刺五加注射液治疗4680例脑血管病的真实世界应用特征及联合用药分析

Application Characteristics of Ciwujia Injection(刺五加注射液)in Treatment of Cerebrovascular Diseases and Analysis of Combined Use:A Real World Study

通过对真实世界中刺五加注射液治疗脑血管病的应用特征及联合用药规律进行回顾性研究,得出使用刺五加注射液治疗的脑血管病患者的诊断主要有脑梗死(58.79%)、椎-基底动脉供血不足(26.78%)、动脉粥样硬化(8.66%)等;中医证候类型以肝肾亏虚证(42.98%)、气虚血瘀证(17.16%)等虚证或虚实夹杂证候为主。根据关联规则分析,提取刺五加注射液以治疗缺血性脑血管病为主的联合用药方案:①缺血性脑血管病:刺五加注射液+桂哌齐特+尼麦角林+化瘀通脉剂;②合并高血压者或冠心病心绞痛:刺五加注射液+桂哌齐特+硝苯地平+化瘀通脉剂;刺五加注射液+尼麦角林+硝苯地平+化瘀通脉剂;③合并高血压及心律失常者:刺五加注射液+美托洛尔+硝苯地平+化瘀通脉剂。联合用药方案仅反映真实世界临床诊疗特点,供临床医生参考,具体应用需根据患者具体病情,并结合药物说明书,权衡风险与获益选择性应用,注意配伍禁忌。今后的研究可以通过前瞻性研究控制混杂因素,来获得更科学的结果。

In this study,the characteristics of Ciwujia Injection(刺五加注射液) in the treatment of cerebrovascular diseases in the real world and the law of combined use of Ciwujia Injection were reviewed.It was concluded that the main diagnosis of cerebrovascular diseases treated with Ciwujia Injection were cerebral infarction(58.79%),vertebrobasilar insufficiency(26.78%),atherosclerosis(8.66%),etc.The syndrome types of traditional Chinese medicine was deficiency of liver and kidney(42.98%),Qi deficiency and blood stasis syndrome(17.16%) and other deficiency syndrome or deficiency and excess mixed syndrome.According to the analysis of association rules,the combination of Ciwujia Injection and treatment of ischemic cerebrovascular disease was extracted:①ischemic cerebrovascular disease: Ciwujia Injection+guipizide+nimergolin+Huayu Tongmai Agent(化瘀通脉剂).②Patients with hypertension or angina pectoris of coronary heart disease: Ciwujia Injection+guipizide+nifedipine+Huayu Tongmai Agent;Ciwujia Injection+nimergolin+nifedipine.③Patients with hypertension and arrhythmia: Ciwujia Injection+metoprolol+nifedipine+Huayu Tongmai Agent.The combination drug scheme only reflects the real world clinical diagnosis and treatment characteristics for the reference of clinicians.The specific application needs to be based on the patients′ specific conditions,combined with the drug instructions,weigh the risks and benefits of selective application,and pay attention to the incompatibility.In the future,more realistic results can be obtained by increasing the sample size or using other methods to control confounding factors.