真实世界2999例使用尪痹片治疗膝骨关节炎患者的临床特征及用药规律分析  

Analysis on Clinical Characteristics and Medication Patterns of 2999 Patients with Knee Osteoarthritis Treated with Wangbi Tablets Based on the Real World

作　　者：张跨越 李超 吴卓耘 董亚炜 刘毓之 林嘉铭 陈月峰 宓保宏 龚春柱[5] 蔺福辉[5] 陈卫衡 ZHANG Kuayue;LI Chao;WU Zhuoyun;DONG Yawei;LIU Yuzhi;LIN Jiaming;CHEN Yuefeng;MI Baohong;GONG Chunzhu;LIN Fuhui;CHEN Weiheng(The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China;Engineering Research Center of Chinese Orthopaedics and Sports Rehabilitation Artificial Intelligent,Ministry of Education,Beijing 100029,China;Institute of Orthopedics and Traumatology,Beijing University of Chinese Medicine,Beijing 100029,China;National Olympic Sports Center,Beijing 100029,China;Shenzhen Pingle Orthopedics Hospital,Shenzhen 518118,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]中医骨伤治疗与运动康复智能化教育部工程研究中心,北京100029 [3]北京中医药大学骨伤科研究所,北京100029 [4]国家奥林匹克体育中心,北京100029 [5]深圳平乐骨伤科医院,广东深圳518118

出　　处：《中国中医药信息杂志》2025年第2期156-163,共8页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：首都卫生发展科研专项重点攻关项目(首发2022-1-7032);深圳市“医疗卫生三名工程”项目(SZZYSM202311020)。

摘　　要：目的研究真实世界中使用尪痹片治疗膝骨关节炎(KOA)患者的临床特征及用药规律,分析中成药治疗优势病种的优势环节与用药特点。方法采用前瞻性病例注册登记研究方法,于2019年4月-2021年12月在全国30家中、西医院共注册登记患者3000例,纳入性别、年龄、体质量指数(BMI)、临床分期、Kellgren-Lawrence(K-L)分级、用药时长、视觉模拟评分(VAS)、既往病史、联合用药资料进行描述性分析,对不同分期及单独用药组(单用组)、联合用药组(联用组)进行比较,利用Apriori算法对联合用药情况进行关联性分析。结果最终纳入患者2999例,其中女性2063例(68.79%)、男性936例(31.21%),年龄(56.89±8.90)岁,BMI(23.80±2.88)kg/m^(2);发作期512例(17.07%),VAS中位数8分;缓解期2181例(72.73%),VAS中位数6分;康复期306例(10.20%),VAS中位数3分;K-L分级Ⅰ级316例(10.54%)、Ⅱ级2477例(82.59%)、Ⅲ级204例(6.80%)、Ⅳ级2例(0.07%)。用药分析显示,单用组1507例(50.25%)多于联用组1492例(49.75%)。联用药物数量方面,以1种(39.01%)和2种(38.14%)为主;用药种类方面,以联合西药(62.27%)、同时联用西药+中药(26.14%)为主;联用频次前3位的药物是氨基葡萄糖胶囊、艾瑞昔布片、玻璃酸钠注射液,支持度前3位的药物组合分别为“活血治伤散+艾瑞昔布片”“氨基葡萄糖胶囊+艾瑞昔布片”“氨基葡萄糖胶囊+玻璃酸钠注射液”。组间比较显示,发作期患者尪痹片用药时长大于缓解期和康复期(P<0.01);发作期中单独用药患者占比(62.11%)高于缓解期(46.54%)和康复期(56.86%)(P<0.001);发作期(16.41%)和康复期(21.24%)患者中联用1种药物占比最高,缓解期(20.50%)联用2种药物占比最高;发作期(19.53%)、缓解期(33.70%)、康复期(30.72%)患者均以联用西药占比最高。结论真实世界使用尪痹片治疗KOA患者中单独用药比例超过1/2,发作期患者近1/5,VAS中位数8分,发作期、缓解期、康复期�Objective To study the clinical characteristics and medication patterns of Wangbi Tablets in treating patients with knee osteoarthritis(KOA)in the real world and to analyze the advantages and specific features of Chinese patent medicines in treating advantage disease.Methods A prospective case registry study was conducted,registering 3000 patients from 30 TCM and Western medicine hospitals across China from April 2019 to December 2021.Data on gender,age,BMI,Chinese medicine staging(CMS),K-L grading,medication duration,VAS score,medical history and combined medication were collected for descriptive analysis.Comparisons were made between different stages and between single-use and combined-use groups.The Apriori algorithm was used for association analysis of combined medications.Results A total of 2999 patients were included,with 2063 females(68.79%)and 936 males(31.21%).The average age was(56.89±8.90)years.The average BMI was(23.80±2.88)kg/m^(2).The proportion of patients in CMS Ⅰ was 512(17.07%),with a VAS median score of 8,while the proportion of patients in CMSⅡwas 2181(72.73%),with a VAS median score of 6.The proportion of patients in CMSⅢwas 306(10.20%),with a VAS median score of 3;316 cases(10.54%)were classified as K-L grade Ⅰ,2477 cases(82.59%)as gradeⅡ,204 cases(6.80%)as gradeⅢ,and 2 cases(0.07%)as gradeⅣ.Medication analysis indicated that the single-use group(1507 cases,50.25%)was larger than the combined-use group(1492 cases,49.75%).In terms of the number of drugs used in combination,one(39.01%)and two(38.14%)were the main types;in terms of medication types,combination therapy with Western medicine(62.27%)and simultaneous use of Western medicine and other Chinese materia medica(26.14%)were the main methods;the top three drugs with the highest frequency of combination use were glucosamine capsules,imrecoxib tablets and sodium hyaluronate injection.The top three drug combinations with the highest support were“Huoxue Zhishang Powder+imrecoxib tablets”,“glucosamine capsules+imrecoxib t

关 键 词：尪痹片 膝骨关节炎 分期 真实世界研究 临床特征 

分 类 号：R274.94[医药卫生—中西医结合]