基于关联规则分析法探讨疾病诊断相关分组下脑缺血疾病的药物联合应用情况  

Drug Combination for Cerebral Ischemia Disease Under Diagnosis-Related Groups Based on Association Rule Analysis Method

作　　者：甘岚澜 伍渊麟 向贵圆 陈世耕 鲜秋婉 刘耀 GAN Lanlan;WU Yuanlin;XIANG Guiyuan;CHEN Shigeng;XIAN Qiuwan;LIU Yao(Dept.of Pharmacy,Army Medical Center of PLA,Chongqing 400042,China;Medical Insurance Office,Army Medical Center of PLA,Chongqing 400042,China;Medical Office,Army Medical Center of PLA,Chongqing 400042,China)

机构地区：[1]陆军特色医学中心药剂科,重庆400042 [2]陆军特色医学中心医保办,重庆400042 [3]陆军特色医学中心医研部医疗办,重庆400042

出　　处：《中国医院用药评价与分析》2023年第11期1369-1372,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：重庆市临床药学重点专科建设项目(No.渝卫办发[2020]68号);2021年重庆市中青年医药高端人才项目。

摘　　要：目的:探究该院神经内科与全科医学科治疗脑缺血疾病的住院费用及用药情况,为脑缺血疾病治疗中的中成药与西药联合应用提供参考。方法:调取2022年1—10月该院出院的“脑缺血性疾患,不伴合并症或并发症”[国家医疗保障疾病诊断相关分组(CHS-DRG)为BR25病组]病例,剔除收治病例数<10例的科室,运用倾向评分匹配法(PSM)对病例进行匹配,并对匹配前后的病例基本信息及住院费用、药品费用进行统计分析。采用频数分析法对病例的用药基本信息进行统计,基于关联规则分析法分析中成药与西药联合应用情况。结果:BR25病组的收治科室涉及8个科室,主要集中在神经内科和全科医学科。神经内科治疗BR25病组的医疗资源消耗高于重庆市该病组平均水平;而全科医学科在脑缺血疾病的治疗中表现出良好的经济效应。上述2个科室使用频率排序居前6位的药物类型中均有其他神经系统药物、治疗功能性胃肠道疾病的药物、调节血脂药、抗血栓形成药。其中全科医学科使用频率排序居第3位的药物类型为治风剂;进一步关联规则分析结果显示,治风剂、调节血脂药和其他神经系统药物的联合应用最多。结论:在治疗脑缺血疾病时,与神经内科相比,全科医学科的用药特点在于治风剂的使用较多。治风剂与调节血脂药和其他神经系统药物联合治疗脑缺血疾病,可改善疗效。但由于中成药成分复杂,临床应进一步重点关注中成药与西药联合应用的安全性和有效性,使联合用药更科学、规范、合理。OBJECTIVE:To explore the hospitalization costs and medication for the treatment of cerebral ischemia disease in neurology department and general medicine department of the hospital,so as to provide reference for the combined application of Chinese patent medicine and Western medicine in the treatment of cerebral ischemia diseases.METHODS:Cases of cerebral ischemic without comorbidities or complications[China Healthcare Security Disease Diagnosis-Related Grouping(CHS-DRG)for disease group BR25]in the hospital from Jan.to Oct.2022 were retrieved,clinical departments with<10 admissions were excluded,and the propensity score matching(PSM)method was applied to match the cases,so that the basic information,hospitalization costs and drug costs were statistically analyzed before and after cases matching.The basic medication information of the cases was statistically analyzed by using frequency analysis method,the combined application of Chinese patent medicine and Western medicine was analyzed based on association rule analysis method.RESULTS:A total of 8 clinical departments were involved with the BR25 disease group,mainly focusing on neurology department and general medicine department.The consumption of medical resources in the neurology department for the treatment of BR25 disease group was higher than the average level of this disease group in Chongqing;while the general medicine department showed good economic effects in the treatment of cerebral ischemic diseases.All the top 6 drug categories used in the above 2 departments included other neurological drugs,drugs for functional gastrointestinal diseases,lipid regulators and antithrombotic drugs.The drug ranked the 3rd highest frequency in the general medicine department was wind-curing formula;results of further association rule analysis showed that the combination of wind-curing formula,lipid regulators and other neurological drugs was the most common.CONCLUSIONS:In the treatment of cerebral ischemic diseases,the drug application in general medicine department is

关 键 词：脑缺血疾病 倾向评分匹配法 中成药 西药 关联规则分析 

分 类 号：R969.3[医药卫生—药理学] R97[医药卫生—药学]