基于HIS真实世界的使用清开灵注射液青少年患者临床特征分析

Clinical features analysis of Qingkailing injection for adolescent patients based on real world HIS

该文探索使用清开灵注射液青少年患者的临床用药特征。基于中国中医科学院中医临床基础医学研究所构建的全国16家大型三级甲等医院HIS系统收录的1998—2011年住院病例,提取使用清开灵注射液的青少年患者615例。采用Apriori算法建模,使用Clementine 12.0进行关联规则分析。结果显示男性患者(355例)多于女性患者(243例);患者年龄14岁以下最多,平均年龄为9.40岁;住院天数以4~7 d居多;患者多集中于儿科,主要是上呼吸道感染;以门诊方式入院居多(451例,75.54%);有中医辨证信息的患者中,主要有痰湿内阻证(38.46%)、肝气郁结(15.38%)、气阴两虚证(11.54%)、阳气虚衰证(11.54%)等;患者入院率最多的节气为小寒(13.01%)。临床联合2种化药时,最常联合头孢注射液+维生素C组合(支持度为24.60%);联合2种中药时,最常联合双黄连+感冒清热颗粒组合(支持度4.065%);联合3种化药时,最常联合氯化钾注射液+头孢注射液+维生素C组合(支持度15.93%);联合3种中药时,最常联合双黄连+云南白药+感冒清热颗粒组合(支持度1.138%)。清开灵注射液在青少年患者中亦有较为广泛的应用,患者诊断及使用方法基本符合药品说明书,男性略多于女性,发病年龄、节气特点与中医证候高度一致,清开灵注射液联合用药以化药为主,也兼顾使用中药,联合用药比较合理。基于HIS真实世界的研究结果为清开灵注射液在青少年患者中规范用药提供思路与参考。

To explore the clinical application features of Qingkailing injection for adolescent patients. This study was based on the information from the hospitalized patients in 1998 -2011 in HIS （hospital information system） of 16 tertiary hospitals in China. 615 adolescent patients with Qingkailing injection were used to investigate the clinical characteristics of Qingkailing injection. Apriori algo-rithm was adopted to establish the model, and Clementine 12. 0 was used for correlation analysis. The results showed that male patients （355 cases） were more than female patients （243 cases） ; the age of the most patients was under 14 years old, with an average age of 9. 40 years old; the hospital stay was most of 4-7 d ; the patients were mostly concentrated in pediatrics, mainly including upper respir- atory tract infection; outpatient admission to the majority （451 cases, accounting for 75. 54% ）. The traditional Chinese medicine （TCM） syndrome mainly included phlegm-dampness internal resistance （38.46%）, Qi and Yin Deficiency （ 11.54% ）, Liver qi stag- nation （15.38%）, and Yang deficiency syndrome （11.54%）; the highest admission rate was during Slight Cold （13.01%）. In combined application, the most common western medicine pair was Cephalosporin injection ＋ vitamin C （with supporting rate of 24. 6% ） and the most common TCM pair was Shuanghuanglian ＋ Ganmao Qingre granules （ with supporting rate of 4. 065% ）. The most common 3 western medicines in combined use were Potassium chloride injection ＋ Cephalosporin injection ＋ vitamin C （ support- ing rate of 15.93% ） ; while the most common three Chinese medicines were Shuanghuanglian ＋ Yunnan Baiyao ＋ Ganmao Qingre gran- ules （supporting rate of 1. 138% ）. Qingkailing injection was also widely used in adolescent patients; the diagnosis and use were basi- cally in line with the instructions ; men were slightly more than women ; age of onset, solar terms and TCM syndromes were highly con- sistent. Qingkailing injection was mainly combined with western medicines in combined drug use, and Chinese medicines were also a- vailable. Combined drug use was more reasonable. Based on the results of the real world HIS, Qingkailing injection could provide the idea and reference for regulating the medication in adolescent patients.