Sha Jing-Yu, Liu Huan, Xie Yan-Ming, Zhuang Yan
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China.
PLA Navy General Hospital Beijing 100048, China.
Zhongguo Zhong Yao Za Zhi. 2020 Aug;45(15):3525-3532. doi: 10.19540/j.cnki.cjcmm.20200616.501.
To investigate the clinical characteristics and the rule of administration of Ciwujia Injection in patients with cardiovascular disease by correlation analysis and frequency analysis. The information of 5 904 patients who used Ciwujia Injection to treat cardiovascular disease for at least three times in the hospital information system(HIS) of 19 comprehensive tertiary hospitals nationwide. The frequency analysis method was used to analyze the higher frequency variables, and the algorithm of Apriori correlation analysis method was used to analyze the clinical characteristics and medication laws of Ciwujia Injection in treating patients with cardiovascular disease. Among the 5 904 patients, the median age of the patients was 70 years, and the number of patients between 65-75 years old was up to 2 096(35.5%). There were more women than men in terms of diagnosis and treatment, and the women at age of 45-65 and 65-75 years old were more than men. The top three diagnoses by Western medicine were coronary heart disease in 8 104 cases(65.66%), dyslipidemia in 2 515 cases(20.38%), and cardiac function grade Ⅱ-Ⅲ in 581 cases(4.71%), while the largest number of syndromes in traditional Chinese medicine(TCM) at discharge was 1 109(21.37%) in other type, followed by 739 cases(14.24%) of Qi deficiency and blood stasis syndrome, and 698(13.46%) of liver and kidney Yin deficiency syndrome. The most frequently used Western medicine in combined use was Nifedipine in 2 567 cases(7.21%), and most frequently used TCM was Compound Xianzhuli Liquid leachate in 766 cases(3.53%). From the results of pharmacological analysis, the frequency of using Ciwujia Injection + stasi-seliminating agent + calcium channel blocking drugs was highest when using 1 Chinese medicine combined with 1 or 2 Western medicines. In the use of 2 Chinese medicines combined with 1 Western medicine, Ciwujia Injection + heat-clearing agent + stasis-eliminating agent + calcium channel blocker was the most common. This study demonstrated that Ciwujia Injection was more common in middle-aged and elderly patients and more in women than men. Treatment should be based on different cardiovascular disease treatment guidelines to reduce complications caused by underlying diseases, and attention should be paid to the prevention and treatment of cardio-vascular disease risk factors such as hypertension, diabetes and abnormal lipid metabolism. According to the analysis of frequency distribution and association rules, it was concluded that Ciwujia Injection was mainly used in combination with calcium channel blockers and stasis-eliminating agents in the treatment of cardiovascular disease. In the treatment of cardiovascular diseases by Ciwujia Injection in combination with other Chinese and Western medicines, in order to avoid pharmacological changes and avoid affecting the efficacy of the drug, it is necessary to closely observe whether adverse reactions occur and ensure that the medication is safe and effective. This study provides a good reference for the follow-up clinical guidance of Ciwujia Injection.
通过相关性分析和频次分析,探讨刺五加注射液治疗心血管疾病患者的临床特点及用药规律。收集全国19家综合性三甲医院医院信息系统(HIS)中使用刺五加注射液治疗心血管疾病至少3次的5904例患者的信息。采用频次分析法分析高频变量,并运用Apriori相关性分析方法的算法分析刺五加注射液治疗心血管疾病患者的临床特点及用药规律。5904例患者中,患者年龄中位数为70岁,65 - 75岁患者人数达2096例(35.5%)。诊疗过程中女性多于男性,45 - 65岁及65 - 75岁年龄段女性多于男性。西医诊断前三位依次为冠心病8104例(65.66%)、血脂异常2515例(20.38%)、心功能Ⅱ - Ⅲ级581例(4.71%),而出院时中医证候构成比最多的是其他证型1109例(21.37%),其次为气虚血瘀证739例(14.24%)、肝肾阴虚证698例(13.46%)。联合使用中最常用的西药是硝苯地平2567例(7.21%),最常用的中药是复方鲜竹沥液766例(3.53%)。从药物分析结果看,1种中药联合1种或2种西药使用时,刺五加注射液 + 化瘀药 + 钙通道阻滞药的使用频次最高。2种中药联合1种西药使用时,刺五加注射液 + 清热药 + 化瘀药 + 钙通道阻滞剂最为常见。本研究表明,刺五加注射液在中老年患者中使用较为普遍,女性多于男性。应依据不同心血管疾病治疗指南进行治疗,以减少基础疾病所致并发症,同时应重视高血压、糖尿病、血脂代谢异常等心血管疾病危险因素的防治。通过频次分布及关联规则分析得出,刺五加注射液治疗心血管疾病主要与钙通道阻滞剂和化瘀药联合使用。在刺五加注射液联合其他中西药治疗心血管疾病时,为避免药理变化影响药物疗效,需密切观察有无不良反应发生,确保用药安全有效。本研究为刺五加注射液后续临床指导提供了良好参考。