基于HIS数据的3050例腰椎滑脱患者临床特征与用药分析

Clinical Characteristics and Medicine Analysis of 3050 Hospitalized Patients with Lumbar Spondylolisthesis Based on Hospital Information System Database

目的：了解腰椎滑脱患者的一般住院信息、发病节气、药物治疗等情况。方法：采集全国20家三甲综合医院信息系统（HIS）数据库中第一诊断为腰椎滑脱的3050例住院患者信息,分析腰椎滑脱住院患者的性别、年龄、职业、入院科室、住院费用、发病节气、中西医治疗等情况。结果：3050例腰椎滑脱住院患者中,入院科室以骨科为主,71.51%的住院患者的年龄为45~74岁,82.46%患者为体力劳动者,56.35%的患者住院天数为15~28 d,最常见的中医证候是肝肾亏虚证和气滞血瘀证,药物信息分析结果显示在腰椎滑脱治疗中使用到278种西药和331种中药（含中成药）,西药中使用最多的是地塞米松,其次依次是甘露醇、甲钴胺、苯巴比妥、青霉素,中药使用最多的是鹿瓜多肽,其次依次是七叶皂苷、血栓通、四磨汤、川芎嗪;药物归类后,西药位于前列者为抗感染药、镇痛药、糖皮质激素、脱水药、营养神经药物,中药以活血剂、补益剂（补肾健骨剂）、清热解表剂、润肠通便剂、脱水剂最为常见。结论：腰椎滑脱疾病中中老年患者发病率高、以女性为主,其中医证型主要是气滞血瘀和肝肾亏虚证型,多发于立夏、寒露时令,西医治疗上以抗感染、镇痛、糖皮质激素、脱水为主,中医治疗上活血、补肾健骨为主。

Objective ： To understand the general information of patients with lumbar spondylolisthesis, solar terms, drug therapy and so on. Methods ： Collect 3050 cases of hospitalized patients whose first diagnose is lumbar spondylolisthesis from 20 general hospitals with 3 - A level in China and analyze their gender, age, occupation, department, hospital cost, solar terms, traditional Chinese and western medicine treatment and so on. Results：Among 3050 cases, most of them are in orthopaedic department ,71.51% 45 - 74 years old,82.46% labour workers ,56.35% live in hospital for 15 -28 days. And the most common Chinese medicine syndrome is liver and kidney deficiency and qi stagnation and blood stasis. The most common medicines used in lumbar spondylolisthesis contain 278 kinds western medicines and 331 kinds traditional Chinese medicine （including proprietary Chinese medicine） according to drug information analysis. Dexamethasone is in the first place in western medicine, followed by mannitol, cobalt amine ,phenobarbital ,penicillin. And Cervus and cucumis polypeptide is in the first place in traditional Chinese medicine,followed by aescin, Xueshuantong, simo decoction, Chuanxiongzine. After classification, the fifth western medicine used in patients with lumbar spondylolisthesis includes anti - infection drugs, analgesic, glucoeorticoid, dehydrating agent, Neurotrophy medicine. And the fifth traditional Chinese medicine includes blood - activating formula, tonic prescriptions, clearing heat and releasing exterior, lubricating the intestine and relaxing the bowel, dehydrating agent. Conclusion：The incidence of lumbar spondylolisthesis disease is high in elderly patients and mainly in women. And the mainly TCM syndrome type is liver and kidney deficiency and qi stagnancy and blood stasis and the mainly solar terms are Lixia and Hanlu. As for western treatment, anti - infection, analgesia, glucocorticoid and dehydration are the first choice and regulating blood and bushen jiangn are mostly used in TCM.