真实世界中参芎葡萄糖注射液治疗脊柱疾病的临床联合用药特征分析
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摘要
目的探索真实世界中参芎葡萄糖注射液治疗脊柱疾病的临床联合用药情况,为合理用药和进一步研究提供参考和思路。方法提取全国19家三甲医院信息系统中使用参芎葡萄糖注射液治疗脊柱疾病患者的医疗信息,标准化后,采用Apriori算法建立模型,使用Clementine 12. 0对联合用药信息进行关联分析。结果纳入551例脊柱疾病患者联合用药中,最常与参芎葡萄糖注射液联合使用的中药是鹿瓜多肽、脉络舒通颗粒、仙灵骨葆胶囊;西药是前列地尔、地塞米松、阿托品、苯巴比妥、泮托拉唑;中药类别是活血化瘀剂、补益剂、祛风除湿剂;西药类别是肾上腺皮质激素、抗生素、质子泵抑制剂、镇静催眠药、抗胆碱类药物等。结论参芎葡萄糖注射液治疗脊柱疾病联合用药广泛,西药间联合应用最常见,中西药联合应用频率次之,中药间联合频率最低。总体联合用药规律符合中西医对脊柱疾病病因机制的认识及基本治疗原则。
Objective To explore the co-medication with shenqiong glucose injection for spondylopathy in the real world so as to provide the references to the rational medication and further study. Methods The medical information of the patients with vertebral diseases prescribed shenqiong glucose injection were extracted from the medical system of 193 A-class hospitals in China. After normalization,using Apriori alogorithm,the model was established. Using clementine12. 0,the association analysis was performed for the information of co-medication. Results Among the co-medications in 551 cases of spondylopathy,the Chinese herbal medicines mostly combined with shenqiong glucose injection were cervus and cucumis polypeptide,mailuo shutong granules and xianling gubao capsules. The western medicines were alprostadil,dexamethasone,atropine,Phenobarbital and pantoprazole. The Chinese herbal medicines were in the categories of the preparations for activating blood circulation and resolving blood,tonic drugs and the preparations for eliminating wind and damp. The western medicines were in the categories of adrenocortical hormone,antibiotics,proton pump inhibitors,sedative hypnotics and anticholinergic drugs. Conclusion Shenqiong glucose injection is widely used together with other drugs in the treatment of spondylopathy. The co-medication among western medicines is the most common. The co-medication frequency between Chinese medicine and western medicine is on the second top and the co-medication among Chinese medicines is the lowest. The overall rule of co-medication is coincident with the recognition of etiology and pathogenesis of spondylopathy and the basic treating principle.
Objective To explore the co-medication with shenqiong glucose injection for spondylopathy in the real world so as to provide the references to the rational medication and further study. Methods The medical information of the patients with vertebral diseases prescribed shenqiong glucose injection were extracted from the medical system of 193 A-class hospitals in China. After normalization,using Apriori alogorithm,the model was established. Using clementine12. 0,the association analysis was performed for the information of co-medication. Results Among the co-medications in 551 cases of spondylopathy,the Chinese herbal medicines mostly combined with shenqiong glucose injection were cervus and cucumis polypeptide,mailuo shutong granules and xianling gubao capsules. The western medicines were alprostadil,dexamethasone,atropine,Phenobarbital and pantoprazole. The Chinese herbal medicines were in the categories of the preparations for activating blood circulation and resolving blood,tonic drugs and the preparations for eliminating wind and damp. The western medicines were in the categories of adrenocortical hormone,antibiotics,proton pump inhibitors,sedative hypnotics and anticholinergic drugs. Conclusion Shenqiong glucose injection is widely used together with other drugs in the treatment of spondylopathy. The co-medication among western medicines is the most common. The co-medication frequency between Chinese medicine and western medicine is on the second top and the co-medication among Chinese medicines is the lowest. The overall rule of co-medication is coincident with the recognition of etiology and pathogenesis of spondylopathy and the basic treating principle.
引文
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[19]杨雅瑾,蔡德新,黄文辉,等.参芎葡萄糖注射液药理作用及临床应用研究[C]∥中国药学会第十三届青年药学科研成果交流会,南昌:2016:4.
[20]闵汇刚,王庆.参芎葡萄糖注射液临床应用的研究进展[J].中华脑血管病杂志:电子版,2013,7(3):41-43.
[21]陈岩,王拥军,徐浩,等.川芎嗪对白介素-1β诱导退变的椎间盘终板软骨细胞的保护作用[J].中华中医药杂志,2015,30(5):1437-1442.
[22]蒋跃绒,陈可冀.川芎嗪的心脑血管药理作用及临床应用研究进展[J].中国中西医结合杂志,2013,33(5):707-711.
[23]冯诚,郭杨,董维,等.益气活血化痰法治疗颈性眩晕的研究进展[J].中国中医基础医学杂志,2016,22(10):1417-1419.
[24]睦顺姬,叶秀兰,姚敏,等.中医药治疗脊髓型颈椎病的机理研究概况[J].世界中医药,2017,12(1):222-228.
[25]舒菁菁,李菲,董雅芬,等.丹参素药理作用及机制的研究进展[J].药学实践杂志,2012,30(4):266-268.
[26]宋蕾,王兴林,张立宁.丹参热蒸治疗对血瘀型腰椎间盘突出症患者疼痛症状评分和血液流变学指标的影响[J].中国临床康复,2006,10(11):17-20.
[27]何元诚,王志威,吴国林,等.丹参注射液对SD大鼠非压迫性腰椎间盘退变的实验研究[J].中医临床研究,2014,6(31):1-6.
[28]展嘉文,朱立国,冯敏山,等.丹参注射液含药血清对离体培养兔脊柱运动节段椎间盘的影响[J].中华中医药杂志,2015,30(5):1834-1837.
[29]陈凯,张俐.丹参及其制剂对脊髓损伤的保护作用及机制研究概况[J].中华中医药杂志,2012,27(11):2887-2890.
[30]孙帅玲,谢雁鸣,黎元元,等.基于真实世界医院使用鹿瓜多肽注射液患者临床用药特征分析[J].中国中药杂志,2016,41(21):4060-4065.
[31]黄多临.仙灵骨葆胶囊治疗骨质疏松症研究述评[J].中医学报,2013,28(2):285-287.
[32]吕鹏飞,梁玉龙,刘宁青,等.脉络舒通颗粒对骨折后血管内皮细胞功能的保护作用[J].中华中医药杂志,2014,29(9):2997-2999.
[33]李士东.复方丹参注射液辅治椎基底动脉供血不足50例临床观察[J].中医临床研究,2016,8(16):68-69.
[2]邵建兵,汪燕.复方中药制剂参芎葡萄糖注射液的临床应用[J].环球中医药,2014,7(S2):113.
[3]陆凤燕,杨靖,谢雁鸣,等.基于医院信息系统的颈椎病合并疾病及用药研究[J].中国全科医学,2017,20(8):980-987.
[4]黄雯静,姜俊杰,谢雁鸣,等.基于40 139例真实世界数据的腰椎间盘突出症用药特征分析[J].中医药导报,2016,22(19):29-33.
[5]王桂倩,谢雁鸣,刘峘,等.真实世界的参芎葡萄糖注射液临床联合用药特征分析[J].中国中药杂志,2017,42(1):175-181.
[6]尹庆水.脊椎相关疾病研究现状及面临的挑战[J].中国骨科临床与基础研究杂志,2014,6(2):69-72.
[7]杨辉,郭丽新,武媛媛.颈椎病病因的相关性研究进展[J].中国实验诊断学,2012,16(6):1152-1154.
[8]潘之清.关于颈源性疾病的临床认识与研究[J].中国临床康复,2004,8(23):4825-4826.
[9]卿柳华,段俊峰,吕晓宇.脊柱病因引起内脏相关疾病的基础研究进展[J].颈腰痛杂志,2009,30(5):444-446.
[10]马信龙,徐云强,张义修,等.腰椎间盘突出症自身免疫因素的研究[J].中国现代神经疾病杂志,2004,4(5):291-296.
[11]王远征,冷辉,吴景山.脊髓型颈椎病病因学研究概况[J].中国医疗前沿,2013,8(1):9-10.
[12]孔敬波,马信龙,王涛,等. Wnt/β-catenin及NF-кB信号通路与椎间盘退变的研究进展[J].中国修复重建外科杂志,2013,27(12):1523-1528.
[13]王华兰,赵明.颈椎调整术治疗颈源性失眠的疗效观察[C]∥第十三次中医推拿学术年会暨推拿手法治疗脊柱相关疾病高级培训班,合肥:2012:3.
[14]刘涛,宋敏,龚彦龙,等.椎动脉型颈椎病的中医临床研究进展[J].甘肃中医药大学学报,2016,33(5):78-80.
[15]李俊杰,赵宝力,白罡,等.脊髓型颈椎病中医综合治疗的临床研究[J].中国医药导报,2014,11(32):77-82.
[16]欧国峰,董博,刘继华,等.神经根型颈椎病的中西医治疗进展[J].现代中西医结合杂志,2017,26(7):791-793.
[17]孙雨.中医药治疗神经根型颈椎病研究概况[J].实用中医内科杂志,2013,27(10):78-79.
[18]陈子前,马太平,刁虹.中西医结合治疗腰椎间盘突出症患者的临床疗效观察及对血清炎性因子的影响[J].世界中医药,2017,12(2):299-302.
[19]杨雅瑾,蔡德新,黄文辉,等.参芎葡萄糖注射液药理作用及临床应用研究[C]∥中国药学会第十三届青年药学科研成果交流会,南昌:2016:4.
[20]闵汇刚,王庆.参芎葡萄糖注射液临床应用的研究进展[J].中华脑血管病杂志:电子版,2013,7(3):41-43.
[21]陈岩,王拥军,徐浩,等.川芎嗪对白介素-1β诱导退变的椎间盘终板软骨细胞的保护作用[J].中华中医药杂志,2015,30(5):1437-1442.
[22]蒋跃绒,陈可冀.川芎嗪的心脑血管药理作用及临床应用研究进展[J].中国中西医结合杂志,2013,33(5):707-711.
[23]冯诚,郭杨,董维,等.益气活血化痰法治疗颈性眩晕的研究进展[J].中国中医基础医学杂志,2016,22(10):1417-1419.
[24]睦顺姬,叶秀兰,姚敏,等.中医药治疗脊髓型颈椎病的机理研究概况[J].世界中医药,2017,12(1):222-228.
[25]舒菁菁,李菲,董雅芬,等.丹参素药理作用及机制的研究进展[J].药学实践杂志,2012,30(4):266-268.
[26]宋蕾,王兴林,张立宁.丹参热蒸治疗对血瘀型腰椎间盘突出症患者疼痛症状评分和血液流变学指标的影响[J].中国临床康复,2006,10(11):17-20.
[27]何元诚,王志威,吴国林,等.丹参注射液对SD大鼠非压迫性腰椎间盘退变的实验研究[J].中医临床研究,2014,6(31):1-6.
[28]展嘉文,朱立国,冯敏山,等.丹参注射液含药血清对离体培养兔脊柱运动节段椎间盘的影响[J].中华中医药杂志,2015,30(5):1834-1837.
[29]陈凯,张俐.丹参及其制剂对脊髓损伤的保护作用及机制研究概况[J].中华中医药杂志,2012,27(11):2887-2890.
[30]孙帅玲,谢雁鸣,黎元元,等.基于真实世界医院使用鹿瓜多肽注射液患者临床用药特征分析[J].中国中药杂志,2016,41(21):4060-4065.
[31]黄多临.仙灵骨葆胶囊治疗骨质疏松症研究述评[J].中医学报,2013,28(2):285-287.
[32]吕鹏飞,梁玉龙,刘宁青,等.脉络舒通颗粒对骨折后血管内皮细胞功能的保护作用[J].中华中医药杂志,2014,29(9):2997-2999.
[33]李士东.复方丹参注射液辅治椎基底动脉供血不足50例临床观察[J].中医临床研究,2016,8(16):68-69.