explore the effectiveness of Shengmai Injection in the treatment of myocardial infarction in the real world.Methods Patients who received Shengmai Injection for the treatment of myocardial infarction between 2001 and 2016 were extracted from the patient database established by the Institute of Basic Research in Clinical Medicine of the China Academy of Chinese Medical Sciences as the exposure group(1848 cases).The control group(1782 cases)was matched in the database based on age,gender,and admission condition,and did not receive Shengmai Injection treatment.Propensity score weighting was used to perform robust processing on confounding factors in the two groups,and various logistic regression methods were used to analyze their effectiveness.Results①The chi-square test showed a significant difference in treatment outcomes between the two groups(P<0.05),and the effective rate(improvement+cure)in the exposure group was 65.4%,which was superior to the control group(47.0%).②Simple logistic regression analysis without propensity score weighting and without adjusting for covariates,logistic regression analysis with propensity score weighting but without covariate adjustment,and propensity score weighting logistic regression analysis with covariate adjustment all showed that the effectiveness of the exposure group was superior to the control group.Conclusion Propensity score weighting improves the validity of the research results.The effectiveness of Shengmai Injection in the treatment of myocardial infarction was demonstrated to be superior to the control group through multiple testing methods,and is worthy of clinical promotion and application.

关 键 词：倾向性评分 真实世界 生脉注射液 心肌梗死 有效性 

分 类 号：R256.2[医药卫生—中医内科学]