| Objective: to collect clinical data of 319 patients with chronic heart failure,observe the treatment of chronic heart failure patients with traditional Chinese medicine after discharge,explore the relevant factors affecting the readmission of patients with chronic heart failure,summarize and analyze the results,and provide reference for the treatment of chronic heart failure in the future.Methods: this study collected 319 hospitalized patients diagnosed as chronic heart failure from October 31,2015 to October 31,2017 in the department of cardiovascular diseases,affiliated hospital of jiangxi university of traditional Chinese medicine.For the patients who were hospitalized for many times,the data of the first hospitalized case were collected.General and clinical data were collected,and TCM syndrome types were recorded.After discharge,the patient was followed up by telephone or by appointment in the outpatient department.The follow-up lasted for 1 year after the patient was readmitted or expired.Follow-up items included the situation of taking traditional Chinese medicine after discharge and re-hospitalization.After data processing and input,SPSS21.0 statistical software was applied to conduct descriptive analysis of general data and chi-square test was used for counting data.P < 0.05 was considered statistically significant.Univariate analysis was used first,followed by binary Logistic multivariate regression analysis.Research results:1.This study included 319 patients with CHF,including 167 males and152 females.The incidence is slightly higher in men than in women.The main age of onset in this study was over 60 years old.The mean age was67.38 12.118 years.The onset season is more common in autumn and winter.NYHA cardiac function classification is more common in class II and class III cardiac function.2.The average length of stay during hospitalization was 14.2 6.82 days,and 205 cases(64.4%)were significantly improved and 114 cases(35.6%)were improved during hospitalization.3.The main diseases were coronary heart disease in 224 cases(70.2%),hypertensive heart disease in 36 cases(11.3%),and rheumatic heart disease in 22 cases(6.9%).The most common concomitant diseases were hypertension in 224 cases(70.2%),pulmonary infection in 160 cases(50.2%),arrhythmia in 156 cases(48.9%),type 2 diabetes in 146 cases(45.8%),renal insufficiency in 123 cases(38.6%),copd in 110 cases(34.5%),chronic cerebral infarction in 104 cases(32.6%),and hypoproteinemia in 56 cases(17.5%).4.In oral administration of western medicine,79.1% of patients took-beta blockers.Patients taking diuretics accounted for 76.3%.Patients taking ACEI or ARB accounted for 71.9%.The number of patients taking aldosterone receptor antagonists was 64.4%.The proportion of patients taking nitrolipid drugs was 43.8%.The number of patients taking digitalis drugs was 20.9%.oral Chinese patent medicine,musk baoxin pill 259 cases(81.2%),ginkgo leaf drop pills 227 cases(71.2%),wenxin granules 200cases(62.7%),qishen yiqi drop pills 140 cases(43.8%),tongxinluo 125cases(39.2%),qiliqiangxin drop pills 113 cases(35.4%).The main TCM intravenous preparations were danhong(83.2%),tanshinone IIa sulfonate sodium(82.3%),tanreqing(73.9%),shuxuetong(68.3%),xuesaitong(55.6%),shenmai(30.9%)and shenfu injection(23.9%).Through the analysis of the main drugs in the traditional Chinese medicine decoctiontaken by the patients in hospital,the most common single Chinese medicine is as follows: the single Chinese medicine with the highest utilization rate of traditional Chinese medicine is codonopsis,astragalus,salvia miltiorrhiza,poria cocos,aconite,notoginseng powder,pinellia ternata,radix ophiopogonis,alisma,draba nilio seed,etc.5.During the 1-year follow-up,a total of 59 patients were hospitalized again,with a rehospitalization rate of 18.5%.Among the subjects,29 cases were re-hospitalized within six months after discharge,with a rate of 9.09%;30 cases were re-hospitalized within six months to one year after discharge,with a rate of 9.40%.6.Univariate analysis showed that there were significant differences in age,onset season,NYHA cardiac function classification,etiology,discharge outcome,taking traditional Chinese medicine after discharge,taking western medicine after discharge,regular follow-up after discharge,BNP,and left ventricular ejection fraction(P<0.05).Logistic regression analysis results showed that age,NYHA cardiac function classification,discharge outcome,and Chinese medicine taken after discharge had statistical significance(P<0.05),which were independent influencing factors for the occurrence of readmission within 1 year after discharge for patients with chronic heart failure.7.The average length of hospitalization for patients taking traditional Chinese medicine continuously was 181 days and the average length of hospitalization was 11.2 days.The mean length of time between the last hospitalization and the discontinuous Chinese medicine rehospitalization was 156 days,and the mean length of hospitalization was 13.2 days.There were 34 patients(69.4%)who were not treated with traditional Chinese medicine,and the average length of hospitalization was 15.6 days,and the interval between the last hospitalization was 134.3days.Research conclusion:1.Patients with chronic heart failure are older;The main causes are coronary heart disease,hypertension heart disease;With a variety of diseases.2.The results of univariate analysis showed that age,season of onset,NYHA cardiac function classification,etiology,discharge outcome,taking traditional Chinese medicine after discharge,taking western medicine after discharge,regular follow-up after discharge,BNP,and left ventricular ejection fraction were the factors affecting readmission.3.Logistic regression analysis related to the readmission rate showed that the factors influencing the readmission of patients with chronic heart failure included age,NYHA cardiac function classification at the first admission,discharge outcome,and the use of traditional Chinese medicine after discharge.4.According to the findings of this study,early intervention and regular follow-up should be carried out for patients with chronic heart failure who are old,have poor cardiac function at the first admission and fail to improve significantly at discharge.The rate of re-hospitalization can be reduced by taking traditional Chinese medicine after discharge.5.Compared with the patients who did not take traditional Chinese medicine after discharge,the average length of re-hospitalization was shorter and the interval from the last hospitalization was longer. |
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