摘要
该研究在＂病证结合、方证相应、动态时空＂理论指导下,采集11 135例来自全国多家三级甲等中医医院的医院信息系统（hospital information system,HIS）中急性缺血性中风病患者数据,以复杂网络分析患者急性期不同时间段内核心证候要素,发现患者入院1 d内核心证候要素为血瘀、痰、内风、阴虚、气虚、热、阳亢和肝、肾,入院8-14 d核心证候要素为血瘀、痰、阴虚、气虚、内风、阳亢和肝、肾。选择治疗结局为＂好转＂和＂治愈＂的患者数据,采用复杂网络分析结合关联分析辨识不同病情患者在入院后不同时间内的中西药物群组模块,发现患者入院14 d内中西药物模块主要有＂活血化瘀模块＂,由＂抗血小板药＋改善循环药物（或抗凝药、降纤药等）＋活血化瘀药＂构成,＂化瘀祛痰模块＂由＂抗血小板药＋改善循环药（或抗凝药、降纤药等）＋化痰醒脑药＂构成。入院7 d内病情为急和一般的患者核心中西药物模块主要使用＂活血化瘀模块＂和＂化瘀祛痰模块＂,入院病情为危的患者未发现使用率1%以上的3项或以上中西药物模块;入院病情为急、危、一般的患者入院8-14 d主要使用＂活血化瘀模块＂。通过研究真实世界医疗大数据发现,缺血性中风病急性期患者中西药物联合使用符合＂病证结合、方证相应、动态时空＂理论,发掘了多个缺血性中风病急性期＂病-证-药-时-效＂多维立体的中西药物群组模块,形成了基于医疗电子大数据的中西药物研究方法。
Under the theoretical guidance of ＂ combination of disease and syndrome,correspondence between syndrome and prescription,and dynamic space-time＂,11 135 acute ischemic stroke patients were collected from hospital information system（ HIS） of many 3 A grade hospitals of traditional Chinese medicine. Complex network analysis was adopted to obtain the core syndrome elements in different periods of acute ischemic stroke patients,and it was found that the core syndrome elements were blood stasis syndrome,phlegm,endogenous wind,Yin deficiency,Qi deficiency,heat,hyperactivity of liver Yang,liver,and kidney of patients in hospital for the first day,and during 8-14 d in hospitalization,the core syndrome elements were blood stasis,phlegm,Yin deficiency,Qi deficiency,endogenous wind,hyperactivity of liver Yang,liver,and kidney. The data with ＂ improved＂ and ＂ cured＂ treatment outcomes were adopted for complex network analysis and correlation analysis to identify the Chinese and Western medicine group modules in patients with different disease conditions in different phases after hospitalization. It was found that the Chinese and Western medicine modules within 14 d after hospitalization mainly included ＂ blood-activating and stasis-dissolving module ＂ consisted by ＂ anti-platelet drug ＋ circulation-improving medicine（ or anticoagulant drug and anti-fibrinogen drug,et al） ＋ blood-activating and stasis-dissolving drugs＂,as well as ＂ stasis-dissolving and phlegm-reducing module＂ consisted by ＂ anti-platelet drugs ＋ circulation-improving medicine（ or anticoagulant drug and anti-fibrinogen drug,et al） ＋ phlegm refreshing drug＂. The core Chinese and Western medicine modules in patients with urgent and general conditions within 7 d after hospitalization mainly used ＂ blood-activating and stasis-dissolving module＂ and ＂ stasis-dissolving and phlegm-reducing module＂. Three or more Chinese medicine and Western medicines module with more than 1% utilization rate was not found in th
作者
杨薇
黎明全
李杨
孙磊磊
谢雁鸣
郭崇慧
庄严
YANG Wei;LI Ming-quan;LI Yang;SUN Lei-lei;XIE Yan-ming;GUO Chong-hui;ZHUANG Yan(The Affiliated Hospital of Changchzm University of Chinese Medicine, Changchun 130021, China;Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China;Institute of Systems Engineerbtg, Dalian University of Technology, Dalian 116024, China;Computer Management Center, Navy Gerwral Hospital, Beijing 100048, China)
出处
《中国中药杂志》
CAS
CSCD
北大核心
2018年第3期618-626,共9页
China Journal of Chinese Materia Medica
基金
中国中医科学院博士研究生创新人才培养基金项目(CX201408)
中药上市后临床再评价关键技术创新团队(PY1303)
中央级公益性科研院所基本科研业务费专项第9批自主选题项目(Z0406)
2015年中医药行业科研专项(201507003-8)
关键词
缺血性中风病急性期
复杂网络
中西药物群组模块
医疗电子数据
医院信息系统
the acute phase of ischemic stroke
complex network
Chinese and Western medicine group module
electronic medical records
hospital information system
