真实世界大数据冠心病患者中西医联合治疗规律初探

目的:观察及分析真实世界中冠心病患者的中西药使用情况,为冠心病中西医结合治疗提供参考和借鉴。方法:选择全国17家三甲医院中第一诊断为冠心病的住院患者,采集其药物信息,使用频数及关联方法进行分析。结果:84 697人中男性47564人,女性32 882人,患者年龄中位数为71岁。76 172人有用药记录,包括278种西药和331种中药。西药使用最多的为阿司匹林,共51 132例(67.08%),其次为硝酸异山梨酯(46 291例,占60.72%)、氯吡格雷(34 030例,占44.64%)等;中成药使用最多者为丹红注射液,共15 174例(19.92%),其次为疏血通注射液(10 166例,占13.35%)。药物归类后,西药位于前列者为抗血小板药、硝酸酯类药物、他汀类药物、β受体阻滞剂、钙离子拮抗剂、血管紧张素转化酶抑制剂;中药使用最多的为活血化瘀注射液,其次为活血化瘀口服药、扶正类口服药、通腑药等。进行关联规则后显示冠心病西药间联合用药最为常见,中西药联合使用中活血化瘀口服药、活血化瘀注射液与西药间的联合用药更为常见,尤其是与抗血小板药、硝酸酸类药物。结论:冠心病的西药治疗符合指南推荐,但使用率较低;中药逐渐成为冠心病治疗的重要方法,活血化瘀是冠心病中药治疗中的重要组成部分。

Preliminary study on integration of traditional Chinese medicine and western medicine in patients with coronary heart disease in real world

Objective: Observe and analyze the informations of western medicine and traditional Chinese medicine in patients with coronary heart disease(CHD), in order to provide reference for clinical treatment. Method: Select patients with CHD in diagnosis of the first place in 17 hospitals, drug informations of these patients were analyzed using frequency method and association rules. Result: In 84 697 patients,there were 47 564 males and 32 882 females.The median age was 71 years old, 76 172 patients have medicine records, including 278 kinds of western medicine and 331 kinds of traditional Chinese medicine. Aspirin was the most common used western medicine(51 132 patients, 67.08%),followed by isosorbide dinitrate, clopidogrel etc.The most common used traditional Chinese medicine was danhong injection,followed by shuxuetong injection.After classified the drugs,at the forefront of western medicine were antiplatelet drugs,nitrates drugs, statins, beta blockers, calcium antagonists,ACEI;the most used in traditional Chinese medicine was injection of blood-activating and stasis-resolving, followed by oral preparations of blood-activating and stasis-resolving medicine, Fuzheng class oral medicine,purgation medicine etc.After association rules,combination therapy among western medicine was the most common, combination of western medicine with blood-activating and stasis-resolving was very commonly, especially antiplatelet drugs and nitrates drugs. Conclusion: Western medicine in the treatment of patients with CHD was in accordance with the guidelines recommend, but with the lower utilization rate. Traditional Chinese medicine has become an important method for the treatment of CHD, promoting blood circulation and removing blood stasis is an important part of traditional Chinese medicine treatment in patients with CHD.