基于真实世界HIS数据分析冠心病患者的临床特征及用药规律

Analysis of Clinical Characteristics and Medication Rules of Patients with Coronary Heart Disease Based on Real World HIS Data

目的收集整理HIS中冠心病患者的诊疗信息,探求真实世界研究中经中西医结合诊治的冠心病患者的临床特征及用药规律,为冠心病的诊断、治疗提供更为可靠的依据。方法选取我院2018-2020年1069例冠心病患者的医疗电子数据信息,采用频数统计患者的性别、年龄、发病节气、证型、合并疾病等情况;采用关联规则分析患者的症状、舌象、脉象、用药,分析其常见症状、体征、联合用药等。结果1069例患者以女性居多(61.18%),年龄在50~80岁;职业大部分集中在商业工作人员,服务性工作人员及生产工作、运输工作和部分体力劳动者之中;发病节气以寒露、霜降、立冬、小雪、大雪等为多见;症状多为胸闷、憋气、心悸;舌象主要有舌暗红苔白、苔黄、苔白腻、苔薄白、苔黄腻,舌淡红苔白,舌红少苔;脉象主要有沉细、弦滑、细弱;主要证型有心血瘀阻证(36.14%)、心气阴两虚证(30.98%)、心肾阳虚证(16.12%)和痰阻心脉证(14.66%);常联合应用的三种药物组合是抗心绞痛药+抗凝血药+活血化瘀类药、抗心绞痛药+抗凝血药+营养类药、抗心绞痛药+调血脂药+抗凝血药、抗心绞痛药+调血脂药+活血化瘀类药、抗心绞痛药+调血脂药+营养类药。结论真实世界研究中,冠心病患者的症状、舌象、脉象可以反映出其临床特征,体现了中医学辨证论治的特点和优势。中西医结合治疗用药具有一定的规律性,并且与相关诊疗指南内容相一致。

Objective To collect and sort out the diagnosis and treatment information of patients with coronary heart disease in HIS,explore the clinical characteristics and medication rules of patients with coronary heart disease treated by integrated traditional Chinese and Western medicine in real world research,and provide more reliable basis for the diagnosis and treatment of coronary heart disease.Methods A total of 1069 cases of medical data information of coronary heart disease patients in our hospital from 2018 to 2020 were studied.Frequency statistics were used to analyze the gender,age,onset solar term,syndrome type and complication;association rules were used to analyze the symptoms,tongue manifestation,pulse manifestation and medication,and the common symptoms,signs and combined medication were obtained.Results Totally 1069 patients were mostly female(61.18%),aged 50-80 years old;the majority of occupations were concentrated in commercial staff,service staff and productive,transport and some physical workers;the onset of febrile was Cold Dew,Frost's Descent,the Beginning of Winter,Lesser Snow,Greater Snow,etc.;most of the symptoms were chest tightness,suffocation and palpitation;the main tongue manifestation include dark red tongue with white fur,yellow fur,white-greasy fur,white and thin fur,yellow-greasy fur,light red tongue with white fur,red tongue with less fur;the pulse manifestation mainly had deep and thin,wiry and rolling,slender and weak;the main syndrome types were Xinxueyuzu(36.14%),Xinqiyinliangxu(30.98%),Xinshenyangxu(16.12%),and Tanzuxinmai(14.66%);the three drug combinations commonly used in combination were antianginal drugs+anticoagulant+Huoxuehuayu drugs,antianginal drugs+anticoagulant+nutrition drugs,antianginal drugs+lipid-regulating drugs+anticoagulant,antianginal drugs+lipid-regulating drugs+Huoxuehuayu drugs,antianginal drugs+lipid-regulating drugs+nutrition drugs.Conclusion In the real world research,the symptoms,tongue manifestation and pulse manifestation of patients with coronary heart disease can reflect their clinical characteristics,reflecting the characteristics and advantages of TCM syndrome differentiation and treatment.The medication of integrated traditional Chinese and Western medicine has certain regularity,which is consistent with the content of relevant diagnosis and treatment guidelines.