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基于大数据的84697例冠心病患者中医证候、中西医结合分析

[Analysis of traditional Chinese medicine syndrome, traditional Chinese medicine and western medicine in 84 697 patients with coronary heart disease based on big data].

作者信息

Li Gui-hua, Jiang Hong-yan, Xie Yan-ming, Jiang Jun-jie, Yang Wei, Zhao Wei, Zhuang Yan, Wang Yong-yan

出版信息

Zhongguo Zhong Yao Za Zhi. 2014 Sep;39(18):3462-8.

Abstract

In order to understand the clinical characteristics of patients with coronary heart disease (CHD) in real world and provide reference for clinical prevention and treatment, this study analyzed informations of patient with CHD in hospital information system. Data from 17 national hospitals were collected. Select patients with coronaryheart disease in diagnosis of the first place in 17 hospitals, general informations and traditional Chinese medicine (TCM) syndrome, complications, medicine were analyzed using frequency method and association rules. This study included 84 697 patients with CHD, the majority of men and in the elderly. The average age of patients was 71 years. The proportion of men to women was about 1. 45: 1. Hospital stay time ranged from 8 to 14 d. The most common total hospitalization cost distribution was 5 000-20 000 RMB. Young patients have a rising trend year by year. The death of patients increased with increasing age. Common complications were hypertension, diabetes, cerebral infarction and hyperlipidemia, 57.24 percent of the CHD patient complicated with hypertension, 21.94 percent patients complicated with diabetes. Among TCM syndrome types, Qi-Yin deficiency and qi deficiency blood stasis were the most common syndromes. Blood stasis was the highest syndrome elements, accounted for 79.97%, followed by Qi deficiency, phlegm, Yin deficiency, and so on. The most common western medicine was aspirin, followed with isosorbide dinitrate, clopidogrel. The most common used traditional Chinese medicine was danhong injection, followed by shuxuetong injection. Combined with removing blood stasis drugs has been more common at present clinical treatment, there were 43.46 percent of patients combined with anti-platelet western drug and injection of removing blood stasis.

摘要

为了解冠心病(CHD)患者的真实世界临床特征,为临床防治提供参考,本研究分析了医院信息系统中冠心病患者的信息。收集了17家全国医院的数据。选取17家医院中诊断为冠心病首位的患者,采用频数法和关联规则分析一般信息、中医证候、并发症及用药情况。本研究纳入84697例冠心病患者,以男性及老年人居多。患者平均年龄71岁。男女比例约为1.45:1。住院时间为8~14天。最常见的总住院费用分布为5000~20000元。年轻患者呈逐年上升趋势。患者死亡率随年龄增长而增加。常见并发症为高血压、糖尿病、脑梗死和高脂血症,57.24%的冠心病患者合并高血压,21.94%的患者合并糖尿病。在中医证候类型中,气阴两虚和气虚血瘀是最常见的证候。血瘀是最高的证素,占79.97%,其次是气虚、痰、阴虚等。最常用的西药是阿司匹林,其次是硝酸异山梨酯、氯吡格雷。最常用的中药是丹红注射液,其次是舒血宁注射液。目前临床治疗中联合使用活血化瘀类药物较为普遍,43.46%的患者联合使用抗血小板西药和活血化瘀注射液。

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