Geng Hong-Jiao, Xie Yan-Ming, Zhuang Yan
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China.
the PLA Navy General Hospital Beijing 100048, China.
Zhongguo Zhong Yao Za Zhi. 2020 May;45(10):2329-2334. doi: 10.19540/j.cnki.cjcmm.20200221.503.
To analyzed the actual clinical application of Xingnaojing Injection in treating cerebral infarction in the real world, selected HIS(hospital information system) database of inpatients in 39 hospitals across the country, and conducted descriptive analysis and association rule analysis on the information of 11 674 patients with cerebral infarction using Xingnaojing Injection. The results showed that the average age of the patients was 69.69 years. TCM syndrome of phlegm stasis and collaterals stagnation was the most(37.56%), followed by wind-phlegm obstruction of collaterals(19.01%). Virtual syndrome accounted for 21.06%. Intravenous drip was the most important route of administration(96.50%). Iv infusion single dose of 10-20 mL(52.44%), other off-label doses accounted for a larger proportion(47.56%). Continuous use of the drug within 3 days(55.45%), 15-28 days accounted for 6.96%, >28 days accounted for 0.89%. The top 10 Western drugs used in combination mainly include antihypertensive drugs, acid-suppressing drugs to protect stomach, drugs to improve brain circulation, drugs to protect brain nerves and drugs to fight infection. The top 10 of Chinese patent medicines are mainly activating blood circulation and removing stasis, clearing heat and clearing the surface, etc. According to the analysis of association rules, three types of clinical drug use modes for the combination of Chinese and Western medicine were obtained, mainly including the first type: Xingnaojing Injection+nifedipine(nifedipine, nifedipyridine, Lixinping)+levoflo-xacin+Huayu Tongmai agent. The second category: Xingnaojing Injection+omeprazole+edaravone+Huayu Tongmai agent; The third category: Xingnaojing Injection+ganglioside and ganglioside derivatives+edaravone+Huayu Tongmai agent. The results show that Xingnaojing Injection is not a standard drug in the treatment of cerebral infarction. At the same time, the combined use of drugs is mainly recommended by the guidelines and conventional treatment drugs, reflecting the clinical application of integrated traditional Chinese and Western medicine.
为分析醒脑静注射液在真实世界中治疗脑梗死的实际临床应用情况，选取全国39家医院住院患者的HIS（医院信息系统）数据库，对11674例使用醒脑静注射液治疗脑梗死患者的信息进行描述性分析和关联规则分析。结果显示，患者平均年龄为69.69岁。中医痰瘀阻络证型最多（37.56%），其次为风痰阻络证（19.01%）。虚证占21.06%。静脉滴注是最主要给药途径（96.50%）。静脉滴注单次剂量10 - 20 mL者占52.44%，其他超说明书剂量占比较大（47.56%）。用药持续3天以内者占55.45%，15 - 28天占6.96%，＞28天占0.89%。联合使用的前10位西药主要包括降压药、护胃抑酸药、改善脑循环药、保护脑神经药及抗感染药。前10位中成药主要为活血化瘀、清热解表等。通过关联规则分析，得出中西医结合临床用药的三种模式，主要包括第一类：醒脑静注射液+硝苯地平（硝苯地平、尼群地平、利心平）+左氧氟沙星+化瘀通脉剂。第二类：醒脑静注射液+奥美拉唑+依达拉奉+化瘀通脉剂；第三类：醒脑静注射液+神经节苷脂及神经节苷脂衍生物+依达拉奉+化瘀通脉剂。结果表明醒脑静注射液并非治疗脑梗死的规范用药。同时，联合用药主要为指南推荐及常规治疗用药，体现了中西医结合的临床应用情况。
