摘要
目的从真实世界中挖掘冠心病支架术后患者运用中成药治疗术后并发症的用药规律及组方规律与中医证型、治则之间的关系,并为以后的新药研发等相关研究提供可参考的科学依据。方法选择2019年1月—2021年6月在河南省中医药研究院附属医院门诊及住院患者处方996张,运用关联规则(矩阵和权重改进的MW-Apriori算法)统计分析其中用药规律和药物组成的组方规律及其与中医证型关系。结果冠心病支架术后患者经过中成药治疗后总有效率达到90.86%(905/996),同时,支架术后患者合并诊断最多的是高血压病,其次是2型糖尿病和高脂血症,在真实世界中,最常用的中成药有30种,以活血化瘀和化痰祛瘀类位使用频数最多,2~3种中成药组合以复方丹参滴丸,血府逐瘀胶囊,麝香保心丸,血塞通注射液,银丹心脑通胶囊,丹蒌片、脂降宁片,心可舒片等药相互组合较为常见,其中中成药主要药物组成有57种,以丹参、三七、瓜蒌、薤白等药物组合频次较高,同时,丹参、三七、当归组合和瓜蒌、薤白、陈皮组合置信度最高,在中医证型方面,总结出常见7个证型及相应的14种治则,且分布规律与相应的用药规律和药物组成的组方规律相互一致。结论冠心病支架术后患者在真实世界中常合并多种疾病诊断,但经过中成药治疗后取得较好疗效,在治疗过程中常用的中成药种类以活血、行气、化痰类药物为主,且中成药运用规律、药物组成的组方规律与中医证型、治则之间有相互的特定规律分布,这为冠心病支架术后患者如何合理用药以及新药研发奠定基础。
Objective To explore the relationship between the medication rules and prescription rules of treating postoperative complications with Chinese patent medicines in patients with coronary heart disease(CHD)after stenting operation and the syndrome types and treatment principles of TCM from the real world,and provide reference scientific basis for future research and development of new drugs and other related studies.Methods A total of 996 outpatient and inpatient prescriptions were selected from the Affiliated Hospital of Henan Academy of Traditional Chinese Medicine from January 2019 to June 2021.Association rules(MW-Apriori algorithm with matrix and weight improvement)were used to statistically analyze the medication rules,prescription rules of drug composition and their relationship with TCM syndrome types.Results The total effective rate of patients with coronary heart disease after stent surgery after Chinese patent medicine treatment reached 90.86%(905/996).At the same time,hypertension was the most common combined diagnosis of patients after stent surgery,followed by type 2 diabetes and hyperlipidemia.In the real world,there are 30 kinds of Chinese patent medicines most commonly used and the prescriptions for promoting blood circulation and removing blood stasis and phlegm and removing blood stasis were used frequently.2-3 kinds of Chinese patent medicine combinations are Compound Danshen Dropping Pills(复方丹参滴丸),Xuefu Zhuyu Capsules(血府逐瘀胶囊),Shexiang Baoxin Pills(麝香保心丸),Xuesaitong Injection(血塞通注射液),Yindan Xinnaotong Capsules(银丹心脑通胶囊),Danlou Tablets(丹蒌片),Zhijiangning Tablets(脂降宁片),Xinkeshu tablets(心可舒片)and other drugs are commonly combined with each other.Among them,there are 57 kinds of Chinese patent medicines,and the combination frequency of Danshen(Salviae Miltiorrhizae Radix Et Rhizoma),Sanqi(Notoginseng Radix Et Rhizoma),Gualou(Trichosanthis Fructus),Xiebai(Allii Macrostemonis Bulbus)and other drugs is higher.At the same time,the combination of Danshen(Salviae Miltiorrhizae Radix Et Rhizoma),Sanqi(Notoginseng Radix Et Rhizoma),Gualou(Trichosanthis Fructus)and the combination of Gualou(Trichosanthis Fructus),Xiebai(Allii Macrostemonis Bulbus)and Chenpi(Citri Reticulatae Pericarpium)have the highest confidence.In terms of TCM syndrome types,seven common syndrome types and 14 corresponding treatment principles are summarized,and the distribution law is consistent with the corresponding medication law and the formula law of drug composition.Conclusion Patients with coronary heart disease after stenting are often diagnosed with a variety of diseases in the real world,but after treatment with Chinese patent medicine,they have achieved good curative effect.The types of Chinese patent medicine commonly used in the treatment process are mainly drugs for promoting blood circulation,promoting Qi circulation,and eliminating phlegm,and there are specific laws between the application law of Chinese patent medicine,the formula law of drug composition,and the syndrome types and treatment principles of traditional Chinese medicine.This will lay a foundation for how to use drugs reasonably and new drug research and development in patients with coronary heart disease after stenting.
作者
马笑凡
崔伟锋
潘玉颖
郭泉滢
张俊萍
MA Xiaofan;CUI Weifeng;PAN Yuying;GUO Quanying;ZHANG Junping(Henan Academy of Traditional Chinese Medicine,Zhengzhong 450004,Henan,China)
出处
《辽宁中医杂志》
CAS
2022年第9期17-24,222,共9页
Liaoning Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81774453)
河南省中医药拔尖人才培养项目(2021-15)
河南省中医药领军人才培养项目(2021-08)
河南省中医药科研专项重点课题(2018ZY1017)
河南省科技攻关项目(222102310486)
关键词
冠心病支架术后
中成药
药物组成
关联规则
真实世界
coronary heart disease after stenting
Chinese patent medicine
drug composition association rules
real world
作者简介
马笑凡(1985-),女,主治医师,研究方向:高血压病、心血管疾病临床疗效评价及相关研究;通讯作者:崔伟锋(1980-),男,副主任医师,研究方向:艾滋病、高血压等疾病疗效评价,E-mail:642596880@qq.com。
