喜炎平注射液治疗心肌损害及心肌炎患者联合用药复杂网络分析

Complex network analysis of combined medication with Xiyanping injection in treating patients with myocardial damage and myocarditis

目的探索临床使用喜炎平注射液治疗心肌损害及心肌炎的更优用药方案。方法提取中国中医科学院中医临床基础医学研究所搭建的大型医院信息系统(HIS)集成数据仓库中国内29家三级甲等医院2006年12月1日至2016年6月30日间,诊治过程中应用喜炎平注射液并有合并用药的19 729例心肌损害及心肌炎患者的临床用药信息,运用Tabu搜索算法进行复杂网络分析。结果纳入的心肌损害及心肌炎患者,年龄在3岁以下的患者占总病例数的84.77%,儿童患者较多。在合并用药时,临床中应用频次最高依次为清热剂、化痰止咳平喘剂、清热解毒剂、活血化瘀剂等,主要作用属于"清""活"法。喜炎平注射液联合中药治疗中应用清热剂的频次最高,且在网络分析中清热剂与其他中药之间呈紧密的结构联系。结论建议以"清热解毒,凉血活血,兼养阴固正"为主要治则,使用中药中能清热解毒、凉血活血、味甘、性寒凉的药物灵活配伍,整体调节,随证加减,以提高患者自身健康水平,从而提升患者病愈后的生活质量。

Objective To explore optimized combined medications with Xiyanping injection in the treatment of myocardial damage and myocarditis. Methods Between December 1, 2006 and June 30, 2016, the clinical data on 19 729 patients with myocardial damage and myocarditis treated with Xiyanping injection and combined medications was retrieved from the integrated data warehouse of large hospital information system(HIS) established by the Institute of Clinical Basic Medicine, Chinese Academy of Chinese Medical Sciences. Complex network analysis was performed using the tabu search algorithm. Results Among the included patients with myocardial damage and myocarditis, 84.77% were under 3 years old. As for drug combinations, the most frequently used ones in clinical practice were heat-clearing prescriptions,phlegm-resolving and cough-relieving and asthma-relieving prescriptions, heat-clearing and detoxicating prescriptions,and blood-activating and stasis-resolving ones, with the main effects attributed to “clearing” and “activating” properties.Heat-clearing prescriptions were used most frequently in combined medications with of Xiyanping injection, and there was a close structural relationship between the heat-clearing prescriptions and other Chinese medicines in network analysis. Conclusion It is recommended that the main therapeutic principle be “clearing heat and detoxification, cooling blood and activating blood, as well as nourishing Yin and consolidating Yang”. The flexible compatibility of Chinese medicines with the effects of clearing heat and detoxification, cooling blood and activating blood can be used to improve the health of patients and their life quality after recovery.