天津中医药2026，Vol.43Issue(4)：448-455,8.DOI:10.11656/j.issn.1672-1519.2026.04.06
冠心病合并2型糖尿病患者中医证型分布及其与病死率的关联性研究
Distribution of TCM syndromes in patients with coronary heart disease complicated with type 2 diabetes and its association with mortality
摘要
Abstract
[Objective]To investigate the distribution characteristics of traditional Chinese medicine(TCM)syndromes in patients with coronary heart disease(CHD)complicated with type 2 diabetes mellitus(T2DM),and to analyze the association between different TCM syndromes and the risks of all-cause mortality and cardiovascular mortality,while examining the interaction effects of gender and age.[Methods]A retrospective cohort study design was adopted.A total of 2 473 patients with CHD and T2DM from 6 hospitals in Tianjin were enrolled from the CSCD-TCMplus database between January 2014 and June 2022.Based on TCM syndrome differentiation,patients were divided into 5 risk strata.Endpoint events,including all-cause death and cardiovascular death,were determined by linking the social security system database.Kaplan-Meier survival analysis and multivariate Cox proportional hazards regression models were used to assess the association between TCM syndromes and mortality risk,and interaction effects of gender and age were analyzed.[Results]Among the 2 473 patients included,the median follow-up time was 4.5 years.phlegm and blood stasis(38.0%)was the most common TCM syndrome.Multivariate Cox regression analysis showed that compared with the low-risk group(qi stagnation and blood stasis),the high-risk group(heart and kidney yang deficiency)had the highest risks of all-cause death(HR=3.08,95%CI:1.48-6.42)and cardiovascular death(HR=3.15,95%CI:1.37-7.26).Interaction analysis revealed significant gender dimorphism:The predictive value of TCM syndromes for mortality risk was more prominent in male patients(P<0.05),while this association was generally attenuated in female patients,with some syndromes even demonstrating a risk trend opposite to that of the reference group.Age stratification analysis showed that the risk of cardiovascular death associated with TCM syndromes was stronger in patients<65 years old,while the risk of all-cause death was more prominent in patients≥65 years old.[Conclusion]In patients with CHD and T2DM,TCM syndrome is significantly associated with mortality risk,and,and the syndrome of yang deficiency of the heart and kidney is a key marker of poor prognosis.The association between TCM syndromes and mortality risk exhibits significant heterogeneity by gender and age,suggesting that patients'gender and age characteristics should be fully considered when formulating individualized TCM prevention and treatment strategies in the future.关键词
冠心病/2型糖尿病/中医证型/病死率Key words
coronary heart disease/type 2 diabetes/traditional Chinese medicine syndrome/mortality分类
医药卫生引用本文复制引用
李宇婷,杨彤,刘述,孙若宁,于春泉,徐强..冠心病合并2型糖尿病患者中医证型分布及其与病死率的关联性研究[J].天津中医药,2026,43(4):448-455,8.基金项目
天津市宏仁堂制药有限公司横向课题(HX2020-16). （HX2020-16）
