基于真实世界骨质疏松患者临床特征与用药分析

为了解真实世界我国骨质疏松症患者的临床实际情况,以全国20家三级甲等医院HIS数据库中9 731例骨质疏松症住院患者为研究对象,分析其一般信息、西医合并病、诊断信息、与发病节气的关系以及治疗药物的应用情况。结果显示骨质疏松症患者年龄中位数为72岁,60~74岁的女性多见;职业以体力劳动者居多(73.87%);入院方式以普通门诊居多;住院病情以一般者居多(81.61%);患者多从骨科收入院(21.94%);住院天数多在8~14 d(39.96%);34.34%的患者住院总费用在5000~1万元;75.01%的患者享有国家医疗保障政策待遇。合并疾病中以高血压、糖尿病和骨关节炎为多见,其中高血压合并率高达34.67%;中医证候最多的为肝肾阴虚证(36.62%);立夏、夏至及寒露3个节气内入院患者最多;关于治疗药物,西药使用最多的为鲑鱼降钙素和碳酸钙,中成药使用最多的为正清风痛宁。由此可见,骨质疏松症以中老年患者多见,与节气密切相关,中医、中西医结合治疗策略临床应用广泛且具备一定优势。

Clinical characteristics and medicinal analysis for osteoporosis based on real world

To understand the actual clinical situation of osteoporosis patients in our country, 9 731 hospitalized patients with osteoporosis from HIS system of 20 national 3A-grade hospitals were selected as the research objects to analyze their general information, western medicine combined diseases, diagnostic information, relationship with the onset of 24 solar terms, and the therapeutics application. Results showed that the median age of hospitalized patients with osteoporosis disease was 72 years old, more common in women aged 60 to 74; mainly in manual workers (73.87%); most in general outpatient clinic during the admission; conditions of the most patients (81.61%) were general during hospital admission; patients were more likely hospitalized from orthopaedics department (21.94%); hospital length of stay was mainly of 8-14 days (39.96%); 34.34% of the patients had a total hospitalization cost of 5 000 yuan to 10 000 yuan; 75.01% of the patients were beneficial from national health medical insurance. The complications mainly included hypertension, diabetes, and osteoarthritis, and the complication rate was as high as 34.67% for hypertension; the most common traditional Chinese medicine syndrome was deficiency of liver-Yin and kidney-Yin (36.62%); the patients were admitted to the hospital most during 3 solar terms: beginning of summer, summer solstice and cold dew. Calcitonin salmon and calcium carbonate were most widely used in western medicine and Zhengqing Fengtongning was most widely used in traditional Chinese medicine. In conclusion, osteoporosis is more common in elderly patients, and is closely related to solar terms; integrated treatment strategies of traditional Chinese medicine and western medicine can be widely used in clinical application and have certain advantages.