基于真实世界12554例刺五加注射液用药患者临床特征及联合用药分析

Analysis of clinical application characteristics and drug combination of Ciwujia Injection in 12 554 cases in real world

该研究为挖掘使用刺五加注射液患者的真实世界临床特征和联合用药规律,从全国共24家三级甲等医院信息系统中,提取12 554例刺五加注射液用药患者的医疗数据,进行规范化分析。中老年患者使用居多,心血管内科(22.50%)和神经内科(17.92%)是主要住院科室;2008年以前单次超剂量使用者占93.77%,2011年后仅2.07%;疗程多在8~14 d(32.98%)。西医诊断前3位依次是高血压病(11.78%)、脑梗死(9.47%)、冠心病(8.15%),最常见的中医证候为肝肾亏虚证(18.59%)。临床最常联用的西药为乙酰水杨酸(51.07%)、中药为丹参注射液(9.67%),最常联合应用西药类别是钙通道阻断药(46.88%)、中药类别为祛瘀剂(93.21%),支持度最高的联合用药组合为单硝酸异山梨酯+乙酰水杨酸;出院治愈好转率高(96.81%)。结果表明刺五加注射液联合用药有一定规律可循,在抗凝活血基础上兼顾基础并发疾病,且有扶正调神作用。此结果可拓展对刺五加注射液认识的广度,为临床优化治疗方案提供较详实的真实世界依据和借鉴。

To explore the real world clinical application characteristics and the drug combination regularity of Ciwujia Injection, 12 554 cases of patients with Ciwujia Injection were extracted from the information systems of 24 class Ⅲ grade A hospitals in China, and a standardized analysis was carried out. Most of the patients were middle-aged and old-aged, and the main departments were cardiovascular department(22.50%) and neurology department(17.92%). Before 2008, 93.77% of the patients were single overdose users, which reduced to only 2.07% after 2011. The course of treatment was mostly between 8-14 days(32.98%). The top three di-seases diagnosed by Western medicine were hypertension(11.78%), cerebral infarction(9.47%), and coronary heart disease(8.15%), and the most common traditional Chinese medicine syndrome was the deficiency of liver and kidney(18.59%). The most commonly used Western medicine was Acetylsalicylic Acid(51.07%), and the most commonly used traditional Chinese medicine was Danshen Injection(9.67%). The most commonly used Western medicine in combined application was calcium channel blocker(46.88%), and the most commonly used traditional Chinese medicine in combined application was stasis removing agent(93.21%). And the drug combination with the highest support was Isosorbide Mononitrate + Acetylsalicylic Acide, with a high recovery rate after discharge(96.81%). The results showed that Ciwujia Injection had certain regularity. It considered underlying concurrent diseases, anticoagulation and blood circulation, with a wide range of effects in strengthening the body and regulating the mind. The results could expand the understanding of Ciwujia Injection and provide a more detailed real world basis and reference for optimizing therapeutic regimen in clinic.