1.河南中医药大学第一附属医院,河南省郑州市金水区人民路19号,450000
2.天津中医药大学第二附属医院
3.新疆医科大学附属中医医院
zhumingjun317@163.com
收稿:2024-06-28,
修回:2024-07-26,
纸质出版:2024-10-17
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于瑞,赵英强,李鹏等.1061例冠心病稳定型心绞痛患者二级预防现状及影响因素的横断面研究[J].中医杂志,2024,65(20):2126-2134.
YU Rui,ZHAO Yingqiang,LI Peng,et al.A Cross-Sectional Study of Secondary Prevention Status and Influencing Factors of Stable Angina in 1061 Patients with Coronary Heart Disease[J].Journal of Traditional Chinese Medicine,2024,65(20):2126-2134.
于瑞,赵英强,李鹏等.1061例冠心病稳定型心绞痛患者二级预防现状及影响因素的横断面研究[J].中医杂志,2024,65(20):2126-2134. DOI: 10.13288/j.11-2166/r.2024.20.011.
YU Rui,ZHAO Yingqiang,LI Peng,et al.A Cross-Sectional Study of Secondary Prevention Status and Influencing Factors of Stable Angina in 1061 Patients with Coronary Heart Disease[J].Journal of Traditional Chinese Medicine,2024,65(20):2126-2134. DOI: 10.13288/j.11-2166/r.2024.20.011.
目的
2
调查我国河南省、新疆维吾尔自治区、天津市三个地区冠心病稳定型心绞痛患者二级预防现状并对其影响因素进行分析。
方法
2
采用横断面研究,纳入2020年8月10日至2021年3月14日河南省、新疆维吾尔自治区、天津市三个不同地区的冠心病稳定型心绞痛患者为研究对象。收集患者一般信息、中医证素、用药情况等资料,分析纳入患者的临床特征及血压、血脂、血糖的达标情况;并分别以血压、血脂、血糖是否达标进行分组,以证素统计中分布最多的证素为主变量,以地区、年龄、性别等为协变量,纳入Logistic回归方程,分析患者血压、血脂、血糖达标的影响因素。
结果
2
共纳入1061例冠心病稳定型心绞痛患者,其中河南省658例、新疆维吾尔自治区210例、天津市193例。三个地区患者临床特征分布在年龄、性别、病程、合并症、血压、血脂、空腹血糖、吸烟情况、饮酒情况、饮食偏好、应用药物等方面差异均有统计学意义(
P
<0.05或
P
<0.01)。纳入患者中医证素分布以气虚(79.55%,844/1061)为主要证素。纳入患者的血压达标率为48.89%(506/1035)、血脂达标率为12.68%(133/1049)、血糖达标率为48.18%(504/1046)。气虚是影响冠心病稳定型心绞痛合并高血压患者血压达标的独立因素[
P
=0.029,95%
CI
(1.048,2.369)],也是影响冠心病稳定型心绞痛患者血脂达标的独立因素[
P
=0.011,95%
CI
(1.133,2.646)],但不是影响冠心病合并糖尿病患者血糖达标的独立因素(
P
>0.05)。
结论
2
冠心病稳定型心绞痛患者临床特征及中医证素分布有地域差异性,总体血压、血脂、血糖达标控制欠佳,气虚是影响血压、血脂达标的独立危险因素。
Objective
2
To investigate the current status of secondary prevention of stable angina in patients with coronary heart disease in three regions of China, namely Henan Province, Xinjiang Uygur Autonomous Region, and Tianjin City, and analyze the the influencing factors.
Methods
2
A cross-sectional study was conducted to include patients with stable angina with coronary heart disease in Henan, Tianjin and Xinjiang from August 10, 2020 to March 14, 2021. General information, traditional Chinese medicine (TCM) syndrome elements, prescriptions and other data of patients were collected, and clinical characteristics, blood pressure, blood lipid and blood glucose of patients were analyzed; the patients were divided into groups according to whether their blood pressure, blood lipid and blood glucose were up to standard. With the most common syndrome element as the main variable, region, age and gender as covariables, Logistic regression equation was incorporated to analyze the influencing factors for the patients' blood pressure, blood lipid and blood glucose being up to standard.
Results
2
A total of 1061 coronary heart disease patients with stable angina were included, including 658 in Henan, 210 in Xinjiang, and 193 in Tianjin. The clinical characteristics of patients in the three regions showed statistical different in age, sex, disease course, complication, blood pressure, blood lipid, blood glucose, smoking, drinking, living habits, and medication treatment (
P
<0.05 or
P
<0.01). For the included patients,
qi
deficiency (79.55%, 844/1061) and blood stasis (39.96%, 424/1061) were the main syndrome elements. The overall compliance rate of blood pressure was 48.89% (506/1035), blood lipids 12.68% (133/1049) and blood glucose 48.18% (504/1046).
Qi
deficiency was the independent factor affecting the blood pressure of coronary heart disease patients with stable angina combined with hypertension (
P
= 0.029,95%
CI
[1.048, 2.369]), and the independent factors influencing the blood lipid standard of coronary heart disease patients with stable angina (
P
= 0.011, 95%
CI
[1.133, 2.646]), but not the independent factors affecting blood glucose standard in coronary heart disease patients with diabetes (
P
>0.05).
Conclusion
2
Coronary artery disease patients with stable angina have geographical variability in clinical characteristics and distribution of TCM syndrome elements, and the overall control of blood pressure, blood lipids, and blood glucose is poor, and
qi
deficiency syndrome is an independent risk factor affect
ing the control of blood pressure and blood lipids.
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