真实世界大数据30034例高血压病住院患者中西医诊疗规律初探  

Study on medical pattern of traditional Chinese medicine and western medicine diagnosis and treatment of hypertension patients in 30 034 cases in real world

作　　者：马金辉[1,2] 王志飞[1] 谢雁鸣[1] 杨薇[1] 杨志欣[3] 庄严[4] 王永炎[1] 

机构地区：[1]中国中医科学院中医临床基础医学研究所,北京100700 [2]北京市和平里医院,北京100013 [3]中国人民大学统计学院,北京100872 [4]中国人民解放军海军总医院,北京100037

出　　处：《中国中药杂志》2014年第18期3435-3441,共7页China Journal of Chinese Materia Medica

基　　金：国家"重大新药创制"科技重大专项(2009ZX09502030);中国中医科学院基本科研业务费自主选题项目(ZZ0808016)

摘　　要：该研究选择全国16家三甲医院中第一诊断为高血压的住院患者,应用频数分析和关联规则开展数据分析,了解真实世界中高血压病住院患者一般信息及其诊疗情况：高血压病住院患者的平均年龄为64岁;男女比例约为1.10：1;入院病情为危急者约占总人数的10.12%;多集中在心血管科;住院天数多在8-14 d;住院费别医保占62.93%;住院总花费分布最多的是0.5万-1万元;高血压病患者多合并冠心病、血脂蛋白紊乱血症;中医证候以痰瘀互结和肝肾阴虚居多;中药治疗以应用活血化瘀药为主;西药治疗基本符合指南;降压药物钙离子拮抗剂最多,约占总人数的81.2%;ACEI类、ARB类、β-受体阻滞剂、利尿剂类依次占比为43.0%,43.4%,42.4%,42.4%,固定复方仅为约占8.0%;五大类降压药总频数是78 206次。因此,高血压病住院患者以老年人居多,男性多于女性,住院费别多以医保居多,近半数人群合并冠心病,证候以痰瘀互结居多,西药基本符合指南,联合用药较多,固定复方制剂较少,中药以活血化瘀药物为主。提示临床治疗上在严格降压的同时,注意联合用药及使用固定复方制剂,结合中药化痰祛瘀,减少靶器官损害,降低并发症。为临床防治高血压病提供参考和借鉴。Select patients diagnosed of hypertension in the first place in 16 hospitals and the patients were described by association rules analysis and distribution for the analysis in the study,in order to understand the information of diagnosis and treatment in hypertension patients in real world.The information include age,gender,admission condition,inpatient department,hospitalization expenses,western medicine comorbidities,the traditional Chinese medicine（TCM） syndrome and the medicine.The average age of patients was 64 years in the study.The proportion of men to women about 1.10：1.Admission condition is critical for about 10.12%of the total and more concentrated in the cardiovascular department.Hospital stay ranged from 8 to 14 d.Inpatients with medical insurance is62.93%.Total hospitalization cost distribution most is the 5 000-10 000 RMB.Hypertension complicated with coronary heart disease,blood lipoprotein disorder disease;phlegm and blood stasis and Yin deficiency of liver and kidney are the most in TCM syndrome type.Promoting blood circulation and removing blood stasis is the major in Chinese medicine treatment.Western medicine treatment basically conforms to the guidelines.The most antihypertensive drugs is calcium antagonistst,accounting for about 81.2%of the total number.Class ACEI,class ARB,beta blockers,diuretics class are accounted for 43.0%,43.4%,42.4%,42.4%,fixed compound is only2 393,accounting for about 8%.the total frequency of five classes of antihypertensive drugs is 78 206 times.The principal conclusions of this analysis are as follows：the elderly people is the most in hypertension,more men than women;medical insurance is the majority type in hospitalization cost;nearly half of the population is combined with coronary heart disease;phlegm and blood stasis and yin deficiency of liver and kidney are the most in TCM syndrome type;western medicine treatment basically conforms to the guidelines.Combination therapy is more,less fixed compound preparation in western medicine.Chinese medicine is m

关 键 词：医院信息数据库 高血压 中医证候 合并病 

分 类 号：R259[医药卫生—中西医结合]