半夏不良反应数据挖掘与分析

Data mining and analysis of adverse reactions of Pinelliae rhizoma

目的:通过统计分析半夏不良反应病例,剖析半夏中毒特点与临床使用注意事项,为半夏临床合理用药提供借鉴依据。方法:检索1981年1月—2021年5月半夏毒性反应相关文献,建立数据库并进行分项统计与分析,分别从:(1)患者性别、年龄分布与用药原因;(2)半夏用法用量、用药疗程、配伍、炮制;(3)毒性反应发生时间、临床表现、严重程度等角度分析半夏中毒特点。结果:共纳入124例半夏不良反应病例,发现半夏口服及外用均可致毒性反应。口服半夏致毒反应可涉及多脏器损伤,以消化系统损害、呼吸系统损害、皮肤及其附件损害为主,在半夏毒性反应症状例次统计中,其占比分别为40.64%、21.18%、17.24%,以舌部/口腔咽喉部发麻或疼痛、上腹部不适、呕吐最为多见;外用半夏致毒以皮肤及其附件损害为主,主要表现为舌部/口腔咽喉部发麻或疼痛。半夏毒性反应的影响因素有:误服、未经炮制或炮制不当、超剂量用药、超疗程用药以及配伍不当等。结论:临床可以通过按指征用药、严控量程、避免重复、合理配伍、用药告知等方式来减少或避免半夏毒性反应发生,促进半夏临床合理用药。

Objective:Through the study of cases of Pinelliae rhizoma adverse reactions,the characteristics of Pinelliae rhizoma poisoning and points for attention in clinical of Pinelliae rhizoma use were analyzed to provide reference for its clinical rational drug use.Methods:Literature related to toxic reactions of Pinelliae rhizoma from January 1981 to May 2021 was retrieved,and a database was established for statistical analysis.The characteristics of Pinelliae rhizoma poisoning were analyzed from the following aspects:(1)Gender,age distribution of patients and reasons for medication;(2)Pinelliae rhizoma usage and dosage,medication course,compatibility processing;(3)Analyze the charactcristics of Pinelliae rhizoma poisoning from the perspectives of the occurrence time,clinical manifestations and severity of toxic reactions.Results:A total of 124 cases of Pinelliae rhizoma adverse reaction were included,it was found that Pinelliae rhizoma could cause adverse reactions both orally and topically.Poisoning reactions caused by oral administration of Pinelliae rhizoma could involve multiple organ injuries,mainly digestive system damage,effects of respiratory system,skin damage.In the case statistics of the toxic reaction symptoms of Pinelliae rhizoma,the proportion was 40.64%,21.18%,17.24%,with tongue/oral throat numbness or pain,upper abdominal discomfort,nausea and vomiting the most common;Aderse reactions caused by external application of Pinelliae rhizoma were mainly skin and accessory damage,and the main manifestations were tongue/mouth and throat numbness or pain.The main risk factors of adverse reactions/events of Pinelliae rhizoma were:misadministration,unprocessed or improperly processed,overdose medication overtrentment course and improper compatibility.Conclusion:In clinical practice,the occurrence of toxic reactions of Pinelliae rhizoma can be reduced or avoided by using drugs according to indications,strictly controlling the range,avoiding duplication,reasonable compatibility,and medication notification,so as to promote the rational use of Pinelliae rhizoma in clinical practice.