Geng Hong-Jiao, Xie Yan-Ming, Zhang Min
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China.
School of Statistics, Renmin University of China Beijing 100872, China.
Zhongguo Zhong Yao Za Zhi. 2020 Jul;45(14):3316-3323. doi: 10.19540/j.cnki.cjcmm.20200314.502.
In this study, Tabu search algorithm was used to analyze the effect of Xingnaojing Injection in the treatment of cerebral hemorrhage in the real world. Through the analysis of the results, the therapies based on the pathogeny of cerebral hemorrhage were screened out: Xingnaojing Injection+hemostatic drugs for promoting blood circulation and removing stasis. Cerebral hemorrhage complicated with brain edema: combined with mannitol or mannitol+aescin. The patients with relevant complications in the acute stage of cerebral hemorrhage could select according to the indications: ①Aminocycline+Oxiracetam+Piperacillin Sodium Sulbactam Sodium+Sodium Lactate Ringer; ②Aminocycline+Oxiracetam+Nifedipine+Captopril+Metoclopramide+Cimetidine; ③Insulin+Pantoprazole+So-dium Nitroprusside. The combined therapies for patients of the stable stage with complicating diseases could select according to the indications: ① Monosialotetrahexosyl Ganglioside Sodium+Deproteinized Calf Blood Serum+Nitroglycerin+Compound Potassium Dihydrogn Phosphate; ② Edaravone+Gangliosides+Captopril+Levofloxacin+Tanreqing Injection+Aminophylline. The analysis of subgroup module of drugs for promoting blood circulation and removing blood stasis suggested that the safety of traditional Chinese medicine should be paid attention to in the treatment of cerebral hemorrhage. This study was based on the data of the real world, but with some problems, such as lack of data and confounding factors. The summarized medication plan is only for the reference of clinicians. The clinical application shall be based on the specific situation of patients and the clinical benefits and risks, and pay attention to the incompatibility.
在本研究中，采用禁忌搜索算法分析醒脑静注射液在真实世界中治疗脑出血的效果。通过对结果的分析，筛选出基于脑出血病因的治疗方案：醒脑静注射液+活血化瘀止血药物。脑出血合并脑水肿：联合甘露醇或甘露醇+七叶皂苷钠。脑出血急性期有相关并发症的患者可根据适应证选择：① 氨甲环酸+奥拉西坦+哌拉西林钠舒巴坦钠+乳酸钠林格注射液；② 氨甲环酸+奥拉西坦+硝苯地平+卡托普利+甲氧氯普胺+西咪替丁；③ 胰岛素+泮托拉唑+硝普钠。脑出血稳定期合并症患者的联合治疗方案可根据适应证选择：① 单唾液酸四己糖神经节苷脂钠+小牛血去蛋白提取物+硝酸甘油+复合磷酸氢钾注射液；② 依达拉奉+神经节苷脂+卡托普利+左氧氟沙星+痰热清注射液+氨茶碱。活血化瘀类药物亚组模块分析提示，脑出血治疗中应关注中药安全性。本研究基于真实世界数据，但存在一些问题，如数据缺乏和混杂因素等。总结的用药方案仅供临床医生参考。临床应用应根据患者具体情况及临床获益与风险，并注意药物配伍禁忌。
