真实世界喜炎平注射液治疗儿童上呼吸道感染及并发症研究

A real-world study of Xiyanping injection in the treatment of upper respiratory tract infections and complications in children

目的分析喜炎平注射液治疗儿童上呼吸道感染(URI)的临床用药优选组合,探索临床优效方案和路径。方法从全国29家三级甲等医院信息管理系统(HIS)中,提取2006年12月5日至2016年6月20日间使用喜炎平注射液的0~14岁21316名URI患儿的医疗数据,规范化后采用Tabu搜索算法及复杂网络进行群组模块分析。结果通过对临床治愈及好转人群核心联用药的子结构划分,得到核心联用西药和中药子群以及各子群子结构间联系;西药对症、对因及并发症治疗时,明显显示出联系的子结构为联合布洛芬/对乙酰氨基酚、联合氯苯那敏复方/氯雷他定、联合溴己新联合氯苯那敏复方、联合对乙酰氨基酚加维生素类加西咪替丁加水合氯醛等;中医证候群的中药子群中,明显显示出联系的子结构为联合小儿柴桂退热颗粒/小柴胡颗粒、联合小儿热速清颗粒/双黄连颗粒、联合蓝芩口服液加口腔炎喷雾剂/开喉剑喷雾剂、联合清热解毒剂加肺力咳合剂等。结论真实世界中喜炎平注射液治疗儿童URI及其并发症显示出联合用药的常用组合模式,联合用药与指南较为契合,有一定规律可循,可为临床用药优选方案提供线索。

Objective To analyze the preferred clinical drug combinations of Xiyanping injection in the treatment of URI in children,and explore clinically optimized schemes and routes of administration.Methods The medical data on 21316 patients aged 0 to 14 with upper respiratory tract infection(URI)treated with Xiyanping injection between December 5,2006 and June 20,2016 was retrieved from the information systems of 29 tertiary hospitals across China.After standardization of the data,the Tabu search algorithm and complex network analysis were used to perform cluster module analysis.Results By dividing the clinically cured and improving population into sub-groups,the sub-groups of western medicine and traditional Chinese medicine used in the core combinations were obtained,and the relationships between the subgroups were clarified.For the treatment of URI and complications with western medicine,the obviously related sub-groups were the combination of Xiyanping with ibuprofen/acetaminophen,chlorpheniramine/loratadine,bromhexine and chlorpheniramine,or acetaminophen plus vitamin plus cimetidine plus chloral hydrate.As for TCM,the obviously related sub-groups included Xiyanping injection combined with Xiaoerchaigui antipyretic granules/Xiaochaihu granules,Xiaoerresuqing granules/Shuanghuanglian granules,Lanqin oral liquid plus stomatological spray/Kaihoujian spray,or antipyretic plus Feilike mixture.Conclusion In the real world,Xiyanping injection is usually used in combination with other drugs in the treatment of URI and its complications in children.The combined medication conforms with the guidelines.There are some regularities that facilitate clinical medication.