真实世界清开灵注射液治疗炎症因子异常患者的联合用药特征分析

Analysis of drug combination characteristics of Qingkailing injection for treating abnormal inflammatory factors in real world

分析真实世界清开灵注射液治疗白细胞、C反应蛋白升高等炎症因子异常患者的联合用药特征。基于中国中医科学院中医临床基础医学研究所构建的来自全国16家大型三级甲等医院医院信息系统(hospital information system,HIS)的医疗电子数据仓库,提取其中使用清开灵注射液的C反应蛋白异常患者、白细胞异常患者,进行基本信息、中西医诊断信息、医嘱信息、实验室检查信息的分析,采用Apriori算法建立模型,使用Clementine 12.0进行关联分析,分析真实世界中清开灵注射液治疗C反应蛋白、白细胞等指标升高患者临床用药规律及联合用药特征。研究结果表明使用清开灵注射液治疗C反应蛋白异常患者,联用1种西药、中药时,联合用药频率最高的分别是维生素C(159例,占74.30%)、痰热清注射液(71例,占33.18%),联合2种中药时频次最高的是血栓通注射液+痰热清注射液(支持度10.75%);治疗白细胞异常患者,联合1种西药、中药时联合用药频率最高的分别是维生素C(596例,占56.02%)、感冒清热颗粒(247例,占23.21%),联合2种中药时频次最高的是双黄连+感冒清热颗粒(支持度5.26%),C反应蛋白异常患者和白细胞异常患者中,从药理作用角度看,西药中,与抗生素类、营养支持剂联合用药最为多见。可见,清开灵注射液治疗C反应蛋白、白细胞等炎症指标升高的患者,多与抗生素类药物联合用药,达到药效协同的作用。

To analyze the drug combination characteristics of Qingkailing injection for treating abnormal inflammatory factors such as elevated white blood cells and C reactive protein in real world. The patients with Qingkailing injection for abnormal C reactive proteins and abnormal white blood cells were extracted from hospital information system （HIS） of 16 Class 3A hospitals. Then the basic information, traditional Chinese medicine and Western medicine diagnostic information, doctor＇s advice information, and laboratory information were analyzed; Apriori algorithm was used to construct the models, and Clementine 12.0 was used for correlation analysis to analyze the clinical medication rules and drug combination characteristics in the patients with Qingkailing injection for treatment of elevated C reactive protein and white blood cells in the real world. The results of the study showed that when Qingkailing injection was combined with one kind of western medicine and traditional Chinese medicine in treatment of patients with abnormal C reactive protein, vitamin C （159 cases, 74.30%） and Tanreqing injection （71 cases, 33.18%） were most frequently used; when it was combined with 2 kinds of traditional Chinese medicines, Xueshuantong injection plus Tanreqing injection （support degree 10.75%） were most frequently used. When Qingkailing injection was combined with one kind of western medicine and traditional Chinese medicine in treatment of patients with abnormal white blood cells, vitamin C （596 cases, 56.02%） and Ganmao Qingre granules （247 cases, 23.21%） were most frequently used; when it was combined with 2 kinds of traditional Chinese medicines, Shuanghuanglian＋Ganmao Qingre granules （support degree 5.26%） were most frequently used. In the patients with abnormal C-reactive protein and white blood cells, its combinations with antibiotics and nutritional support agents were most common from the pharmacological perspective, indicating that in the treatment of abnormal C-reactive protein, white blood cells and other increased inflammatory indicators, Qingkailing injection was most frequently combined with antibiotic drugs to achieve synergistic effect.