基于真实世界的喜炎平注射液治疗支气管炎的复杂网络分析

Complex Network Analysis of Xiyanping Injection in Treatment of Bronchitis Based on Real World

目的:探究在真实世界中喜炎平注射液治疗支气管炎患者的中西药群组模块,为临床中西药治疗支气管炎提供参考。方法:从全国29家医院信息系统(HIS)提取应用喜炎平注射液治疗支气管炎患者共13 874例,运用禁忌(Tabu)搜索算法进行复杂网络分析,获得喜炎平注射液治疗支气管炎核心联用药物的子结构及关联信息,分析临床用药方案。结果:支气管炎针对病原体治疗方案,(1)细菌感染可选择喜炎平注射液+头孢呋辛;(2)病毒感染可选择喜炎平注射液+干扰素;(3)支原体感染可选择喜炎平注射液+阿奇霉素。针对支气管炎临床表现分型及并发症选择适宜用药方案,(1)单纯型支气管炎可考虑喜炎平注射液+氨溴索+肺力咳合剂+布洛芬;(2)喘息型支气管炎可考虑喜炎平注射液+异丙托溴铵+布地奈德+沙丁胺醇;(3)支气管炎并发病毒性脑炎:喜炎平注射液+甘露醇+呋塞米+苯巴比妥+神经节苷脂+免疫球蛋白;(4)支气管炎并发病毒性心肌炎:喜炎平注射液+磷酸肌酸钠+维生素C。结合支气管炎中医特点选择联用中药治疗。结论:该研究数据来源于真实世界,提取总结出喜炎平注射液治疗支气管炎临床表现分型及并发症的联合用药方案,但临床上需要针对其具体情况,个体化制定治疗方案。

Objective:To explore the group modules of Chinese medicine and western medicine for the treatment of bronchitis patients with Xiyanping injection based on the real world to provide references for the clinical treatment of bronchitis with Chinese medicine and western medicine. Method: Medical records of13 874 patients with bronchitis treated by Xiyanping injection were extracted from 29 hospital information systems(HISs)in China,and complex network analysis was carried out using Tabu Search algorithm to obtain the substructure and associated information of core drug combination of Xiyanping injection for the treatment of bronchitis and to analyze clinical medication protocols. Result: Medication protocols for the pathogens of bronchitis are listed below:Xiyanping injection + cefuroxime for bacterial infection. Xiyanping injection +interferon for viral infection. Xiyanping injection + azithromycin for mycoplasma infection. According to the clinical symptoms and complications of bronchitis,the appropriate medication protocols were as follows:Xiyanping injection + ambroxol + Feilike mixture + ibuprofen for uncomplicated bronchitis. Xiyanping injection + ipratropium bromide + budesonide + salbutamol for asthmatic bronchitis. Xiyanping injection +mannitol + furosemide + phenobarbital + gangliosides + immunoglobulin for bronchitis complicated with viral encephalitis. Xiyanping injection + creatine phosphate sodium + vitamin C for bronchitis complicated with viral myocarditis. The combined medication of Chinese medicine for the treatment of bronchitis was adopted based on its characteristics of traditional Chinese medicine. Conclusion:The data of this study were derived from the real world. The combined medications protocols of Xiyanping injection targeting the clinical symptoms and complications of bronchitis were extracted and summarized. However, it is necessary to formulate an individualized medication protocol according to the specific condition.