基于真实世界的急性脑梗死死亡患者死亡节气时辰与用药分析

Analysis of solar terms, one of the 12 two-hour periods and medications of death in patients with acute cerebral infarction based on the real world

目的:分析真实世界中急性脑梗死死亡患者的死亡节气时辰与用药分析情况。方法:通过选择全国19家三甲医院信息系统(HIS)数据库中急性脑梗死死亡患者的临床特征,采用Apriori算法建立模型,使用Clementine 12.0进行关联分析,分析急性脑梗死的临床联合用药特征。结果:524例急性脑梗死死亡患者以老年男性为主,出院主证风痰阻络53例(36.30%),肝肾阴虚22例(15.07%),气虚血瘀15例(10.27%)为主,死亡节气以大寒为首,死亡时辰以申时为首,使用频率高的中药大多属于清热解毒类药物、活血化瘀类药物,西药中应用最多的是呼吸系统药物和循环系统药物,中西药联合应用情况以西药之间的联合应用最常见。结论:急性脑梗死患者在节气大寒、雨水、谷雨,时辰申时、子时、未时病死率最高,临床医生应高度重视,起到既病防变的目的;在联合用药方面,发现急性脑梗死临床用药基本符合指南建议。

Objective： To analyze the solar terms, one of the 12 two-hour periods and medications of death in patients with acute cerebral infarction based on the real world. Methods： Clinical features of patients with acute cerebral infarction death were collected in 19 databases of national 3-A grade hospital information system（HIS）, Apriori algorithm was applied to establish the model, and Clementine 12.0 was applied in correlation analysis to analyze clinical features of drug combination in acute cerebral infarction. Results： Patients with acute cerebral infarction death were given priority to the older men, among them, syndrome of wind-phlegm blocking collaterals was 53 cases（36.3%）, syndrome of liver and kidney yin deficiency was 22 cases（15.07%）, syndrome of qi deficiency and blood stasis was 15 cases（10.27%）; the solar terms was led by Great Cold, and the death time was headed in the period of the day from 3 p.m. to 5 p.m.; the high frequency TCM drugs were mostly belonged to ‘clearing heat and removing toxicity＇ and ‘promoting blood circulation for removing blood stasis＇, the most common treating Western drugs were respiratory and circulatory system drugs, and the drug combinations among Western drugs were more common used in all the combination of Western and Chinese medications. Conclusion： Patients with acute cerebral infarction showed the highest death rate in Great Cold, Rain Water, Grain Rain and the period of the day from 3 p.m. to 5 p.m., from 11 p.m. to 1 a.m., from 1 p.m. to 3 p.m.. Clinicians should pay great attention in these conditions to prevent disease from exacerbating; in combination with medication, it was found that clinical drugs prescribed in acute cerebral infarction were according with the guidelines.