基于真实世界的喜炎平注射液治疗扁桃体炎的复杂网络分析

Complex Network Analysis on Xiyanping Injection in Combined Use with Chinese and Western Medicine for Amygdalitis in Real World Study

目的基于真实世界中喜炎平注射液治疗扁桃体炎的联合用药现状行复杂网络分析。方法选取来源于全国29家大型三甲医院多维数据仓库HIS系统中喜炎平注射液治疗扁桃体炎的数据,根据联合用药种类和频次构建复杂网络,并采用Tabu搜索算法对其网络矩阵行联合用药规律分析。结果经分析联合用药网络及药理学可知,单纯扁桃体炎临床治疗方案:(1)病毒感染:单用喜炎平注射液;(2)有细菌学感染证据:喜炎平注射液联用抗生素类药物。扁桃体炎及合并症临床治疗方案:(1)合并急性支气管炎或支气管肺炎:喜炎平注射液联用地塞米松、盐酸氨溴索,或联用抗生素,或联用痰热清注射液;(2)合并手足口病:喜炎平注射液联蓝芩口服液或痰热清注射液;(3)合并病毒性脑炎:喜炎平注射液联用阿糖腺苷;(4)合并腺样体肥大或鼾症:喜炎平注射液联用抗生素类药物,急性期辅以布地奈德雾化吸入,慢性期辅以氨溴索化痰,同时用康复新液局部冲洗。结论喜炎平注射液作为治疗扁桃体炎及其合并症的主要治疗药物,临床应用广泛,且效果显著,符合最新专家共识推荐;其联合用药因其扁桃体炎患者合并症不同而存在差异,该联合用药方案可作为制定其合并症用药策略的参考依据,为进一步因果研究提供信号和思路。

Objective Complex network analysis was performed based on the current situation of Xiyanping Injection in treating tonsillitis in the real world.Methods Data of Xiyanping Injection in the treatment of tonsillitis from HIS system of 29 large third-class grade A hospitals in China were selected to construct a complex network according to the type and frequency of drug combination,and Tabu search algorithm was used to analyze the rules of drug combinations in the network matrix.Results Based on the analyses of combined drug network and pharmacology,the clinical treatment plan of simple tonsillitis was as follows:(1)virus infection:Xiyanping Injection alone;(2)Evidence of bacteriological infection:Xiyanping Injection combined with antibiotics.Clinical treatment of tonsillitis and complications:(1)complicated with acute bronchitis or bronchial pneumonia:Xiyanping Injection combined with dexamethasone,ambroxol hydrochloride,or combined with antibiotics,or combined with Tanreqing Injection;(2)complicated with hand,foot,and mouth disease:Xiyanping Injection combined with Lanqin Oral Liquid or Tanreqing Injection;(3)complicated with viral encephalitis:Xiyanping Injection combined with atosine;(4)complicated with adenoid hypertrophy or snoring:Xiyanping Injection combined with antibiotics,supplemented by Budesonide atomization inhalation in the acute phase;supplemented by Ambroxol phlegm in the chronic phase,and local flushing with Kangfuxin Solution.Conclusions Xiyanping Injection,as the main treatment for tonsillitis and its complications,is widely used in clinical practice and has remarkable effect,which is in line with the latest expert consensus recommendation.The drug combination varies due to different complications of tonsillitis patients.This drug combination regimen can be used as a reference for the formulation of drug strategy for complications,and provide signals and ideas for further causal studies.