真实世界的复方南星止痛膏治疗慢性肌肉骨骼疼痛的用药规律研究OA

Objective:To investigate the clinical characteristics and medication patterns of patients with chronic musculo-skeletal pain treated with Compound Nanxing Zhitong plaster in a real-world setting objective evidence for rational drug use in clinical management of chronic musculoskeletal pain.Methods:A multicenter,prospective real-world study was con-ducted across 38 Chinese and Western medicine hospitals nationwide from November 2021 to December 2022,enrolling 1 921 patients treated with Compound Nanxing Zhitong plaster for chronic musculoskeletal pain.Descriptive analyses were performed on the duration of use,frequency of use,total dosage,pain location,and concomitant medication data.Compari-sons were made between the Compound Nanxing Zhitong plaster monotherapy group and the combination therapy group(Compound Nanxing Zhitong plaster plus nonsteroidal anti-inflammatory drugs).Concomitant medication patterns were analyzed for associations using the Apriori algorithm.Results:Among 1 921 enrolled patients,1 625(84.6％)were in the monotherapy group and 296(15.4％)in the combination therapy group.Patient characteristics showed that the mean age in the monotherapy group was(52.04±15.74)years old and BMI was(23.45±2.86)kg/m2,both significantly higher than the mean age(51.16±15.19)years old and mean BMI(23.29±3.13)kg/m2 in the combination therapy group(P＜0.05).The male-to-female ratio was 0.61∶1.00 in the monotherapy group and 0.60∶1.00 in the combination therapy group(P＞0.05).Intergroup analysis revealed no statistically significant difference in pre-treatment VAS scores between the monotherapy group(5.87±1.10)points and combination therapy group(5.81±1.01)points(P＞0.05).However,significant differences were observed in SF-12 scores(monotherapy group(30.36±2.30)points,combination therapy group(30.76±2.41)points),GPS scores(monotherapy group(83.42±34.73)points,combination therapy group(73.85±31.05)points),and total traditional Chinese medicine syndrome/symptom scale scores(monotherapy group(10.82±2.50)points,combination therapy group(11.00±2.40)points)showed significant differences between the combination therapy group and the monotherapy group(P＜0.05).Further analysis of specific TCM syndromes/symp-toms revealed significant differences between groups in items such as aversion to wind and cold at the affected site,re-stricted joint mobility,and stiffness at the painful area(P＜0.05).Clinical medication results showed that among patients using the Compound Nanxing Zhitong plaster,the most common initial application frequency was once daily(80.4％);the largest proportion of patients(1 349 cases,70.3％)had treatment courses shorter than 4 weeks;followed by 314 patients(16.4％)with treatment cycles between 8 and 12 weeks;while the smallest group had treatment courses exceeding 12 weeks,totaling 22 cases(1.1％).Regarding combined medication frequency,the drugs overall were glucosamine hydro-chloride(93 instances,18.20％),lbuprofen and codeine(67 instances,13.11％),and meloxicam(32 instances,6.26％).For pain locations,the top combination drugs for the neck/shoulder region,lumbar/back region,and extremities were ke-toprofen gel(10 instances,18.18％),meloxicam(20 instances,21.98％),and glucosamine hydrochloride(82 instances,49.10％),respectively.Regarding combination drug associations,the top three drug combinations in the overall population were"Lbuprofen and Codeine+Glucosamine Hydrochloride","Aceclofenac+Glucosamine Hydrochloride",and"Methyl-cobalamin+Ketoprofen Gel".The top combinations for the neck/shoulder region,lumbar/back region,and extremities were"Ketoprofen gel+Eperisone Hydrochloride","Ketoprofen gel+methylcobalamin",and"Lbuprofen and Codeine+glucosamine hydrochloride",respectively.Conclusion:In real-world settings,Compound Nanxing Zhitong plaster is clinically applied primarily to patients with VAS scores of 5-6 points,with monotherapy accounting for 80％of cases.Combination ther-apy predominantly features"Lofendine+Glucosamine Hydrochloride".Optimal drug combinations vary significantly across different pain locations,suggesting that individualized combination therapy should be tailored to the specific pain site.This provides evidence-based support for optimizing the clinical application of Compound Nanxing Zhitong plaster.