| 引用本文:杨歆科1，唐启盛1，郑军然2，刘向哲3，尹洪娜4，马良5，黄世敬6，王娣7.运用队列研究观察抑郁障碍心肾不交型复发率的多中心前瞻性研究[J].世界中医药,2024,(07):. |
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| 运用队列研究观察抑郁障碍心肾不交型复发率的多中心前瞻性研究 |
| A Multicenter Prospective Cohort Study on the Recurrence Rate of Depression with Heart-kidney Disharmony |
| 投稿时间：2023-06-15 |
| DOI：10.3969/j.issn.1673-7202.2024.07.017 |
| 中文关键词: 抑郁障碍 复发率 心肾不交型 前瞻性队列研究 云数据 多中心 中西医结合 暴露水平 |
| English Keywords:Major Depressive Disorder Recurrence rate Heart-Kidney Disharmony Type Prospective Cohort Study Cloud Data Multicenter Integration of Traditional Chinese Medicine and Western Medicine Exposure Levels |
| 基金项目:国家中医药行业专项（201507001）；国家中医药管理局岐黄学者项目（10400633210001）；北京市第六批中医药专家学术经验传承项目 |
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| 中文摘要: |
| 目的：评价滋阴降火、除烦安神功效中医药治疗方案对心肾不交型抑郁障碍（MDD）2年复发率的疗效。方法：运用队列研究方法，选取2017年1月至2018年12月全国13个分中心的心肾不交型MDD患者，根据患者接受干预方案的不同，自然形成中医、中西医结合及西医队列，比较3个队列复发率。并根据患者接受中医药方案干预时间的不同，将中医和中西医结合队列分为低、中、高3个暴露水平，比较3种暴露水平的复发率，以评价中医药方案降低心肾不交型MDD远期复发率的疗效。结果：共纳入506例患者，其中中医队列172例、中西医结合队列166例、西医队列168例。2年复发率方面，中医队列25.6%、中西医结合队列21.1%、西医队列35.1%。复发风险方面，中医队列中水平暴露比低水平暴露低63.0%（HR=0.370，95%CI为0.170～0.808，P<0.05），高水平暴露比低水平暴露低94.5%（HR=0.055，95%CI为0.016～0.192，P<0.01）；中西医结合队列中水平暴露比低水平暴露低72.3%（HR=0.277，95%CI为0.111～0.689，P<0.01），高水平暴露比低水平暴露低83.9%（HR=0.161，95%CI为0.058～0.446，P<0.01）。结论：滋阴降火、除烦安神治法的中医药综合方案能有效降低心肾不交型MDD远期复发率，同时随接受中医药干预时间的增加，MDD复发率亦有逐渐下降趋势。 |
| English Summary: |
| To evaluate the curative effect of traditional Chinese medicine(TCM) treatment focused on nourishing yin，reducing fire，relieving vexation and calming nerves on the two-year recurrence rate of major depressive disorder(MDD) with heart-kidney disharmony.Methods:Using a cohort study method，MDD patients with heart-kidney disharmony were recruited from 13 sub-centers nationwide from January 2017 to December 2018.According to the different intervention plans received by patients，they were naturally divided into traditional Chinese medicine(TCM)，integrated TCM and Western medicine，and Western medicine cohorts，and the recurrence rates among the three cohorts were compared.And according to the different intervention time of patients receiving TCM programs，the TCM and integrated TCM and Western medicine cohorts were divided into three exposure levels：low，medium，and high.The recurrence rates of the three exposure levels were compared to evaluate the efficacy of TCM programs in reducing the long-term recurrence rate of MDD with heart-kidney disharmony.Results:A total of 506 patients were included，including 172 in the TCM cohort，166 in the integrated TCM and Western medicine cohort，and 168 in the Western medicine cohort.The two-year recurrence rate was 25.6% in the TCM cohort，21.1% in the integrated TCM and Western medicine cohort，and 35.1% in the Western medicine cohort.In terms of recurrence risk，in the TCM cohort，medium exposure level was 63% lower than low exposure level（HR=0.370，95%CI 0.170 to 0.808，P<0.05），and high exposure level was 94.5% lower than low exposure level（HR=0.055，95%CI 0.016 to 0.192，P<0.01）.In the combination of TCM and Western medicine cohort，medium exposure level was 72.3% lower than low exposure level（HR=0.277，95%CI 0.111 to 0.689，P<0.01），while high exposure level was 83.9% lower than low exposure level（HR=0.161，95%CI 0.058 to 0.446，P<0.01）.Conclusion:The TCM comprehensive programme of nourishing yin，reducing fire，relieving vexation and calming nerves can effectively treat the long-term recurrence rate of MDD with heart-kidney disharmony，as well as，the recurrence rate of MDD can be gradually decreased with the intervention time of TCM. |
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