基于25704例电子医疗病历的参附注射液临床常用药物组合方案探索研究  

Common clinical medical combinations with Shenfu injection based on 25704 electronic medical records

作　　者：彭时雨[1,2] 杨薇[1] 谢雁鸣[1] 李霖[3] 庄严[4] 

机构地区：[1]中国中医科学院中医临床基础医学临床所,北京100700 [2]中国中医科学院望京医院,北京100102 [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》2015年第12期2435-2439,共5页China Journal of Chinese Materia Medica

基　　金：国家"重大新药创制"科技重大专项(2009ZX09502030);中国中医科学院博士研究生创新人才培养基金项目;中药上市后临床再评价关键技术创新团队(PY1303)

摘　　要：参附注射液为临床常用药,为了解真实世界参附注射液临床常用药物组合方案,该研究以中国中医科学院中医临床基础医学研究所建立的医院信息系统(hospital information system,HIS)数据仓库中25 704位使用参附注射液患者为研究对象,采用关联规则对使用参附注射液患者的常用药物组合进行关联性分析,发现参附注射液临床使用过程中合并1种药物使用时,与奥美拉唑、利多因卡、呋塞米同时使用概率分别为22.19%,20.32%,19.61%;参附注射液合并2种药物使用时,使用概率位于前3位的分别是咪达唑仑+奥美拉唑为11.01%、利多卡因+奥美拉唑为10.80%、丙泊酚+咪达唑仑为10.76%;参附注射液合并3种药物使用时,使用概率位于前3位分别是丙泊酚+芬太尼+咪达唑仑为8.83%、瑞芬太尼+丙泊酚+咪达唑仑为8.77%、丙泊酚+咪达唑仑+奥美拉唑为8.77%。进一步分析得出,参附注射液+丙泊酚+芬太尼+咪达唑仑组合可能起到降低麻醉过程中低血压和心动过缓的发生率,加快麻醉后苏醒,减轻麻醉后遗效应的协同作用。参附注射液+呋塞米组合可能通过减少回心血量和增强心肌的收缩力及活力,起到对急性左心衰竭治疗的协同作用。参附注射液+奥美拉唑组合可能起到缩短消化道溃疡愈合时间,减少溃疡复发的协同作用;同时,在治疗溃疡性出血时可能起到防止失血性休克及休克所致应激性溃疡发生的协同作用。Shenfu injection is a common clinical medicine. To explore the common clinical medical combinations with Shenfu injection the real world, 25 704 patients who used Shenfu injection were selected from the hospital information system （HIS） database established by Clinical and Basic Research Institute for Traditional Chinese Medicine of China Academy of Chinese Medical Sciences. The association rules were applied in a correlation analysis on common medical combinations with Shenfu injection in the patients. According to the findings cwhen Shenfu injection was combined with a single medicine in clinic, the ratio of using Omeprazole, Lidocaine or Furosemide were respectively 22. 19% , 20. 32%, 19. 61% ; when Shenfu injection was combined with two medicines, the top three medical combinations were respectively midazolam ＋ omeprazole （ 11.01% ） , hdocaine ＋ omeprazole （ 10. 8% ） and propofol ＋ midazolam （10. 76% ）; when Shenfu injection was combined with three medicines, the top three medical combinations were respectively propofol ＋ fentany ＋ midazolam （ 8.83% ）, remifentanil ＋ propofol ＋ midazolam （ 8.77% ） and propofol ＋ midazolam ＋ omeprazole （8. 77% ）. According to the further analysis, the combination of Shenfu injection and Propofol ＋ Fentany ＋ Midazolam may reduce the incidence of hypotension and bradycardia during anesthesia, accelerate recovery after anesthesia and relieve the synergistic effect after anesthesia. The combination of Shenfu injection and furosemide may show the synergistic effect in treating the acute left ventricular failure by reducing the returned blood volume and increasing the myocardial contractile force and vitality. The combination of Shenfu injection and Omeprazole may play the synergistic effect in shortening the digestive tract ulcer healing time, reducing the ulcer recurrence and preventing hemorrhagic shock and stress ulcer caused by shock in treating ulcer hemorrhage.

关 键 词：参附注射液 药物组合 关联分析 真实世界 

分 类 号：R288[医药卫生—中药学]