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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

ISSN号：1001-5213
期刊名称：《中国医院药学杂志》
时间：0
分类：R969[医药卫生—药理学;医药卫生—药学]
作者机构：[1]南京中医药大学江苏省中药资源产业化过程协同创新中心,江苏省方剂高技术研究重点实验室,江苏南京210046, [2]南京中医药大学附属医院,江苏南京210029, [3]陕西中医药大学,陕西咸阳712000, [4]菏泽步长制药有限公司,陕西西安710000
相关基金：国家重点基础研究发展计划（“973计划”）项目（编号：2011CB505300）; 国家“重大新药创制”科技重大专项（编号：2015ZX09501004001006）; 江苏省高校自然科学研究重大项目（编号：14KJA360001）; 江苏省中药资源产业化过程协同创新中心重点项目（编号：ZDXM-2-2）; 江苏省普通高校研究生科研创新计划项目（编号：KYLX_0968）; 江苏省高等学校大学生创新创业训练计划省级项目（编号：201510315064Y）

作者：张倩[1,2], 居文政[2], 郭建明[1], 李建萍[1], 王晓骁[2], 戴国梁[2], 谭喜莹[2], 唐志书[3], 赵步长, 段金廒[1]

关键词：丹红注射液, 临床联合用药, 药物相互作用, Danhong injection, clinical drug combination, drug-drug interaction

中文摘要：

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。

英文摘要：

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 5combinations.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.

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