基于关联规则Apriori算法的真实世界中结肠恶性肿瘤患者的中西药联合应用特征研究

Real-World Study on the Characteristics of Combined Application of Chinese and Western Medicine in the treatment for Colonic Malignant Tumors by Association Rules Analysis

目的:探讨真实世界中结肠恶性肿瘤患者的中西药物联合使用特征。方法:提取全国33家三甲医院中22691例结肠恶性肿瘤患者的电子医疗数据,对其临床用药信息采用基于Apriori算法的关联规则分析。结果:铂剂细胞毒类药、抗代谢细胞毒类药、免疫调节药、补血药4类西药药理联合使用频率最高(支持度18.8%);氟尿嘧啶、亚叶酸钙、奥沙利铂、胸腺肽注射液、托烷司琼5种西药品种联合使用频率最高(支持度4.55%);清热解毒剂、益气扶正剂、活血化瘀剂3类中药功效联合使用频率最高(支持度1.93%);鸦胆子油注射液、复方苦参注射液2种中药品种联合使用频率最高(支持度1.94%)。结论:化疗是结肠恶性肿瘤的主要治疗手段之一,氟尿嘧啶联合亚叶酸钙与奥沙利铂是临床经典的一线化疗方案。化疗与中医药相结合可达到增效解毒的效果,最常联合使用清热解毒剂、益气扶正剂和活血化瘀剂。

Objective:To investigate the characteristics of the combined use of Chinese and western medicine in patients with colonic malignant tumors in the real world.Methods:Electronic medical data of 22691 patients with colonic malignant tumors from 33 Grade three hospitals in China were selected.The clinical medication information was analyzed by association rules based on Apriori algorithm.Results:The combination of four classes of western medicines was applied most frequently:platinum cytotoxic drugs,anti-metabolic cytotoxic drugs,immune regulatory drugs and blood tonic drugs(support 18.8%).Combination of five western medicines were used most frequently:fluorouracil,calcium leucovorin,oxaliplatin,thymosin injection and tropisetron(support rate 4.55%).Combination of these three traditional Chinese medicine prescription were used most frequently:Qingrejieduji,Yiqifuzhengji and Huoxuehuayuji(support rate 1.93%).Combination of two traditional Chinese medicine compounds were applied most frequently:Brucea javanica oil injection and compound Kushen injection(support rate 1.94%).Conclusion:Chemotherapy is one of the main treatments for colonic malignancies.Fluorouracil combined with calcium leucovorin and oxaliplatin is a classic first-line chemotherapy regimen.The combination of chemotherapy and traditional Chinese medicine can achieve the effect of synergism and detoxification,the mostly used prescription for combination are Qingrejieduji,Yiqifuzhengji and Huoxuehuayuji.