CAJ | 학술논문

目的：随访中医药治疗冠心病心律失常出院患者的终点事件发生情况，分析其与中医药治疗的相关性。方法采用队列研究设计，选择山东中医药大学附属医院2008－01－01—2013－12－31收治的冠心病心律失常患者，定义应用口服中成药或中药汤剂≥28 d为暴露组，电话随访出院后口服中成药及中药汤剂应用情况和终点事件发生情况，并采用多因素Logistic回归分析中医药治疗与终点事件的相关性。结果研究纳入386例冠心病心律失常患者，完成随访313例，失访率18．91％。暴露组194例，非暴露组119例。发生终点事件依次为心血管病再入院123例、急性心力衰竭36例、脑卒中31例、全因死亡16例、心肌梗死13例等；随访时间≥6个月阶段显示应用中医药能减少心血管病再入院、急性心力衰竭及脑卒中的风险。心血管病再入院、脑卒中事件的发生与中医药治疗强度构成相关。结论冠心病心律失常患者出院后终点事件主要为全因死亡、心血管病再入院、急性心力衰竭、脑卒中等，长期应用中医药可减少随访期间心血管病再入院、脑卒中事件的发生。
목적：수방중의약치료관심병심률실상출원환자적종점사건발생정황，분석기여중의약치료적상관성。방법채용대렬연구설계，선택산동중의약대학부속의원2008－01－01—2013－12－31수치적관심병심률실상환자，정의응용구복중성약혹중약탕제≥28 d위폭로조，전화수방출원후구복중성약급중약탕제응용정황화종점사건발생정황，병채용다인소Logistic회귀분석중의약치료여종점사건적상관성。결과연구납입386례관심병심률실상환자，완성수방313례，실방솔18．91％。폭로조194례，비폭로조119례。발생종점사건의차위심혈관병재입원123례、급성심력쇠갈36례、뇌졸중31례、전인사망16례、심기경사13례등；수방시간≥6개월계단현시응용중의약능감소심혈관병재입원、급성심력쇠갈급뇌졸중적풍험。심혈관병재입원、뇌졸중사건적발생여중의약치료강도구성상관。결론관심병심률실상환자출원후종점사건주요위전인사망、심혈관병재입원、급성심력쇠갈、뇌졸중등，장기응용중의약가감소수방기간심혈관병재입원、뇌졸중사건적발생。
Objective To follow up the happenings of outcome event of traditional Chinese medicine ( TCM) on discharged coronary heart disease patients with arrhythmia ,and to analyze the correlation between TCM and out-come event.Methods Using cohort study design,coronary heart disease patients with arrhythmia admitted to Shan-dong traditional Chinese medicine university from January 1,2008 to December 31, 2013 were selected.Patients who received oral Chinese patent medicines or Chinese decoction over 28 days were defined as exposed group .The situa-tion of medications and the happenings of outcome event were followed up by telephone ,and the correlation between TCM and outcome event was analyzed by multiple logistic regression analysis .Results 386 coronary heart disease patients with arrhythmia were involved ,313 of them completed the follow -up,and complete lost rate was 18.91%. There were 194 patients in the exposed group,and 119 patients in non -exposed group.The outcome events were,in order,cardiovascular disease readmission (123 cases),acute heart failure (36 cases),stroke (31 cases),all-cause mortality(16 cases),myocardial infarction (13 cases) and so on.The stage of follow-up time over 6 months showed that the application of TCM could reduce the risk of cardiovascular disease readmission ,acute heart failure and stroke . There was correlation between the happenings of cardiovascular disease readmission and stroke and the treatment in -tensity of TCM.Conclusion The mainly cause of outcome events of discharged coronary heart disease patients with arrhythmia were all-cause mortality ,cardiovascular disease readmission ,acute heart failure ,stroke and so on .Long-term treatment of TCM can reduce the happening of cardiovascular disease readmission and stroke during follow -up period.