真实世界中丹参川芎嗪注射液治疗冠状动脉硬化性心脏病联合用药复杂网络分析

Complex Network Analysis of Combination Medication of Danshen Chuanxiongqin Injection in the Treatment of Coronary Heart Disease Based on Real World

目的本研究为探究丹参川芎嗪注射液治疗冠状动脉硬化性心脏病联合用药优效方案。通过全国19家三甲医院信息系统(hospital information system,HIS)数据库中优效人群联合用药规律探讨冠心病治疗中丹参川芎嗪联合用药方案。方法全国19家三甲医院4952例患者纳入分析,采用真实世界研究方法及Tabu搜索算法。结果丹参川芎嗪注射液+单硝酸异山梨酯+速效救心丸+阿卡波糖+蛋白水解物,为冠心病中西医联合用药频次最高组合,适宜冠心病心绞痛合并糖尿病及缺血性脑血管疾病患者;丹参川芎嗪注射液+维生素复方+蛋白水解物+硝酸甘油+头孢类+阿卡波糖为最常见西药搭配,用于冠心病合并消化性溃疡、失眠、炎症及糖尿病;活血化瘀制剂(化瘀通脉剂)+益气养阴剂+清热类中药为使用频率最高组合用于冠心病血瘀证合并气阴两虚或阴虚火旺证。结论目前临床治疗冠心病越来越关注全身治疗,符合中医整体观念及治未病原则。丹参川芎嗪注射液治疗冠心病联合用药符合最新的冠心病诊疗指南。

Objective To investigate the efficacy of the combination of Danshen Chuanxiongzin injection in the treatment of coronary arteriosclerotic heart disease,and to explore the combination of Danshen Chuanxiongqin in the treatment of coronary arteriosclerotic heart disease by using the combination pattern of the efficacy population in the hospital information system(HIS)database of 19 tertiary hospitals across China.Methods According to the real world research method and Tabu search algorithm,4952 patients from 19 top three hospitals in China were included in the analysis.Results Danshen Chuanxiongqin injection+isosorbide mononitrate+quick-acting heart pill+acarbose+protein hydrolysate was the most frequently used combination of Chinese and Western medicine for coronary heart disease,suitable for patients with coronary angina combined with diabetes and ischemic cerebrovascular disease;Danshen Chuanxiongqin injection+vitamin compound+protein hydrolysate+nitroglycerin+cephalosporins+acarbose was the most common combination of Western medicine for coronary heart disease combined with peptic ulcer,insomnia,inflammation and diabetes.The most frequently used combination was blood stasis preparations(blood stasis and blood circulation agents)+qi and yin nourishing agents+heat clearing herbs for coronary heart disease combined with qi and yin deficiency or yin deficiency and fire.Conclusion The results showed that the current clinical treatment of coronary heart disease is increasingly focused on systemic treatment,in line with the holistic concept of Chinese medicine and the principle of treating the disease before it occurs.The combination of Danshen Chuanxiongqin Injection for the treatment of coronary heart disease is in accordance with the latest guidelines for the treatment of coronary heart disease.