基于临床统计丹红注射液常见联合用药的药物相互作用文献研究

目的:基于临床数据统计丹红注射液常见临床联用药物,并针对联用组合进行药物相互作用文献研究,为进一步开展药物相互作用实验评价,完善联合用药方案奠定基础。方法:采用回顾性研究方法,基于南京中医药大学附属医院信息系统(HIS)选取2014年1月-12月使用丹红注射液的2673例患者医嘱信息,运用基本统计和关联分析方法整理联合用药信息,并针对联用频率排序前5位的药物组合,通过CNKI、Pubmed、Web of Science与Cochrane Library检索2000年1月-2016年1月的药物相互作用文献进行研究。结果:丹红注射液临床常与抗血小板药、调血脂药和脑血管病药物联用,单项合并用药联用频次排序前5为阿司匹林、氯吡格雷、阿托伐他汀、瑞舒伐他汀和美托洛尔。多项关联分析置信度最高为丹红注射液+氯吡格雷+阿托伐他汀,其次为丹红注射液+阿司匹林+阿托伐他汀。文献检索发现丹红注射液与这些药物联用的临床效益较好,但仍潜在风险。结论:丹红注射液联合用药复杂,常与功效相近的西药联用,且文献研究表明联合用药研究以协同增效为主,为保证临床用药安全和效益,需进行系统的药物相互作用实验研究,完善联合用药方案,为中药注射剂联合用药提供示范性研究。

A literature review on drug-drug interactions between Danhong injection and commonly combined drugs based on clinical statistics

OBJECTIVE To obtain common drug combinations of Danhong injection (DHI) based on clinical data, summarize literatures of drug-drug interactions within the combinations,and make a foundation for investigation of herb-drug interactions between DHI and combined drugs. METHODS A retrospective study was conducted on 2673 cases of patients in HIS database of our hospital from January to December in 2014.Frequency analysis and association rule analysis were adopted to sort common drug combinations.Then drug-drug interaction literatures were searched in databases including CNKI,Pubmed,Web of Science and Cochrane Library from January 2000 to January 2016,to find out top 5 combinations. RESULTS DHI was often used with antiplatelet drugs,lipid regulating agents and cerebrovascular drugs.It was sorted in order that aspirin,clopidogrel,atorvastatin,rosuvastatin and metoprolol were the most frequently used clinical combinations.In multiple association rule analysis,combination of the highest confidence level was clopidogrel and atorvastatin,followed by aspirin and atorvastatin.It was found that clinical efficacy proved to be positive between DHI and agents according to references,but risks of drug-drug interactions still existed. CONCLUSION DHI is usually combined with western drugs of similar efficacy,which has been proved that such combination has synergistic effects.However,to guarantee clinical safety and benefits,systemic studies on drug interactions should be performed to improve medication regimen,and provide a demonstration research for combination with Chinese patent injection.