基于Louvain聚类方法的连花清瘟胶囊治疗上呼吸道感染临床用药方案的复杂网络分析

Complex Network Analysis of Lianhua Qingwen Capsule in Treatment of Upper Respiratory Tract Infection Based on Louvain Clustering

目的:探究基于真实世界的连花清瘟胶囊治疗上呼吸道感染的临床诊疗特征的挖掘及优效方案探索。方法:根据中国中医科学院中医临床基础医学研究所构建的来自全国16家大型三级甲等医院信息系统的医疗电子数据仓库中的454例使用连花清瘟胶囊治疗上呼吸道感染患者的信息,采用描述分析,Apriori算法建立模型以及基于Louvain聚类方法的复杂网络分析研究临床用药方案。结果:中西药联合用药主要为清热解毒中药注射液联合西药化痰药物,或者联合西药解热镇痛类、西药抗菌药物类,其他联合用药还包括联合中药清热化痰类、维生素类、针对基础疾病治疗药物为降压药、调脂药物、降糖药物、改善冠脉循环药物、抗血小板聚集类等。结论:基于Louvain聚类方法的复杂网络分析得出的结论,可以挖掘出连花清瘟胶囊治疗上呼吸道感染联合用药方案的规律。在化痰止咳方面,中药应用非常广泛,作用突出;抗菌药物的联用充分显示了遵循抗菌药物应用指南的精神;药物安全性是临床上药物联合应用中比较受关注的方面之一。这些规律的发现为探索优效治疗方案提供了方向。

Objective: To explore the clinical diagnosis and treatment characteristics as well as the optimal schemes of Lianhua Qingwen Capsule in the treatment of upper respiratory tract infection(URTI)in the real world. Method: The information of 454 patients receiving Lianhua Qingwen Capsule for URTI was collected from the electronic medical data warehouse constructed by the Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,which covered 16 large-scale tertiary Class A hospital information systems(HISs). The harvested information was subjected to descriptive analysis,Apriori algorithmbased analysis and Louvain(BGLL) algorithm-based complex network analysis to explore the clinical medication schemes. Result: The commonly adopted medication schemes were heat-clearing and detoxicating Chinese medicinal injections combined with expectorants,analgesic-antipyretic drugs,or antibacterial agents in western medicine. Besides, the combination with heat-clearing and phlegm-resolving Chinese medicinals,vitamins, or hypotensive, lipid-lowering, hypoglycemic, coronary circulation-improving, or antiplatelet aggregation drugs targeting the underlying diseases was also detectable. Conclusion: The complex network analysis based on BGLL clustering method can be used to find out the medication rules of Lianhua Qingwen Capsule for URTI. The traditional Chinese medicine has been widely employed for resolving phlegm and relieving cough due to its good efficacy. The combination with antibiotics follows the guidelines for the use of antimicrobial agents. Drug safety is one of the most concerned aspects in clinical drug combination. The uncovering of these rules has provided a direction for exploring the optimal treatments.