基于Tabu搜索算法分析真实世界中原发性肝癌的用药特征

Real-World Study on the Medication Characteristics for Primary Liver Cancer Based on Tabu Search

目的:探讨真实世界中原发性肝癌患者的临床中西药物使用特征。方法:提取全国33家三甲医院中49732例原发性肝癌患者的电子医疗数据,采用Tabu搜索算法对其临床用药信息进行复杂网络分析。结果:共纳入128类西药,666种西药药品,临床最常用的3大类化疗药物分别是抗代谢类细胞毒类药、抗生素类细胞毒类药和铂剂类细胞毒类药;保肝药高居西医用药首位,还原性谷胱甘肽、复方甘草酸苷和多烯磷脂酰胆碱是临床最常用的3种保肝药品;免疫调节药使用频数仅次于保肝药,临床应用最多的是胸腺肽ɑ1注射液;西医对症支持治疗多涉及镇痛药、5-HT受体阻断药、利尿药、肾上腺皮质激素类药、电解质平衡调节药、镇静药、等。共纳入19类中药,129种中药药品,清热解毒剂使用频数居于首位,益气扶正剂次之,理气剂、活血化瘀药、破血药等分别以较高频次紧随其后。消癌平注射液、复方苦参注射液、槐耳颗粒是临床治疗肝癌居于前3的中药制剂。结论:本研究基于Tabu搜索算法分析原发性肝癌的临床用药特点,表明西药以抗肿瘤和对症治疗为主,中药以清热解毒和益气扶正为主,提倡中西医结合治疗,发挥中药增效减毒、提高免疫、逆转耐药、防止复发等独特优势。

Objective:To explore the characteristics of the clinical use of Chinese and western medicines in patients with primary liver cancer(PLC)in the real world.Methods:The electronic medical records of 49732 PLC patients from 33 top hospitals in China were extracted,and Tabu Search was employed for analyzing the clinical drug information.Results:A total of 666 western medicines in 128 categories were screened out.The three most frequently used clinical chemotherapeutic drugs were anti-metabolism cytotoxic drugs,antibiotic cytotoxic drugs,and platinum cytotoxic drugs.Liver-protecting drugs ranked the first in all western medicines,and reduced glutathione,compound glycyrrhizin,and polyene phosphatidylcholine were most commonly used.The use frequency of immunomodulators was second only to liver-protecting drugs,and thymosinɑ1 injection was the most widely used one.The symptomatic and supportive drugs in western medicine were analgesics,5-HT receptor blockers,diuretics,adrenocortical hormones,electrolyte balance regulators,sedatives,etc.A total of 129 Chinese medicines in 19 categories were retrieved.Qingrejiedu(清热解毒)drugs took the first place in use frequency,followed by Yiqifuzheng(益气扶正)drugs,Liqi(理气)drugs,Huoxuehuayu(活血化瘀)drugs,and Poxue(破血)drugs.Xiaoaiping Injection(消癌平注射液),Compound Kushen Injection(复方苦参注射液),and Huaier Granules(槐耳颗粒)were the top three Chinese medicine preparations for clinical treatment of liver cancer.Conclusion:With Tabu Search,we analyzed the characteristics of clinical medications for PLC and found that anti-tumor and symptomatic treatment was preferred in western medicine,while Qingrejiedu(清热解毒)and Yiqifuzheng(益气扶正)were emphasized in Chinese medicine.The combination of Chinese and western medicine is advocated to give full play to the unique advantages of Chinese medicine,such as enhancing efficacy,reducing toxicity,improving immunity,reversing drug resistance,and preventing recurrence.