北京市远郊区冠心病患者院外中药使用情况调查研究

Investigation on the use of traditional Chinese medicine outside the hospital in patients with coronary heart disease in the suburb of Beijing

目的了解北京远郊区冠心病患者院外应用中药的情况.方法入选在北京密云区医院和中医院两家当地医疗中心就医的冠心病患者562例.依据入排标准初筛患者,获取一般资料、人口学特征、联系方式,电话随访其院外中药应用情况.结果共纳入562例患者,男性443例(78.8%),女性119例(21.2%);年龄(63.9±9.7)岁.院外应用过中药的患者为178例,占31.7%.区医院住院的患者院外用过中药的比例低于中医院(P<0.01);女性患者用中药的比例高于男性(P<0.01);初中及以下用中药者高于高中及以上者(P<0.01);60岁以下的患者高于60岁以上的患者,城镇患者略高于农村患者,但差异均无统计学意义(P>0.05).logistic回归分析显示,影响冠心病患者是否应用中药的因素为就诊医院类型(区医院VS中医院)、性别、教育程度(P<0.01或P<0.05).居住地和年龄对是否应用中药影响较小(P均>0.05).使用过中药的冠心病患者在冠心病二级预防用药的依从性上略差于未使用的患者,差异不具有显著性(P>0.05).结论北京市远郊区冠心病患者院外应用中医药的比例偏低,尤其是男性、高学历及在区医院就诊的患者.医生和患者对中药治疗冠心病的相关知识仍然缺乏,需要加强继续教育和民众普及.应用中药治疗不影响冠心病二级预防治疗的依从性.

Objective To investigate the application of traditional Chinese medicine(TCM)in patients with coronary heart disease(CHD)out of hospital.Methods 562 patients with coronary heart disease were selected from two local medical centers of Miyun County Hospital and traditional Chinese medicine hospital.Patients were initially screened according to the inclusion and exclusion criteria,obtainning the general information,demographic characteristics,contact information,and telephone number.And then,we follow-up their application of traditional Chinese medicine outside the hospital.Results A total of 562 patients were included,443(78.8%)males and 119(21.2%)females,aged(63.9±9.7)years.178 patients(31.7%)had used traditional Chinese medicine outside the hospital.The proportion of patients in western medicine hospital who had used traditional Chinese medicine outside hospital was lower than that in traditional Chinese medicine hospital(P<0.01).The proportion of female patients using traditional Chinese medicine was higher than that of male patients(P<0.01).The proportion of patients with junior high school education or below was higher than that with senior high school education or above(P<0.01).Patients under 60 years old were higher than those over 60 years old,and urban patients were slightly higher than rural patients,but the difference was not statistically significant(P>0.05).Logistic regression analysis showed that the factors influencing the use of traditional Chinese medicine in patients with coronary heart disease were hospital type(West hospital vs hospital of traditional Chinese Medicine),gender and education level(P<0.01 or P<0.05).Residence and age had little effect on the application of traditional Chinese medicine(P>0.05).CHD patients who had used traditional Chinese medicine had slightly worse compliance with secondary preventive medication for CHD than those who had not used it,with no significant difference(P>0.05).Conclusion The proportion of out of hospital application of traditional Chinese medicine in patients with coronary heart disease in the outskirts of Beijing is relatively low,especially in men,those with high educational background and those who are treated in western medicine hospitals.Doctors and patients are still lack of knowledge about the treatment of coronary heart disease with traditional Chinese medicine,so it is necessary to strengthen continuing education and popularization of the public.The application of traditional Chinese medicine does not affect the compliance of secondary prevention of coronary heart disease.