丹参川芎嗪注射液治疗冠心病合并高血压的临床用药特征——一项真实世界研究

Clinical characteristics of Danshen Ligustrazine injection in the treatment of coronary heart disease with hypertension-A real world study

目的:挖掘应用丹参川芎嗪注射液治疗冠心病合并高血压的特点和用药规律。方法:从全国12家三级甲等医院信息系统中,提取应用丹参川芎嗪注射液治疗冠心病合并高血压患者的医疗数据,标准化后通过Apriori算法建模,并使用Clementine12.0软件进行关联规则分析。结果:1928例患者年龄大多为75~90岁(54.26%),男性多于女性,常合并2型糖尿病、脑梗死等;每次用药剂量多为10 mL以上(52.78%)。临床常联用西药为阿司匹林肠溶片(67.63%)、左卡尼汀注射液(58.77%)、阿托伐他汀钙胶囊(50.93%);常联合的中药为红花黄色素(22.20%)、麝香保心丸(16.55%)、速效救心丸(15.09%);最常联合应用的西药种类为抗凝溶栓及抗血小板药(85.84%)、中药种类是活血化瘀剂(72.98%);联合2种西药最常见的组合为左卡尼汀注射液+阿司匹林肠溶片,支持度41.9%;联合2种中西药物作用最常见的组合是西药·抗心绞痛药+西药·抗凝溶栓及抗血小板药,支持度67.6%。结论:应用丹参川芎嗪注射液的冠心病合并高血压患者以老年男性为主,合并症多;需加强剂量规范;联合用药与指南相契合,有一定规律可循,可提供临床诊治、优化用药线索。

Objective:To explore the characteristics and rules of Danshen Ligustrazine Injection in the treatment of coronary heart disease with hypertension.Methods:From the information systems of 12 tertiary tier-one hospitals across the country,we extracted the medical data of the application of Danshen Ligustrazine Injection in the treatment of patients with coronary heart disease and hypertension.After normalization,the model was established by Apriori algorithm,and the association rules were analyzed by Clementine 12.0 software.Results:Most of the 1928 patients were between 75 and 90 years old(54.26%).There were more males than females,most with type 2 diabetes,cerebral infarction,etc.Each dose was more than 10 mL(52.78%).Aspirin enteric-coated tablets(67.63%),L-carnitine injection(58.77%),and atorvastatin calcium capsules(50.93%)were often used in combination with safflower yellow pigment(22.20%),Shexiang Baoxin Pill(16.55%),Suxiao Jiuxin Pill(15.09%);the most commonly used combination of western medicine was anticoagulant thrombolytic and antiplatelet drugs(85.84%),and the type of Chinese medicine was Huoxuehuayu(72.98%);The most common combination of two western medicines was L-carnitine injection+aspirin enteric-coated tablets,with a support of 41.9%;The most common combination of two Chinese and western medicines is western medicine·anti-anginal medicine+western medicine·anticoagulant thrombolytic and antiplatelet drugs with a support of 67.6%.Conclusion:Danshen Ligustrazine injection is mainly used in elderly patients with coronary heart disease and hypertension,with many comorbidities.The dosage standard needs to be optimized.The combination of drugs and guidelines should coordinate with each other,which provide clues for clinical diagnosis and treatment and optimization of medication.