Effects of integrated traditional Chinese and Western medicine for acute pancreatitis: A real‐world study in a tertiary teaching hospital

急性胰腺炎 西医 三级护理 中医药 医学 传统医学 内科学 重症监护医学 替代医学 病理
作者
Lihui Deng,Zhiyao Chen,Ping Zhu,Cheng Hu,Tao Jin,Xinwei Wang,Lan Li,Ziqi Lin,Jia Guo,Xiaonan Yang,Na Shi,Xiao-Xin Zhang,Xinmin Yang,Kun Jiang,Yun Ma,Qingyuan Tan,Ling Li,Wen Wang,Wei Huang,Xin Sun
出处
期刊:Journal of Evidence-based Medicine [Wiley]
卷期号:17 (3): 575-587 被引量:2
标识
DOI:10.1111/jebm.12635
摘要

Abstract Aim This study aimed to evaluate whether integrated traditional Chinese medicine (TCM) and Western medicine (WM) is more effective than WM for acute pancreatitis (AP). Methods Patients with AP were enrolled and divided into the TCM and WM (TCM&WM) and WM groups according to the therapeutic protocol in real clinical settings. We applied 1:3 propensity score matching, which was to adjust confounding factors. The primary outcome was mortality, whereas the secondary outcomes were organ failure, organ supportive therapies, local complications, hospitalization cost, and length of hospital stay. Sensitivity and subgroup analyses were also performed. Results Of 5442 patients with AP, 4691 and 751 were included in the TCM&WM and WM groups, respectively. After PSM, patient baseline characteristics were well balanced. Compared with the WM group ( n = 734), the TCM&WM group ( n = 2096) had lower overall mortality rate (1.7% vs. 3.4%; risk ratio, 0.482; 95% confidence interval, 0.286–0.810; p = 0.005). The TCM&WM group was associated with lower risk of persistent renal failure, multiple organ failure, and infection, lower utilization of organ supportive therapies, shortened lengths of hospital and intensive care unit stay, and lower hospital costs. Sensitivity analyses showed similar results. Subgroup analysis favored TCM&WM treatment for patients aged < 60 years, with hypertriglyceridic etiology, and with admission interval between 24 and 48 h. Conclusion TCM&WM treatment can achieve lower risks of mortality and organ failure and better economic effectiveness in patients with AP than WM treatment. This study provides a promising alternative of TCM&WM treatment for AP in the real‐world setting.
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