一种基于SPSS Clementine关联规则分析联合用药规律的方法

目的通过对我院肿瘤患者使用榄香烯注射液联合用药规律的挖掘,介绍使用SPSS Clementine软件进行关联规则分析的方法。方法收集2016年1月至2018年12月使用榄香烯注射液的出院肿瘤患者,通过医院信息管理系统查看医嘱、病历,询问相关医护人员等,统计使用榄香烯注射液联合用药的信息,逐一介绍使用SPSS Clementine软件进行Apriori算法及关联规则进行关联性分析的方法步骤。结果共952例肿瘤住院患者使用榄香烯注射液。榄香烯注射液与地塞米松、氯化钾、维生素C、维生素B_6及泮托拉唑联用最为密切。结论榄香烯注射液联合用药具有一定规律性及合理性,SPSS Clementine关联规则分析可以用于联合用药规律挖掘,从而为临床合理用药提供参考。     

中医药治疗糖尿病便秘用药规律探讨

目的 探求治疗糖尿病便秘的中药组方规律。方法 自2021年1―7月从CNKI、CBM、VIP、WANFANG中筛选关于应用中药治疗糖尿病便秘的临床试验文献110篇,搜集组方用药后运用频数统计、关联规则、聚类和因子分析方法,探讨其中的用药配伍规律。结果 最终纳入104首中药复方,涉及125味中药,结果显示用药频次≥10的有27味中药,药物功效以补益为主,性味多甘温,主要归脾、胃、肺三经,关联规则分析得到15条;聚类分析结果选取出8组具有关联性的药组;通过因子分析方法,得到公因子11个。结论 中医药治疗糖尿病便秘以养阴生津为主,同时结合消渴病的病机特点,灵活运用温阳、活血、理气类药物。     

基于数据挖掘分析针药结合治疗急性痛风性关节炎的临床规律

目的 基于数据挖掘技术来分析研究针药结合治疗急性痛风性关节炎的临床治疗规律,为临床上药穴结合治疗急性痛风性关节炎提供选穴和用药的参考和借鉴。方法 检索并筛选20年来使用针药结合治疗急性痛风性关节炎的相关文献,用Excel 2019建立处方数据库并对处方中药、腧穴、归经、药类进行频数分析,SPSS Statistics 26进行聚类分析,SPSS Modeler18.0进行关联规则分析。结果 共纳入40个针药结合处方,其中使用频率最高的腧穴和药物分别为三阴交、薏苡仁;关联规则分析显示药穴关联性最高的是：三阴交-薏苡仁-足三里;聚类分析得出10个聚类群。结论 本研究总结出针药结合治疗急性痛风性关节炎的选穴与用药中常用组合的临床规律,为临床针药结合治疗急性痛风性关节炎提供了思路。     

心脑血管疾病用药与药物不良反应间的关联关系

目的寻找心脑血管疾病用药与药物不良反应间关联关系,为临床合理用药提供参考。方法以数据挖掘技术中的关联规则对广东省2004—2009年心脑血管疾病用药后出现的不良反应病例报告进行分析。采用支持度和置信度衡量关联规则的强度。结果共收集有效报告6 753份,三磷腺苷、脑蛋白水解物与寒战、发热间具有强关联,卡托普利与咳嗽间具有强关联。此外,脑蛋白水解物还与皮疹和瘙痒具有一定的关联关系,胞磷胆碱、曲克芦丁与过敏样反应具有一定的关联关系。结论心脑血管疾病用药的不良反应现象主要表现为寒战、发热、过敏样反应、皮疹、瘙痒、咳嗽和头痛,应关注三磷腺苷、脑蛋白水解物、卡托普利、胞磷胆碱的应用。     

基于关联规则分析肿瘤患者帕博利珠单抗联合用药特征

目的 探究免疫检查点抑制剂帕博利珠单抗的临床应用现状及利用SPSS Clementine关联规则分析药物联用特征。方法 统计患者的基本信息、医嘱信息、用药顺序、不良反应及药物联用,并对以上数据利用Apriori算法及关联规则进行关联性分析,探究联合用药的规律。结果 本次共统计使用帕博利珠单抗179例患者,共计410例次。男性患者占多数(134例,74.86%),年龄60～69岁患者居多(80例,44.69%),患癌类型主要为肺癌(81例,45.25%)、食管癌(29例,16.20%)、胃癌(11例,6.25%)。帕博利珠单抗联合化疗共179例次,占43.66%。采用Clementine 12.0软件建立关联规则,帕博利珠单抗联合化疗方案最常用的是紫杉醇+铂类药物。结论 利用数据挖掘关联规则分析帕博利珠单抗联合用药规律,为临床合理用药提供参考。     

964例丹红注射液不良反应报告关联规则分析

目的对丹红注射液药品不良反应(ADR)报告进行一般情况及关联规则分析,为临床合理用药提供参考。方法应用SPSS Modeler软件,对四川省药品不良反应监测中心2010年1月至2017年12月丹红注射液ADR报告进行关联规则分析。结果共964份有效报告,超过50%的病例为60岁及以上的老年人,ADR累及皮肤及其附件、心血管及呼吸等系统。严重ADR表现中,"皮肤及其附件损害+心血管系统一般损害+初次用药时发生ADR"等组合置信度可达100%;一般ADR报告中,"心血管系统一般损害+皮肤及其附件损害+初次用药时发生ADR"组合置信度可达77.273%。结论丹红注射液ADR病例多为一般类型,涉及不同器官和组织的ADR与患者自身年龄、原患疾病有很大关系,因此,在临床用药之前应做出安全评估。     

基于数据挖掘的白附子临床外用规律分析

摘要：目的:挖掘中药白附子临床外用的配伍规律。方法:从中国知网、万方数据库、维普数据库中筛选一定年限内含白附子的临床外用文献,将得到的外用方剂使用Excel 2013软件建立数据库,进行中药性味归经、剂型、用法的统计,并采用SPSS Modeler 14.1的Apriori算法进行高频中药关联规则分析,挖掘白附子临床外用配伍的应用规律。结果:入选129首方剂共含中药220种,较多使用解表药、活血化瘀药、化痰药及祛风湿药,如白芷、僵蚕、当归、红花、全蝎等,并以性温、平,味辛、苦、甘,归肝经药物居多。白附子外用方剂剂型、用法多样,常采用糊剂-外敷疗法。对白附子外用高频中药进行关联规则分析共得到15个高关联性中药组合,涉及面部疾病、痹症、炎症、疼痛等32种主治疾病,对面神经炎及黄褐斑所使用方剂进行关联规则分析,分别得到17、18个高关联性中药组合。结论:白附子在临床外治中常用于面部疾病面神经炎、黄褐斑的治疗并呈现出明显的中药配伍规律,可为白附子的临床应用及相关实验研究提供参考。     

基于数据挖掘的中药治疗流行性感冒用药规律分析

目的 基于关联规则和系统聚类分析探讨流行性感冒用药配伍规律。方法 以"流行性感冒"为主题，在中国知网查找2009年1月-2019年1月文献，纳入符合标准的文献290篇，使用Excel 2013、SPSS Clementine 12.0、SPSS Statistics 23.0统计软件，将符合纳入标准方剂中的中药进行频数分析、关联规则分析和系统聚类分析。结果 频数分析发现，在290例临床治疗文献中，单味中药甘草（204，70.34%）、连翘（168，57.93%）和金银花（151，52.07%）出现频率最高；在性味统计中，寒（16次，53.33%）、苦（19次，42.22%）最为常见；归经中肺经（25次，32.47%）、心经（14次，18.18%）最多；关联规则分析中得到关联强度最高的药对组合8组；聚5类为系统聚类分析中的核心组方。结论 对临床治疗流行性感冒的有效临床处方运用现代信息技术进行分析，可以得到流行性感冒疾病最关键的药物配伍以及高发证型，对于减少临床大处方用药和开发新药均具有重要意义。     

静脉药物调配中心(PIVAS)医嘱自定义审查模块的设计与实现

目的:设计医嘱自动审查系统(PCSS)减少用药差错,提高静脉用药调配中心(PIVAS)医嘱审查效率。方法:基于PIVAS软件开发平台新增药品属性等数据库,构建医嘱审查规则表达式,从而实现医嘱自定义审查功能。结果:医嘱自定义审查模块能完成普通审查医嘱的合理性审查,包括配伍禁忌、溶媒选择不当、给药途径不当、给药浓度不当等问题。同时对不合理全胃肠外营养(TPN)医嘱的原因和相关因素进行关联性评价。结论:该模块审查规则构建灵活,评价指标明确,为减少临床用药差错,提高临床药师审方效率,保障患者用药安全起到了较好的作用。     

基于数据挖掘的治疗银屑病用药规律分析

摘要： 目的 基于数据挖掘中药治疗银屑病的组方用药规律分析。方法 以中国知网、万方数据库、维普数据库收录的期刊文献为资料来源,使用Excel 2013和SPSS?Modeler?14.1等软件对筛选出的纳入标准的中药复方进行关联规则分析和因子分析。结果 在纳入标准的178首方剂中,单药生地黄、牡丹皮最为常见。通过关联规则分析发现共有13种关联强度最高的药对组合,因子分析中7个公因子被提取出。结论 本文运用现代信息技术,将中医临床资料与大数据相结合进行更深层次分析整合,初步明确了中医治疗银屑病的用药规律,最终反馈给临床,为指导临床更加安全合理的用药及新处方研发提供依据。     

Association of alcohol consumption with HIV sex- and drug-risk behaviors among drug users.

The relationship between alcohol use and HIV transmission is well recognized but not fully understood. In particular, the role of alcohol abuse as a mediator of HIV risk behavior among drug users is not well documented. We hypothesized that alcohol use in drug users will result in greater HIV risk-taking behavior. Participants were 354 drug users, of whom 105 were recent injection drug users. Multiple regression models were used to characterize whether measures of sexual and injection drug use HIV risk behavior were related to alcohol consumption, controlling for other potentially associated factors. We found that sexual HIV risk-taking behavior is associated with increased alcohol consumption among women (p = 0.02), with women having more risky sexual behavior than males. However, contrary to our hypothesis, there was no significant association of alcohol consumption with risky injection drug behavior. Addressing alcohol problems among drug users, particularly women, may be an important opportunity to reduce HIV sexual risk behavior among this high-risk population.     

Antihypertensive-related adverse drug reactions among older hospitalized adults

Background Antihypertensive medications are commonly used for a wide range of indications, yet it is unknown to what extent older adults are at risk of adverse drug reactions (ADRs) associated with their antihypertensive medication use. Objective The aim of this study was to determine the prevalence and characteristics of antihypertensive-related ADRs on hospital admission. Setting Metropolitan teaching hospital in Sydney, Australia. Method A retrospective cross-sectional audit of 503 older patients (≥ 65 years) admitted to hospital was conducted. Potential ADRS were identified from the medical record. Two independent clinical pharmacists reviewed each potential ADR using validated tools for causality, severity, preventability and contribution to hospitalization. Characteristics associated with an increased ADR risk among antihypertensive users were identified via logistic regression. Main outcome measure Antihypertensive related ADRs. Results Antihypertensives were used on admission by 68% of the cohort and the prevalence of ‘definite/probable’ antihypertensive-related ADRs among antihypertensive users was 16.4%. Antihypertensive medications were associated with a threefold ADR risk (OR = 3.09, 95% CI 1.85–5.16). Angiotensin II Receptor Blockers (ARB), impaired renal function, recent medication changes and previous history of allergy or ADR were all associated with an increased risk of experiencing an ADR. Conclusions ADRS associated with antihypertensive medicines were relatively common among older adults admitted to hospital. Increased awareness of those older persons who are most at risk of experiencing an antihypertensive-related ADR in the clinical setting may lead to early detection and minimization of ADR associated harms.     

Characteristics Associated with Ability to Prevent Adverse Drug Reactions in Hospitalized Patients

We conducted a retrospective analysis to identify characteristics of preventable adverse drug reactions (ADRs). We reviewed reports on 612 ADRs occurring in hospitalized patients over 4 years, identified by the hospital's spontaneous ADR reporting program, and classified the events as potentially preventable or not preventable. Characteristics related to ADR preventability in the univariate analysis were the patient's clinical service, organ system involved in the ADR, class of drug causing the ADR, relationship to dosage, type of ADR, and probability that the reaction was due to the drug. Among these, relationship to dosage (p<0.001) and type of ADR (p<0.001) appeared to be most strongly related to preventability. In a multivariate analysis, preventable ADRs were associated with dosing (OR 3.82, 95% CI 2.42-6.03) and previous allergy to the drug (OR 3.46, 95%CI 1.01–11.88). An ADR that was classified as an allergic (OR 0.50, 95% CI 0.27-0.94) or idiosyncratic reaction (OR 0.44, 95% CI 0.28-0.71) was unlikely to be considered preventable. Preventable ADRs in hospitalized patients are likely to be dosage related or to occur among patients allergic to the specific agent.     

308例儿童药品不良反应回顾性分析

目的:分析儿童药品不良反应(ADR)发生特点,为促进临床合理用药提供参考.方法:采用回顾性分析方法,对2011年4月至2018年12月主动上报的308例有效ADR报告进行统计分析.结果:308例ADR中,男女比例1.59 ∶ 1,1～3岁年龄组发生ADR最多(51.62％);给药途径以静脉滴注为主(93.33％);引发...     

某三甲医院近5年药品不良反应分析

目的 促进临床安全用药,并加强医疗机构药品不良反应(ADR)的报告工作.方法 检索国家药品不良反应监测系统中某三甲医院2015年至2019年上报并完成评价的ADR报告,回顾性分析ADR的类型、患者年龄、性别、给药途径、药品类别、累及系统/器官、转归、报告人职业等.结果 共检索到ADR报告1127例.ADR发生最多的类型...     

近年我国药品不良反应报告与监测总体情况分析

目的了解我国近年来药品不良反应报告的现状,找出存在的问题,为加强药品不良反应报告和监测管理提出建议。方法收集2010~2014年连续5年国家药品不良反应监测年度报告,采用内容分析、二次分析、对比分析等方法对药品不良反应报告情况进行了探讨。结果我国药品不良反应报告的数量逐年增加,新的和严重的药品不良反应数量较少;药品不良反应报告主体是医疗机构,药品生产经营企业的报告比例较低,抗感染药品的药品不良反应仍居首位。结论加强药品不良反应报告管理依然是业内关注的重要问题之一。建议:提高新的、严重的不良反应报告率;强化药品生产、经营企业药品不良反应报告工作;重视抗感染药品的不良反应;促进药品不良反应的信息共享。     

某院562例儿童药品不良反应回顾性分析

目的:了解我院儿童药品不良反应(ADR)发生的特点及规律,为临床合理用药提供参考。方法:采用回顾性分析方法,对我院2015-2016年上报国家ADR监测系统的562例儿童ADR报告进行统计、分析和评价。结果:在562例儿童ADR中,男304 例(54.1%),女258例(45.9%);1-3岁年龄组ADR发生率最高(47.0%);静脉滴注是引发ADR最主要的给药途径,共372例(66.2%);引发ADR最多的药品种类为抗感染药(44.8%),而抗感染药又以头孢菌素类为主(57.5%);ADR最常见的临床表现为皮肤及其附件损害(68.4%)。结论:给药途径、品种等多种因素与儿童ADR 的发生密切相关,临床需严格掌握药物的适应证、给药途径、给药速度等,以促进临床合理用药,减少ADR的发生。     

A tripartite of HIV-risk for African American women: the intersection of drug use,violence, and depression

The intersection of drug use, violence, and depression with HIV-risk among African American women is an under explored area of research. The current analyses examine whether particular sexual risk behaviors are associated with exposure to violence, depression or both among 420 African American out-of-treatment female drug users. Women were stratified into four mutually exclusive groups: drug users with exposure to violence (n=64), drug users with clinical depression (n=62), drug users with both (n=41), and drug users only (n=253). Multinomial logistic regression analyses examined the association of demographics and sexual risk behaviors across the tripartite groups. Women with a history of sexually transmitted diseases were more likely to experience violence and depression both alone and jointly. Women who had two or more sexual partners in the last 30 days (OR=2.26) and women who had an early onset of alcohol use (OR=2.50) were at an increased risk for having the full tripartite of drug use, violence and depression. Never being married was a protective factor for the full tripartite. As expected, more risk factors were found among women who had the full tripartite than among women with one or two of the factors. The co-existence of the tripartite factors and sexual risk behaviors may indicate a need to ultimately provide more specialized prevention and intervention efforts to combat HIV infection. This area of research may improve our understanding of the numerous obstacles to HIV intervention among drug-using populations.     

Spontaneous reporting of adverse drug reactions: who reports and what?

A survey among Bordeaux pharmacovigilance centre 'users' and 'non-users' was conducted in Aquitaine, France. Two hundred physicians having reported to the centre at least one adverse drug reaction (ADR) during the past 3 years were matched to a randomly selected sample of 400 physicians who did not report. They were asked to anonymously fill out a postal questionnaire collecting data on their individual characteristics, including their practice mode, and on ADRs that they observed and reported during the past 12 months. The number of questionnaires returned was 151 (25%), of which 76 were from users (38%) and 75 from non-users (19%). The two groups had very close individual characteristics. All but three responders had observed at least one ADR during the past 12 months. For the different types of ADRs defined in terms of seriousness and labelling, more users had seen ADRs than non-users but among those who observed them, the numbers of ADRs seen were similar in both groups. In any case, the more recent the drug, the more prone to report were the physicians.     

Factors that influence under-reporting of suspected adverse drug reactions among community pharmacists in a Spanish region.

BACKGROUND: The spontaneous reporting system is the most efficient warning system of adverse drug reactions (ADRs). Pharmacists can play an important role in the detection and reporting of ADRs. The factors that affect under-reporting among these professionals are unknown in Spain. OBJECTIVE: To identify the factors that influence community pharmacists' ADR under-reporting in Navarra, a Northern Spanish region. METHODS: A case-control study was conducted on a population of 802 community pharmacists working in Navarra. Cases were pharmacists who had reported at least two ADRs to the region's drug surveillance unit between 2003 and 2005 and who agreed to participate in the study (18/20; 90%). A random sample of 60 controls was selected from the 762 pharmacists who had not reported any ADR during the same period of time. RESULTS: Factors positively associated with ADR reporting were age, years of work experience as a pharmacist, participation in educational activities related to the detection and resolution of drug-related problems, the habit of detecting ADRs as part of pharmacists' duties, having the basic knowledge needed to report ADRs, and disagreement with the common belief among healthcare professionals that 'to report an ADR it is necessary to be sure that the reaction is related to the use of a particular drug'. The most frequently mentioned reasons for not reporting ADRs were the ADR is not serious, the ADR is already known, uncertainty concerning the causal relationship between the ADR and the drug, forgetting to report the ADR and a lack of time. CONCLUSIONS: Pharmacists' knowledge, beliefs, behaviour and motivation play an important role in ADR reporting. Under-reporting might be improved through activities focused on modifying such factors.