| Objective: The research is a retrospective cohort study to evaluate the effectiveness of combination of traditional Chinese medicine and Western medicine in the treatment of hypertension to reduce the risk of cardiovascular and cerebrovascular incidence.Methods: a retrospective cohort study,the medical record database is selected from the initial visits and taking the Series of Jiang Yabao traditional Chinese Medicine of National Center for diagnosis and treatment of hypertension in Chinese Medicine of our hospilal between 2001 to 2005,using stratified random sampling method finally selected 25 cases of patients as the sample population.All patients meet the relevant standards.Completing the questionnaires by means of medical record checking and phone visiting,the primary issue is to investigate the exposure degree of Jiang Yabao traditional Chinese Medicine,it is the time of taking the Jiang Yabao traditional Chinese Medicine,the end point of cardiovascular and cerebrovascular events.Firstly,to investigate the risk factors which can influence the cardiovascular and cerebrovascular risk caused by hypertension,including patients personal data,living habit,disease,medication,overall blood pressure control and cardiovascular risk factors,target organ damage,with clinical disorders and so on.Forming analysis database after the investigation.Secondly,grouped by exposure levels(cumulative time of TCM treatment),take the incidence of cardiovascular and cerebrovascular risk events and cardiovascular and cerebrovascular disease as the main evaluation index,take the propensity score method dealing with confounding factors,to evaluate the efficacy of CMH test in evaluating the exposure level of traditional Chinese Medicine,so as to extract the efficiency of traditional Chinese medicine treatment of hypertension and decrease the rate of cardiovascular risk.Results: 1.evaluation of the effectiveness of acupuncture group : PS in the original data set matching method before the adjustment,the probability of A group without cardiovascular events was 82.68% and the probability of occurrence of cardiovascular events was 17.31%,the probability of B group had no cardiovascular events was 90.12% and the probability of occurrence of cardiovascular events was 9.87%,B was superior to A in the PS group;the adjusted probability matching method,A group had no cardiovascular events was 86.84% and the probability of occurrence of cardiovascular events was 13.15%,the probability of B group had no cardiovascular events was 90.57% and the probability of occurrence of cardiovascular events was 9.42%,B group results better than the A group,the preliminary judgment of taking antihypertensive treasure more than three years of control of hypertension to reduce the risk of cardiovascular and cerebrovascular events obvious effect.2.feasibility evaluation: after the adjustment of the data through the propensity score method,the overall balance is improved,so that the matching data between the two groups is more comparable.There was little difference in the incidence of cardiovascular events between the two groups before and after the adjustment of the probability of the occurrence of cardiovascular events.Using CMH test before and after the adjustment between the two groups of cardiovascular and cerebrovascular events occurrence probability are compared,the adjustment within the group before the difference(P = 0.0002),the P value is less than 0.05,with statistical significance.Between two groups after adjustment for differences in P=0.0952.No statistical significance(P > 0.05).Conclusion: 1.From the results of this study,we can not prove the effectiveness of Jiang Yabao traditional Chinese medicine in reducing cardiovascular risk.We need to increase the sample content for further statistical analysis and investigation.2.Using the method of propensity score to deal with the analytical result of the confounding factors can improve the reliability of the research conclusion. |
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