真实世界丹参川芎嗪注射液治疗肾功能不全患者的复杂网络分析

Complex Network Analysis of Danshen Chuanxiongqin Injection in the Treatment of Renal Insufficiency in the Real World

目的研究真实世界中使用丹参川芎嗪注射液治疗肾功能不全的患者用药方案特征和规律。方法从全国18家医院信息系统(hospital information system,HIS)数据库中提取2010~2019年使用丹参川芎嗪治疗肾功能不全患者的临床诊疗数据,采用Tabu搜索算法建立模型,利用社群图或矩阵法展示不同子网络间关系进行关联规则分析,寻找肾功能不全的核心处方以及多种药物之间的关联和强相关性。结果丹参川芎嗪注射液治疗肾功能不全的常用中西医治疗方案主要包括:改善肾功能的药物组合—丹参川芎嗪注射液联合替米沙坦;治疗心力衰竭并发症的药物组合—丹参川芎嗪注射液联合呋塞米、螺内酯;针对抗感染的药物组合—丹参川芎嗪注射液联合头孢地嗪。结论由于各类慢性疾病以及用药不当所引致的肾功能不全,其病因病机复杂多样,在常规对症治疗的基础上联合中药治疗能一定程度提高疗效。丹参川芎嗪注射液的联合用药方案符合肾功能不全的临床诊疗指南,这为临床个体化综合治疗提供了更有效的参考。

Objective To study the characteristics and regularities of combined use of Danshen Chuanxiongqin injection in the treatment of renal insufficiency in the real world.Methods The clinical data on diagnosis and treatment of patients with renal insufficiency treated with Danshen Chuanxiongqin injection between 2010 and 2019 was retrieved from the database of information systems of 18 hospitals nationwide before the tabu search algorithm was used to establish models.Community graphs or matrix methods were used to show the relationship between different self-networks in order to analyze the correlations.The core prescriptions for renal insufficiency and the correlations between multiple drugs were studied.Results The treatments of renal insufficiency with Danshen Chuanxiongqin injection included Danshen Chuanxiongqin injection combined with telmisartan to strengthen renal function,Danshen Chuanxiongqin injection combined with furosemide and spironolactone against heart failure,and Danshen Chuanxiongqin injection combined with cefodizime against infections.Conclusion Because of the complicated etiology and pathogenesis of renal insufficiency caused by various chronic diseases and improper medication,the combination with traditional Chinese medicine on the basis of conventional symptomatic treatment has a significant effect.The combined medication with Danshen Chuanxiongqin injection conforms to the guidelines for diagnosis and treatment of renal insufficiency,which provides more effective reference for individualized clinical treatment.