基于医院信息管理系统数据的抑郁障碍患者临床特征及病证诊疗分析

Analysis of Clinical Features,Diagnosis and Treatment on Patients with Depressive Disorder Based on the Data from Hospital Information Systems

目的了解抑郁障碍患者人口学特征、发病与节气规律以及中西医治疗用药的分布情况,为临床提供合理治疗及前瞻性研究提供思路与指导。方法收集2003年12月22日至2011年8月12日全国19家三级甲等综合医院的医院信息管理系统（HIS）住院数据,对出院诊断中有＂抑郁障碍＂诊断的患者性别、年龄、入院方式、付费方式、住院科室、住院天数、住院费用、用药情况等进行统计分析,研究患者发病与节气规律。结果共收集抑郁障碍患者1808例,性别缺失301例,有性别信息的患者中男性650例（43.13%）,女性857例（56.87%）;年龄中位数为56岁,18~74岁为主,共908例（82.17%）;住院科室神经科最多751例（41.54%）;住院天数以28天以内为主1596例（88.27%）。二十四节气中入院在寒露期间93例（5.92%）,小寒期间105例（6.68%）。患者使用最多的抗抑郁剂为氟哌噻吨美利曲辛（20.95%）,使用最多的中成药为银杏叶提取物（27.91%）。结论抑郁障碍患者女性多于男性,随年龄段递增住院天数渐增加,抑郁障碍发作高峰期集中在小寒、寒露,使用抗抑郁剂频率最高的西药为氟哌噻吨美利曲辛,中成药为银杏叶提取物。

Objective To understand the demographic characters,the pattern in the incidence and solar terms,and the rule of medication with traditional Chinese medicine and western medicine in patients with depressive disorder,in order to provide reasonable treatments in clinic and to bring thoughts and guidance to prospective studies.Methods Hospitalization data from December 22 nd,2003 to Auguest 12 th,2011 were collected from hospital information systems（ HIS） in 19 Class A Tertiary General Hospitals nationwide. Frequency statistical analysis was performed on information like gender,age,admission,mode of payment,hospitalized department,days of hospitalization,hospitalization expenses,medication,etc. of patients whose discharge diagnosis described as ‘depressive disorder＇. The pattern in the incidence and solar terms was studied. Results Totally 1 808 cases of depressive disorders were collected,with 650 males（ 43. 13%）,857 females（ 56. 87%） and 301 without gender records. Median age of the patients was 56,and most of cases（ 908,82. 17%） were among age 18 to 74; Most of those patients（ 751,41. 54%） were hospitalized in the department of neurology; and most of cases（ 1 596,88. 27%） stayed in hospitals less than 28 days. 105 cases（ 6. 68%） were admitted to hospital during the slight cold in 24 solar terms,and 93 patients（ 5. 95%） were hospitalized during cold dew. The most prescribed antidepressant agent was flupentixol and melitracen tablet（ 20. 95%）; and the most used traditional Chinese patent medicine was ginkgo biloba extract（ 27. 91%）. Conclusion There are more females than males in patients with depressive disorder. Hospitalization days increase with age. The onset peak of depressive disorder are the slight cold and cold dew in 24 solar terms. Flupentixol and melitracen has the highest usage frequency in antidepressant,while ginkgo biloba extract is the most prescribed traditional Chinese patent medicine.