中药治疗2型糖尿病患者发生冠状动脉疾病的风险

Hsin-Sheng Fang, Chih-Ching Liu, Chun-Hua Jia, Yen-Hsun Chen, Chung-Yi Li
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引用次数: 3

摘要

目的:比较中药与西药治疗糖尿病患者发生冠心病(CAD)的风险。方法:前瞻性队列研究纳入13655例单纯中医治疗的糖尿病患者和435165例单纯西医治疗的糖尿病患者。本研究病患为2000-2001年台湾全民健保(NHI)流动索偿病患。然后将这些患者与2000-2008年国民健康保险住院患者索赔联系起来,寻找可能的CAD住院新发病例。采用Cox比例风险模型和logistic回归模型评估冠心病入院的风险比和与中医相关的冠心病高入院率的优势比(OR)。结果:在9年的随访中,2607例中医糖尿病患者因冠心病住院,累计发病率为19.1%,发病率密度为50.5 / 1000人年。WM治疗患者的相应数据为24.1%和72.7 / 1000人年。与中西医结合治疗的患者相比,中西医结合治疗的患者冠心病入院调整OR值略有降低,但不显著(0.96;95%可信区间为0.92-1.01)。此外,中西医结合患者CAD入院率较高(≥0.212次/人年)的校正OR也无显著降低,为0.97。结论:调整既往合并症评分后,中医治疗的糖尿病患者与西医治疗的糖尿病患者冠心病入院的风险或发生率无显著差异,提示中医在预防糖尿病合并冠心病方面与西医治疗同样有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk of Developing Coronary Artery Disease in Patients with Type 2 Diabetes Receiving Traditional Chinese Medicine Therapy.

Objectives: To compare risk of developing coronary artery disease (CAD) between diabetic patients receiving Traditional Chinese Medicine (TCM) therapy and those treated by Western medicine (WM).

Methods: This prospective cohort study included 13,655 diabetic patients receiving solely TCM and 435,165 patients treated exclusively by WM. Study patients were identified from Taiwan's National Health Insurance (NHI) ambulatory claims in 2000-2001. These patients were then linked to the 2000-2008 NHI inpatient claims, searching for possible new onset of hospitalization for CAD. A Cox proportional hazard model and logistic regression model were used to assess the hazard ratio of CAD admission and odds ratio (OR) of higher rates of admission for CAD in relation to TCM.

Results: During 9 years of follow-up, 2607 diabetic patients with TCM were hospitalized for CAD, representing a cumulative incidence rate of 19.1% and an incidence density of 50.5 per 1000 person-years. The corresponding figures for patients treated by WM were 24.1% and 72.7 per 1000 person-years. Compared with the patients treated by WM, those treated by TCM were associated with a slightly reduced, but insignificantly, adjusted OR of CAD admission (0.96; 95% confidence interval, 0.92-1.01). Moreover, the adjusted OR for a higher rate (≥0.212 admission per person-year) of CAD admission for the patients with TCM was also insignificantly decreased at 0.97.

Conclusions: After adjustment for prior co-morbidity score, risk or rate of CAD admission did not significantly differ between diabetic patients receiving TCM therapy and those treated by WM, suggesting that TCM is as efficacious as WM in preventing diabetes from being complicated with CAD.

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