喜炎平注射液治疗细菌性肠道感染临床用药及复杂网络分析

Clinical medication and complex network analysis of Xiyanping injection in the treatment of bacterial intestinal infection

目的:分析喜炎平注射液治疗细菌性肠道感染真实世界临床用药的特点,筛选出喜炎平注射液治疗细菌性肠道感染及并发症临床用药方案。方法:从中国中医科学院中医临床基础医学研究所构建的医院信息系统(Hospital Information System,HIS)数据仓库中,抽取了全国29家三甲医院3727例使用喜炎平注射液治疗细菌性肠道感染患者的数据,采用Tabu搜索算法对真实世界临床用药进行复杂网络分析。结果:3岁以内儿童是细菌性肠道感染高发人群。对于基础治疗,喜炎平注射液常联合使用西咪替丁、蒙脱石散制剂、氨基酸多肽复方、活菌制剂、多种维生素及微量元素。对于抗感染治疗,常用二代、三代头孢菌素抗菌药物。免疫功能低下感染者,成人可采用喜炎平注射液联合左氧氟沙星+西咪替丁+胸腺肽,儿童可联合头孢菌素。细菌感染严重者,如有伤寒菌血症,头痛、意识障碍等症状,可采用喜炎平注射液+头孢替安+免疫球蛋白类+干扰素α+多巴酚丁胺+醒脑静注射液。志贺氏菌引起急性全身感染者,可采用喜炎平注射液+纳美芬注射液+黄芪注射液+胞磷胆碱+中药灌肠。志贺氏菌和痢疾引起发热、精神障碍甚至中毒性休克者,可采用喜炎平注射液+多巴胺+氢化可的松+咪达唑仑+美罗培南。安全性上,须按照药品说明书使用,注意避免混合配伍。结论:真实世界喜炎平注射液常用于儿童细菌性肠道感染治疗,在对症治疗和抗感染治疗中多合并使用西药。

Objective:To analyze the characteristics of clinical medication of Xiyanping injection(喜炎平注射液)in treating bacterial intestinal infection in the real world,and screen out the clinical medication plan of Xiyanping injection in treating bacterial intestinal infection and its complications.Methods:The data of 3727 patients with bacterial intestinal infection treated with Xiyanping injection from 29 top three hospitals in China was extracted from the HIS data warehouse constructed by the Institute of Clinical Basic Medicine of Chinese Medicine,Chinese Academy of Traditional Chinese Medicine.Tabu search algorithm was used to analyze the complex network of real world clinical drugs.Results:Children under 3 years old had a high incidence of bacterial intestinal infection.For basic treatment,Xiyanping injection is often combined with cimetidine,montmorillonite powder preparation,amino acid polypeptide compound,living bacteria preparation,vitamins and trace elements.The third generation cephalosporins and the second generation cephalosporins are commonly used as antibacterial drugs.For the anti-infection treatment and the infection with low immune function,the adults can take the combination of Xiyanping injection and levofloxacin+cimetidine+thymosin,and the children can take the combination of cephalosporin.Some people who have serious bacterial infections,such as typhoid bacteremia,headache,disturbance of consciousness and other symptoms can be treated with Xiyanping injection+Cefotiam+immunoglobulins+interferonα+Dobutamine+Xingnaojing injection.Acute systemic infection caused by Shigella can be treated with Xiyanping injection+Huangqi(Namefene)injection(黄芪注射液)+astragalus injection+citicoline+TCM medicine enema.Shigella and dysentery can cause fever,psychiatric disorders and even toxic shock,which can be treated with Xiyanping injection+dopamine+hydrocortisone+midazolam+meropenem.In terms of safety,it must be used according to the drug instructions to avoid mixing and compatibility.Conclusion:In the real world,Xiyanping injection is commonly used in the treatment of bacterial infection among children,and it is often combined with Western medicine in symptomatic treatment and anti-infection treatment.