基于块模型的喜炎平注射液治疗上呼吸道感染用药方案的真实世界研究

Real world study on therapeutic schemes of Xiyanping Injection in treatment of upper respiratory tract infection based on block model

目的基于大样本医疗电子数据探索喜炎平注射液治疗上呼吸道感染的临床药物治疗规律,为临床合理用药提供参考。方法从中国中医科学院中医临床基础医学研究所构建的真实世界电子医疗数据仓库中提取喜炎平注射液治疗上呼吸道感染患者的医疗电子病历27 584例,基于块模型Tabu搜索算法,对患者的合并用药进行复杂网络分析,最后对结果进行归纳得到临床用药规律。结果复杂网络分析共纳入119种中西药,根据算法对药物关系网络进行最优划分,得到30个中西药子群,并做出复杂网络图。结论喜炎平注射液治疗上呼吸道感染的药物治疗包括对症、支持及针对合并疾病的方案,临床实践中常根据实际情况组合应用。对症治疗主要针对发热、咳嗽、惊厥等症状;支持治疗主要是维生素、氨基酸、电解质、益生菌的补充。上述方案与上呼吸道感染的指南或共识推荐常规治疗基本符合,但可能存在抗生素不合理使用的情况。因此,联合用药的合理性还需结合临床实际情况进一步探讨或开展临床研究进一步验证,以期为临床用药提供更为合理的证据。

Objective To explore the medication therapeutic rule from large sample medical electronic record of upper respiratory tract infection treated by Xiyanping Injection(喜炎平注射液), in order to provide reference for clinical rational drug use. Method Electronic medical records of 27 584 cases of patients with upper respiratory tract infections treated with Xiyanping Injection were extracted from the real world electronic health data warehouse established by China Academy of Chinese Medical Sciences. The complex network analysis was carried out on the patients’ concomitant medications by Tabu search algorithm of block model and the results were summarized to obtain the clinical medication rules. Results A total of 119 kinds of Chinese and western medicine were included in the complex network analysis. Tabu search algorithm was implemented to divide the medications relationship network into 30 subgroups to obtain the complex network chart. Conclusion The pharmacological treatment of Xiyanping Injection for upper respiratory tract infection includes support therapy and therapy to symptomatic and combined diseases, usually prescribed as combinations in the actual clinical practice situation. Symptomatic therapy was mainly for fever, cough, and convulsion. The support therapy was the supplements of vitamins, amino acids, electrolytes and probiotics. However, there seems to be a problem of irrational use of antibiotics. Consequently, it is indispensable to further explore the rationality of medicine combination according to clinical actual circumstances or carry out clinical research to verify its effects.