基于HIS数据的48398例四肢骨折患者临床用药规律分析

Analysis of clinical medication rules in 48 398 patients with limb fractures based on hospital information system

探讨真实世界中四肢骨折的临床用药情况,为肢体骨折合理用药提供临床借鉴。以中国中医科学院中医临床基础医学研究所构建的医院信息系统（hospital information system,HIS）中48 398例四肢骨折患者（2001—2011年）为研究对象,对患者的性别与年龄分布、中西药基本用药情况进行描述,采用关联规则对中西药常用药物组合进行关联性分析。研究结果显示所纳入病例中男性与女性比为1.83∶1,年龄分段中18-44岁发生四肢骨折患者最多。关联分析显示西药使用频率高于中药,临床医嘱用药统计最常用的中药为鹿瓜多肽、七叶皂苷钠注射液,最常使用的中药类型为活血化瘀药、强筋壮骨药。西药抗生素和活血化瘀中药或者强筋壮骨药联合使用频率最高。基于现有数据分析发现四肢骨折患者男性多于女性,中青年患者较多,中西药常见的联合用药情况为抗生素＋活血化瘀药/强筋壮骨药。在未来的研究中,应广泛开展前瞻性的高质量的临床试验来验证中药或中西药联用治疗四肢骨折的临床疗效。

To explore the clinical medication rules in the patients with limb fractures,and provide guidance for clinical practice.Data of 48 398 patients with limb fractures from 2001 to 2011 was extracted from the hospital information system（ HIS） established by the institute of basic research in clinical medicine,China academy of Chinese medical sciences. The gender and age distribution of patients and clinical medication characteristics were described. Apriori algorithm was adopted to analyze the common drug combinations of Chinese medicine（ CM） and western medicine（ WM）. The study results showed that the ratio of included males and females was1. 83∶ 1. There was a high peak of incidence for the patients from 18 to 44 years. Apriori algorithm showed that the usage of WM was more frequent than that of CM. The most commonly used CM was Lugua polypeptide and sodium aescinate injection. Blood-activating and stasis-resolving medicines,as well as tendons and bones-strengthening medicines were the commonly used CM types. In addition,WM antibiotics plus blood-activating and stasis-resolving CM,or antibiotics plus tendons and bones-strengthening CM was the most commonly used drug combination. Based on the analysis of available data,the prevalence of limb fracture was higher in men than in women; more in young and middle-aged patients; the common drug combination was antibiotics plus blood-activating and stasis-resolving CM,or antibiotics plus tendons and bones-strengthening CM. More prospective and high-quality clinical trials are necessary to evaluate the effect of CM or integrative medicine treatment for limb fracture in the future research.