基于关联规则Apriori算法的真实世界复方苦参注射液治疗食管恶性肿瘤联用西药特征的研究

A Real-world study based on hospital information system of association rules based analysis of Fufangkushen Injection in combination with modern medications in treating malignant esophageal tumors

目的:基于关联规则Apriori算法,提取真实世界2550例食管恶性肿瘤住院患者电子医疗数据,挖掘复方苦参注射液真实世界治疗食管恶性肿瘤的联合用药特征规律,为指导临床合理用药提供借鉴。方法:以中国中医科学院中医临床基础医学研究所建立的医院信息系统电子医疗数据集成仓库为数据来源,对全国范围的22家三甲医院主要入院诊断为食管恶性肿瘤,并使用复方苦参注射液治疗的患者提取其电子医疗数据,基于频数统计与关联规则数据挖掘、解析联合用药特征。结果:复方苦参注射液治疗食管恶性肿瘤常与抗生素类药、抗肿瘤化疗药、免疫调节药、糖皮质激素药、营养支持药、质子泵抑制剂等联用,其联用药物关联规则组合呈现出特定规律,联合用药特征符合食管恶性肿瘤相关诊疗指南。结论:复方苦参注射液治疗食管恶性肿瘤临床联用药物广泛,联用中西药物组合规律基本符合相关临床指南。基于对真实世界临床用药特征的解析,发现复方苦参注射液侧重于降低化疗副作用、延长生存期、提高生存质量,为其治疗食管恶性肿瘤的临床合理用药提供了参考依据。

Objective： To analysis association rules of Fufangkushen injection in combination with other modern medications while treating malignant esophageal tumors. Methods： The data of this study was based on electrical medical records in real world clinical situations extracted from hospital information system of 22 hospitals in China. Clinicians’ orders regarding to such treatment related usage of modern medications were included in the analysis. Results： Electrical medical records of 2671 patients with both malignant esophageal tumors diagnosis and Fufangkushen injection orders were extracted. Modern medications including antibiotics,chemotherapeutic drugs,immunomodulatory drugs,glucocorticoids,serotonin receptor blockers,nutritional supplements,and proton pump inhibitor were the most common combinations of Fufangkushen injection. There were also specific association rules between these combinations. Conclusion： Detailed correlations between modern medications applying accompany with Fufangkushen injection factors were revealed based on apriori algorithm,which were generally correspond to clinical guidelines and contributed to reasonable application of Fufangkushen injection in clinical treatment.