基于大数据84697例冠心病中医证候及其中西药使用分析

该研究选择全国17家三甲医院中第一诊断为冠心病的住院患者,采集其一般信息、合并疾病、中医证候及中西药使用信息,使用频数分析及关联规则方法对相关指标进行分析。在该HIS数据库84 697例冠心病患者中,以男性、老年人居多。年龄中位数为71岁,男女比例约为1.45:1。住院天数多为8~14 d,住院总费用分布多在0.5万~2万元;25~59岁冠心病患者比例有逐年上升的趋势;冠心病死亡随年龄的增大而增多。该数据库中患者最常见合并的疾病为高血压、糖尿病、脑梗死、血脂蛋白紊乱血症。中医证候以气阴两虚、气虚血瘀最为多见;血瘀是比例最高的证候要素,占79.97%,其次为气虚、痰浊、阴虚等。西药使用最多的为阿司匹林,其次为硝酸异山梨酯、氯吡格雷;中成药使用最多为丹红注射液,其次为疏血通注射液;使用活血化瘀药进行中西医联合治疗已经较为普遍,有43.46%的患者共同使用了抗血小板西药及活血化瘀注射液,同时联合硝酸酯类药物的频率也较高。

Analysis of traditional Chinese medicine syndrome, traditional Chinese medicine and western medicine in 84 697 patients with coronary heart disease based on big data

In order to understand the clinical characteristics of patients with coronary heart disease(CHD) in real world and provide reference for clinical prevention and treatment, this study analyzed informations of patient with CHD in hospital information system. Data from 17 national hospitals were collected.Select patients with coronary heart disease in diagnosis of the first place in 17 hospitals, general informations and traditional Chinese medicine(TCM) syndrome,complications,medicine were analyzed using frequency method and association rules. This study included 84 697 patients with CHD, the majority of men and in the elderly.The average age of patients was 71 years. The proportion of men to women was about 1.45:1. Hospital stay time ranged from 8 to 14 d. The most common total hospitalization cost distribution was 5 000-20 000 RMB. Young patients have a rising trend year by year. The death of patients increased with increasing age.Common complications were hypertension,diabetes,cerebral infarction and hyperlipidemia, 57.24 percent of the CHD patient complicated with hypertension, 21.94 percent patients complicated with diabetes.Among TCM syndrome types,Qi-Yin deficiency and qi deficiency blood stasis were the most common syndromes..Blood stasis was the highest syndrome elements,accounted for 79.97%,followed by Qi deficiency,phlegm,Yin deficiency,and so on.The most common western medicine was aspirin, followed with isosorbide dinitrate, clopidogrel.The most common used traditional Chinese medicine was danhong injection,followed by shuxuetong injection.Combined with removing blood stasis drugs has been more common at present clinical treatment,there were 43.46 percent of patients combined with anti-platelet western drug and injection of removing blood stasis.