摘要
目的 了解我国二级医院急性冠状动脉综合征（ACS）患者住院期间中药使用现状,并对中药使用的相关因素进行探讨.方法 对我国15个省和自治区的102家二级医院2011年9月至2012年5月期间收入院的新发ACS患者进行前瞻性登记研究,摘录并整理患者病历中院内使用中药的资料.中药使用影响因素的单因素分析采用卡方检验、多因素分析采用logistic回归分析.结果 入选ACS患者共5 432例,其中3 503例患者使用中药（64.5％）.多因素logistic回归分析显示：院前使用中药与住院期间使用中药呈正相关（OR=2.08,P＜0.01）；院前使用过至少1种指南推荐的4类药物（指阿司匹林或氯吡格雷、β受体阻滞剂、他汀类药物、血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体拮抗剂）、吸烟或曾吸烟以及出院诊断为心肌梗死与住院期间使用中药呈负相关（OR值分别为0.58、0.78和0.71,P均＜0.01）；以西南地区为参照,华东、华南、华中、华北、西北、东北地区使用中药的OR值为2.98 ～ 13.37（P均＜0.01）.结论 中药在我国二级医院的ACS住院患者中使用非常普遍；院内是否使用中药与多种因素相关.
Objective To explore the current status on traditional Chinese medicine （TCM） use for hospitalized acute coronary syndrome patients in China＇s level 2 hospitals, and to explore associated factors of TCM use for these patients. Methods This survey was performed in 102 level 2 hospitals from 15 provinces or autonomous region in China. Patients admitted to these hospitals with acute coronary syndrome during September 2011 to May 2012 were eligible for this study. Information on TCM use was obtained from their medical records. Chi-square test and logistic regression analysis were used to explore the related factors of TCM use in these patients. Results We recruited 5 432 acute coronary syndrome patients in this study, TCM was applied to 3 503 patients （64. 5% ）. Muhivariable logistic regression showed that pre-hospital TCM use was positively related with in-hospital TCM use（ OR = 2.08, P 〈 0.01 ） ,while pre-hospital use of 4 medicines recommended by the guidelines （including aspirin/clopidogrel, Bacceptor blocker, stain and angiotensin converting enzyme inhibitor/angiotensin converting enzyme receptor blocker ） , being a smoker and diagnosis of myocardial infarction rather than unstable angina at hospital discharge were negatively related with in-hospital TCM use （ the ORs were 0. 58, 0. 78 and 0. 71, respectively, all P 〈 0.01 ）. The TCM use varied significantly between regions. Taking southwest region as a reference, the ORs varied between 2. 98- 13.37 （all P 〈0. 01） in eastern China, south China, central China, north China, northwest and northeast regions. Conclusions TCM is widely used in hospitalized acute coronary syndrome patients in China＇s resource-constrained level 2 hospitals. Pre-hospital TCM use is positively correlated with in-hospital TCM use for these patients.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2014年第2期156-160,共5页
Chinese Journal of Cardiology
关键词
冠状动脉疾病
中草药
中国
Coronary disease
Drugs,Chinese herbal
China
