基于倾向性评分匹配法评价调畅气机法治疗心肌桥回顾性队列研究  

Retrospective Cohort Study on Evaluation of Treatment of Myocardial Bridge with Method of Regulating Qi Flow Based on Propensity Score Matching

作　　者：吴希泽 康健[2] 刘之然 王晓玉 庞敏[3] 高静[3] WU Xize;KANG Jian;LIU Zhiran;WANG Xiaoyu;PANG Min;GAO Jing(Nantong Hospital of Traditional Chinese Medicine,Nantong Hospital Affiliatd to Nanjing University of Chinese Medicine,Nantong 226000,Jiangsu,China;Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China;The Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110034,Liaoning,China)

机构地区：[1]南通市中医院,南京中医药大学南通附属医院,江苏南通226000 [2]辽宁中医药大学,辽宁沈阳110032 [3]辽宁中医药大学附属第二医院,辽宁沈阳110034

出　　处：《辽宁中医杂志》2024年第2期33-38,共6页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划资助项目(2018YFC1704100);东北部地区名老中医学术观点、特色诊疗方法和重大疾病防治经验研究项目(2018YFC1704105)。

摘　　要：目的基于倾向性评分匹配法(PSM)探讨“调畅气机法”(柴胡-桔梗-枳壳-牛膝)治疗心肌桥的临床疗效。方法采用回顾性队列研究方法,选取158例心肌桥医案,将其分为暴露组与非暴露组,暴露组为接受中药汤剂中含有调畅气机法(包含柴胡-桔梗-枳壳-牛膝)的医案,非暴露组为基础类中药临症加减的医案。运用PSM进行匹配后得到样本35对。观察治疗前后中医证候积分和心电图。结果匹配后暴露组与非暴露组治疗后中医证候积分较治疗前有显著的改善(P<0.01),以暴露组改善更明显(P<0.01);匹配后暴露组的总有效率(94.29%,33/35)高于非暴露组(77.14%,27/35);暴露组的显效率(42.86,15/35%)高于非暴露组(20.00%,7/35),均差异具有统计学意义(P<0.05);匹配后暴露组的心电图总有效率(37.14%,13/35)高于非暴露组(14.29%,5/35),差异具有统计学意义(P<0.05)。结论“调畅气机法”治疗心肌桥疗效良好,缓解临床症状,且一定程度上减轻心电图心肌缺血改变。Objective To investigate the clinical efficacy of“regulating Qi flow method”[Chaihu(Bupleuri Radix)-Jiegeng(Platycodonis Radix)-Zhiqiao(Aurantii Fructus)-Niuxi(Achyranthis Bidentatae Radix)]in the treatment of myocardial bridges based on propensity score matching method(PSM).Methods A retrospective cohort study was conducted to select 158 cases of myocardial bridges,which were divided into exposed and non-exposed groups,with the exposed group being those who received traditional Chinese medicine tonics containing the method of regulating Qi flow[including Chaihu(Bupleuri Radix)-Jiegeng(Platycodonis Radix)-Zhiqiao(Aurantii Fructus)-Niuxi(Achyranthis Bidentatae Radix)],and the non-exposed group being those who received basic Chinese medicine according to syndrome differentiation.A sample of 35 pairs was obtained after matching by using PSM.The TCM symptom scores and electrocardiogram(ECG)were observed before and after treatment.Results The total effective rate was higher in the exposed group(94.29%,33/35)than that in the non-exposed group(77.14,27/35%),and the significant rate was higher in the exposed group(42.86%,15/35)than that(20.00%,7/35)in the non-exposed group,which were statistically difference(P<0.05).The total ECG efficiency in the exposed group(37.14%,13/35)was higher than that in the non-exposed group(14.29%,5/35)after matching,with a statistical difference(P<0.05).Conclusion The treatment of myocardial bridge by“regulating Qi flow method”is effective,relieving clinical symptoms and alleviating myocardial ischemic changes of ECG to a certain extent.

关 键 词：调畅气机法 心肌桥 倾向性评分匹配 真实世界研究 柴胡-桔梗-枳壳-牛膝 

分 类 号：R256.2[医药卫生—中医内科学]