中国中药杂志

2020, v.45(14) 3316-3323

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基于Tabu搜索算法醒脑静注射液治疗脑出血及并发症真实世界用药研究
Effect of Xingnaojing Injection in treatment of cerebral hemorrhage based on Tabu search algorithm:a real world study

耿洪娇;谢雁鸣;张敏;
GENG Hong-jiao;XIE Yan-ming;ZHANG Min;Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences;School of Statistics, Renmin University of China;

摘要(Abstract):

该研究针对真实世界中醒脑静注射液治疗脑出血的情况,采用Tabu搜索算法进行分析。通过分析筛选出脑出血病因治疗:醒脑静注射液+止血类药物活血化瘀类;脑出血并发脑水肿者:联合甘露醇或甘露醇+七叶皂苷。脑出血急性期伴相关并发症的患者可根据适应症选择:①氨甲环酸+奥拉西坦+哌拉西林钠舒巴坦钠+乳酸钠林格;②氨甲环酸+奥拉西坦+硝苯地平+卡托普利+甲氧氯普胺+西咪替丁;③胰岛素+泮托拉唑+硝普钠。稳定期合并病的联合治疗可根据适应症选择:①单唾酸四己糖神经节苷脂钠+小牛血清去蛋白+硝酸甘油+复合磷酸氢钾;②依达拉奉+神经节苷脂+卡托普利+左氧氟沙星+痰热清注射液+氨茶碱。活血化瘀类用药子群模块的分析提示脑出血治疗中应用活血化瘀类中成药要注意其用药安全性。该文属于真实世界研究,存在数据缺失及混杂因素等问题,归纳的用药方案仅供临床医师参考,在该研究基础上,可进一步开展前瞻性临床疗效和安全性评价。
In this study, Tabu search algorithm was used to analyze the effect of Xingnaojing Injection in the treatment of cerebral hemorrhage in the real world. Through the analysis of the results, the therapies based on the pathogeny of cerebral hemorrhage were screened out: Xingnaojing Injection+hemostatic drugs for promoting blood circulation and removing stasis. Cerebral hemorrhage complicated with brain edema: combined with mannitol or mannitol+aescin. The patients with relevant complications in the acute stage of cerebral hemorrhage could select according to the indications: ①Aminocycline+Oxiracetam+Piperacillin Sodium Sulbactam Sodium+Sodium Lactate Ringer; ②Aminocycline+Oxiracetam+Nifedipine+Captopril+Metoclopramide+Cimetidine; ③Insulin+Pantoprazole+So-dium Nitroprusside. The combined therapies for patients of the stable stage with complicating diseases could select according to the indications: ① Monosialotetrahexosyl Ganglioside Sodium+Deproteinized Calf Blood Serum+Nitroglycerin+Compound Potassium Dihydrogn Phosphate; ② Edaravone+Gangliosides+Captopril+Levofloxacin+Tanreqing Injection+Aminophylline. The analysis of subgroup module of drugs for promoting blood circulation and removing blood stasis suggested that the safety of traditional Chinese medicine should be paid attention to in the treatment of cerebral hemorrhage. This study was based on the data of the real world, but with some problems, such as lack of data and confounding factors. The summarized medication plan is only for the reference of clinicians. The clinical application shall be based on the specific situation of patients and the clinical benefits and risks, and pay attention to the incompatibility.

关键词(KeyWords): 脑出血;醒脑静注射液;联合用药;真实世界研究;Tabu搜索算法
cerebral hemorrhage;Xingnaojing Injection;combined medication;real world study;Tabu search algorithm

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基金项目(Foundation): 国家重点研发计划项目(2018YFC1707400,2018YFC1707410)

作者(Author): 耿洪娇;谢雁鸣;张敏;
GENG Hong-jiao;XIE Yan-ming;ZHANG Min;Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences;School of Statistics, Renmin University of China;

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