CAJ | 학술논문

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.
목적 료해아국이급의원급성관상동맥종합정(ACS)환자주원기간중약사용현상,병대중약사용적상관인소진행탐토.방법 대아국15개성화자치구적102가이급의원2011년9월지2012년5월기간수입원적신발ACS환자진행전첨성등기연구,적록병정리환자병력중원내사용중약적자료.중약사용영향인소적단인소분석채용잡방검험、다인소분석채용logistic회귀분석.결과 입선ACS환자공5 432례,기중3 503례환자사용중약(64.5％).다인소logistic회귀분석현시:원전사용중약여주원기간사용중약정정상관(OR=2.08,P＜0.01)；원전사용과지소1충지남추천적4류약물(지아사필림혹록필격뢰、β수체조체제、타정류약물、혈관긴장소전환매억제제혹혈관긴장소Ⅱ수체길항제)、흡연혹증흡연이급출원진단위심기경사여주원기간사용중약정부상관(OR치분별위0.58、0.78화0.71,P균＜0.01)；이서남지구위삼조,화동、화남、화중、화북、서북、동북지구사용중약적OR치위2.98 ～ 13.37(P균＜0.01).결론 중약재아국이급의원적ACS주원환자중사용비상보편；원내시부사용중약여다충인소상관.
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,βacceptor 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.