基于louvain算法生脉注射液治疗AP的真实世界优效方案研究

Optimal scheme of Shengmai Injection in the treatment of angina pectoris of coronary heart disease based on Louvain algorithm:A real world study

目的:挖掘生脉注射液治疗心绞痛(AP)的优效方案供临床医生借鉴。方法:基于中国中医科学院中医临床基础医学研究所建立的大型数据仓库,采集了全国22家三级甲等医院的医院信息系统(hospital information system,HIS),选取1 751例使用生脉注射液后AP症状好转的患者,采用Louvain算法及复杂网络分析方法,总结出在使用生脉注射液基础上,联合其他药物治疗AP的用药方案。结果:针对症状治疗,联合使用硝酸酯类药物或速效救心丸扩张冠状动脉;针对AP的危险因素治疗,联合使用“胰岛素+阿卡波糖+比索洛尔+硝苯地平+卡托普利+艾司唑仑”控制血糖血压、“感冒清热颗粒+左氧氟沙星”治疗上呼吸道感染等用药方案;针对AP的并发症治疗,联合使用“呋塞米+螺内酯+氯化钾”减轻水肿“、硝酸异山梨酯+美托洛尔+参麦注射液+稳心颗粒”改善气阴两虚型心力衰竭用药方案。结论:生脉注射液联合中西医药物的治疗方案与现行指南基本一致,仍需要大量的临床研究来探索更多疗效显著的联合用药方案。

Objective:To explore the optimal scheme of Shengmai Injection combined with other drugs for clinical doctors.Methods:Based on the large-scale data warehouse established by the institute of Clinical Basic Medicine,Chinese Academy of Traditional Chinese Medicine,the hospital information system of 22 large-scale tertiary hospitals in China was collected and 1751 patients with angina pectoris who were treated with Shengmai Injection were selected.Louvain algorithm and complex network analysis are used to build the model to summarize the rule of Shengmai Injection in the treatment of angina pectoris of coronary heart disease.Results:On the basis of Shengmai Injection,according to the symptom treatment of angina pectoris of coronary heart disease,nitrates or Suxiao Jiuxin Pill was used to dilate coronary artery;for the treatment of risk factors of angina pectoris,a combination of"insulin+acarbose+bisoprolol+nifedipine+captopril+estazolam"was used to control blood glucose and blood pressure;"Ganmao Qingre Granule+levofloxacin"to treat upper respiratory tract infection and other medication regimens were used as well.For the complications of angina pectoris of coronary heart disease,"furosemide+spironolactone+potassium chloride+magnesium sulfate"was used to reduce edema and"isosorbide nitrate+metoprolol+Shenmai injection+Wenxin Granule"was used to improve symptom of heart failure of qi and yin deficiency type.Conclusion:The therapeutic regimen of Shengmai Injection combined with traditional chinese medicine and western medicine is basically consistent with the current guide‐lines,but more clinical studies are still needed to explore more effective combination therapy.