Beijing Area, The West Hospital With Acute Myocardial Infarction Hospitalization Status And Case Fatality Rate Comparison Analysis

Theory study In this study,a large number of Traditional Chinese medicine (TCM) and modern medicine literature about acute myocardial infarction(AMI) were collected,collated and analyzed synthetically. Based on these literatures,the study progresses of modern medicine and TCM on AMI were reviewed briefly and completely,additionally,some new ideas that AMI is treated by applying TCM method were put forward.Literature study In this study,useful data was extracted from the clinical research literatures of TCM treatment on AMI with identifiable case-fatality rate, which was retrieved from Chinese academic periodical full-text data base during 1994-2005 based on some standards, and was described and analyzed by statistical analysis software SPSS 11.0. The results is that 95 literatures retrieved, containing 6540 cases in total, 626 fatal cases, and the case-fatality rate is 9.57%.There are 47 literatures setting up control group with 4197 cases,the rate of fatal cases of the treatment group is 6.19%, which is 15.09% of the control group, so the diff. of two has statistical significance (p<0.01). There are 48 literatures that dont'include the control group, containing 2343 cases, and the case-fatality rate is 8.41%. 4638 cases used TCM treatment in total, the case-fatality rate is 7.31%, which is also below the rate of control group, and the diff. has statistical significance (p<0.01).These results indicate that TCM treatment may has some effects on decreasing the case-fatality rate of AMI, but it still needs more multi-centric randomized controlled clinical trials with normative design and rational sample size, in order to get more evidence on the validity of TCM treatment on AMI.Clinical study【Objective】To investigate and analyze the clinical feature,therapies status and case-fatality rate of hospitalized AMI patients between"Sanjia"TCM Hospital and Western Medicine Hospital in Beijing.【Methods】The clinical data of 595 AMI patients of 6 TCM Hospitals and 4 Western Medicine hospitals in Beijing from January 2005 to December 2005 were enrolled by using the uniform questionary. To set up a database by ACESS and analyze it by SPSS13.0. Describe the clinical feature,therapies status and analyze the corresponding factors which influence the case-fatality rate by one-way factor analysis means【.Result】In total 595 cases,TCM Hospitals contain 296 cases,and Western Medicine Hospitals contain 299 cases. The average ages and male/female ratio between TCM and Western Medicine Hospitals are 69 to 62,and 1.57:1 to 2.48:1,and compared with Western Medicine Hospitals,the patients in the hospitals of TCM have more accompaniment and concurrent diseases,such as history of Coronary Heart Disease(CHD),history of Stroke, Arrhythmia and Cardiac Inadequacy, and the diff. has statistical significance (p<0.01).On treatment, the usage factor of Reperfusion therapy,β- receptor blockers, Statins and ADP-receptor antagonist in TCM Hospitals was lower than which in Western medicine hospitals, and the use of nitrate drugs, Ca-antagonist, diuretics, digitalis and intravenous Chinese prepared medicines is more frequent in TCM hospitals;The total case-fatality rate is 11.6%, which is higher in TCM hospitals,respectively 15.9% to 7.4%. And the case-fatality rate is positively correlated with AMI age, female ratio, history of CHD, history of stroke arrhythmias, Cardiac Inadequacy and so on, which are also the important factors making the hospitals of TCM have a higher fatality rate.【Conclusion】The AMI patients in TCM hospitals have special clinical feature, and have a greater average age , higher female ratio, more accompanied disease, more complications, and higher case-fatality rate; The therapeutic technique and concept on AMI in TCM hospitals has a lot of progress than five years ago, but still has some gaps to which in the Western Medicine hospitals and in the "Guidelines "; The higher case-fatality rate in TCM hospitals has positive relation with the special clinical feature.