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血栓心脉宁片为消栓类药物可治疗血瘀所致的胸痹心痛,在临床广泛用于冠心病的防治。为了解血栓心脉宁片对冠心病患者治疗结局的影响,该研究基于中国中医科学院中医临床基础医学研究所构建的全国18家大型三级甲等医院的电子医疗病历数据库,将使用和未使用血栓心脉宁片的冠心病患者按性别、年龄、入院病情和是否合并心功能不全进行1∶1匹配。匹配后使用血栓心脉宁片患者组(A组)与未使用血栓心脉宁片患者组(B组)均为1 122人。将“痊愈”和“好转”合并定义为治疗有效人群,将“无效”和“死亡”合并定义为无效人群,对治疗结局的有效率进行评价。卡方检验结果显示未平衡混杂因素的情况下,2组冠心病患者的治疗结局有显著的统计学差异(P<0.05),使用血栓心脉宁片的患者的有效率相对较高。经典Logistic回归结果显示2组间治疗结局的有效率无显著统计学差异;不带协变量的倾向评分加权Logistic回归和带协变量的倾向评分加权Logistic回归对2组间的45个协变量进行了有效平衡,结果显示不仅回归系数大于0,且有显著统计学差异(P<0.05)。结果显示,使用血栓心脉宁片的冠心病患者治疗的有效率较不使用血栓心脉宁片的冠心病患者有效率高,可以提高冠心病患者的临床疗效。由于该研究并不能肯定已将所有可能存在的混杂因素全部平衡,且纳入的研究对象尚不能很好的反应全部医院的整体情况。因此,研究所得结论仅为临床医师治疗冠心病用药提供参考,仍需进一步进行大样本随机对照试验得出更加可靠的结果以指导临床合理有效用药。
Thrombosis Ningmai Ning film for the elimination of suppository drugs can be treated due to blood stasis chest pain, heart disease, widely used in clinical prevention and treatment of coronary heart disease. In order to understand the influence of XHXD on the therapeutic outcome of patients with coronary heart disease, the study was based on the electronic medical record database of 18 large-scale tertiary level A hospitals constructed by the Institute of Chinese Medical Clinical Basic Medicine, China Academy of Traditional Chinese Medicine, with and without the use of Thrombosis Xinmaining tablets of coronary heart disease patients by sex, age, admission and whether the merger of cardiac dysfunction 1: 1 match. The number of patients who received thrombosis Xintongning tablets (group A) and those who did not use thrombosis Xintinning tablets (group B) after the match were 1 122. The combination of “heal ” and “heal ” is defined as the treatment effective population. The “invalid” and the “death” are combined into an invalid population to evaluate the effectiveness of the treatment outcome. The results of chi-square test showed that the treatment outcome of two groups of patients with coronary heart disease had significant statistical difference (P <0.05) in the case of unbalanced confounding factors. The patients with thrombosis Xinmaining capsule were relatively effective. The results of classic Logistic regression analysis showed that there was no statistically significant difference in the treatment outcome between the two groups; propensity score-weighted Logistic regression without covariates and propensity score-weighted Logistic regression with covariates performed 45 covariates between the two groups Effective balance, the results show that not only the regression coefficient greater than 0, and there was a statistically significant difference (P <0.05). The results show that the use of thrombosis in patients with coronary heart disease rather effective treatment of coronary heart disease patients not using thrombosis Xinmaining rather high, can improve the clinical efficacy of coronary heart disease patients. Since the study is not certain that all possible confounders have been fully balanced and that the subjects included in the study are not yet well-informed of the overall hospital situation. Therefore, the findings of the study only provide a reference for clinicians to treat coronary heart disease, and still need to conduct further large-scale randomized controlled trials to obtain more reliable results to guide clinical rational and effective drug use.