社区中老年高血压用药患者单纯采用中药治疗的影响因素研究

  目的  分析我国社区中老年高血压用药群体单纯采用中药治疗的影响因素。  方法  利用CHARLS(2018)数据库,以正在接受单纯中药或单纯西药治疗的社区45岁及以上高血压患者为研究对象,采用多因素logistic回归分析,对单纯采用中药治疗的相关因素进行分析。  结果  研究共纳入5 184名单纯采用中药或西药治疗的高血压患者,其中312人仅接受中药治疗,4 872人仅接受西药治疗。使用其他医疗保险患者单纯采用中药治疗是无医疗保险患者的0.347倍;> 000~7 000经济发展区域患者单纯采用中药治疗是000以上经济发展区域患者的3.197倍;BMI显示肥胖患者单纯采用中药治疗是BMI正常患者的0.629倍;自报健康状况很不好的患者单纯采用中药治疗是自报健康状况很好患者的0.331倍;患有3种以上其他慢性病患者单纯采用中药治疗是无高血压之外其他慢性病患者的0.167倍;正在接受其他疾病中药治疗的患者是未接受其他疾病中药治疗患者单纯采用中药的7.271倍。  结论  位于中低经济发展区域、BMI正常、自报健康状况良好、无高血压之外其他慢性病以及正在接受其他中药治疗的患者与其他类型的患者相比,更倾向单纯采用中药治疗高血压。今后,需进一步前瞻性地观察中药和西药2组用药者心脑血管终点事件结局改善的差异,为高血压中药治疗提供更高级别质量的证据。 

Factors associated with taking antihypertensive traditional Chinese medicine only among community-dwelling middle-aged and elderly adults

  Objective  To investigate the factors associated with antihypertensive traditional Chinese medicine (TCM) intake only among community-dwelling middle-aged and elderly adults in China.  Methods  The analysis was based on the national representative China Health and Retirement Longitudinal Study (CHARLS) in 2018. Community-dwelling adults aged 45 years old or above and who were either taking TCM or western modern medicine (WMM) only were included. Multivariate logistic regression analysis was used to examine the factors associated with taking TCM only for hypertension.  Results  A total of 5 184 patients with hypertension were included, including 312 TCM and 4 872 WMM users. The odds of patients with other types of medical insurances and who used TCM alone was 0.347 times that of patients without medical insurance. The odds of patients in economic development areas of > 000-7 000 and who used TCM alone was 3.197 times that of patients in economic development areas above 000. The odds of obese patients were 0.629 times more than the patients with normal body mass index and who used TCM alone. The odds of patients with self-reported very poor health status and who used TCM alone was 0.331 times that of patients who self-reported very good health status. The odds of patients with more than three types of chronic diseases were 0.167 times more than those with hypertension and used TCM alone. The odds of patients who received TCM for other diseases was 7.271 times that of patients used TCM alone and who were not receiving TCM for other diseases.  Conclusions  Patients in the middle or deprived economic development region, with very good self-reported health status, without other diagnosed chronic disease and under TCM treatment for other diseases are more likely to take TCM for hypertension compared with other patients. In the future, it is necessary to further prospectively observe the difference in the improvement of cardiovascular and cerebrovascular end point outcomes between the two groups of TCM and WMM, so as to provide higher quality evidence for the treatment of hypertension with TCM.