基于louvain算法的生脉注射液治疗心肌梗死的真实世界优效方案研究

Real-World Optimal Efficacy of Shengmai(生脉)Injection in the Treatment of Myocardial Infarction:Based on Louvain Algorithm

目的:分析真实世界生脉注射液治疗心肌梗死的联合用药方案,为生脉注射液更好地应用于心肌梗死的治疗提供参考。方法:提取全国24家三甲医院信息系统(hospital information system,HIS)数据库中使用生脉注射液治疗的1208名心肌梗死患者的用药信息,利用Louvain算法对数据进行复杂网络分析,筛选出针对心肌梗死病因、症状、并发症的中西药联合用药方案。结果:针对病因的治疗可以联合使用“单硝酸异山梨酯+乙酰水杨酸+丹参注射液+麝香保心丸”扩冠抗栓、“人胰岛素+阿卡波糖+阿伐他汀+贝那普利”降糖调脂降压;针对症状的治疗可以联合使用“吗啡+地西泮+丹红注射液”缓解疼痛、“氯吡格雷+奥美拉唑+泮托拉唑+甲氧氯普胺”改善消化道症状;针对并发症的治疗可以联合应用“地高辛+参附注射液+呋塞米+螺内酯”强心利尿,缓解心衰。结论:生脉注射液联合其他中成药和西药治疗心肌梗死体现了中西结合治疗的优势,有利于今后更好地展开心肌梗死个体化综合治疗,未来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 analyze the combined drug regimen of Shengmai(生脉)Injection in treatment of myocardial infarction in the real world and further to provide reference for the clinical application of the injection.Methods:The medication information of 1208 patients with myocardial infarction treated with Shengmai(生脉)Injection was collected from the hospital information system(HIS)of 24 first-class hospitals,and Louvain algorithm was employed for complex network analysis of the data in a bid to screen the combined regimens of Chinese and western medicine for the causes,symptoms and complications of the disease.Results:The combinations targeting the causes are as follows:"isosorbide mononitrate+acetylsalicylic acid+Danshen(丹参)Injecction+Shexiang Baoxin(麝香保心)Pills"for coronary artery dilatation and anti-thrombus,and"human insulin+acarbose+avastatin+benazepril"for lowering blood glucose and lipids and blood pressure.As for the treatment of symptoms,the combinations are as below:"morphine+diazepam+Danghong(丹红)Injection"for relieving pain,and"clopidogrel+omeprazole+pantoprazole+metoclopramide"for alleviating digestive tract symptoms.As to the treatment of complications,"digoxin+Shenfu(参附)Injection+furosemide+spironolactone"is used for cardiac,diuretic and alleviating heart failure.Conclusion:The combination of Shengmai(生脉)Injection with other Chinese patent medicines and western medicines in the treatment of myocardial infarction is an indication of the superiority of combination of Chinese and western medicine,which allows individualized treatment of myocardial infarction.More clinical studies are expected to explore more effective combined drug schemes in the future.