中国临床药学杂志

目的 基于“Chou-Talalay”模型，分析缺血性脑梗死合并周围神经损伤（PNI）病例的药对配伍强度，为该类患者的临床用药的综合评价提供合理方法及依据。方法 收集神经脑科中心2022-2023年的所有缺血性脑梗死合并PNI的患者用药信息，将排名前五的缺血性脑梗死及PNI联合用药的品种品规进行药对配伍。基于“Chou-Talalay”模型和CompuSyn 1.0软件，计算药对配伍CI值并根据CI值大小，判断各配伍药对的协同/拮抗作用（CI <1.00为协同，CI=1.00为相加，CI> 1.00为拮抗）及量化配伍作用程度。结果 缺血性脑梗死合并PNI的患者中，缺血性脑梗死主要用药品规为盐酸倍他司汀注射液（使用率为81.23%）、注射用己酮可可碱（使用率为57.43%）、依达拉奉右莰醇注射用浓溶液（使用率为43.83%）、丁苯酞氯化钠注射液（使用率为43.32%）及甲磺酸倍他司汀片（使用率为21.41%）;PNI用药品规为盐酸罂粟碱注射液（使用率为11.96%）、普瑞巴林胶囊（使用率为10.45%）、甲钴胺胶囊（使用率为8.56%）、维生素B6片（使用率为5.54%）及盐酸乙哌立松片（使用率为4.41%）。按药对有效率85%计算，甲磺酸倍他司汀片与各PNI用药的协同作用强度最大，其次为注射用己酮可可碱和丁苯酞氯化钠注射液（P=0.0193）；甲磺酸倍他司汀片与甲钴胺片的协同作用最强（CI=0.01），丁苯酞氯化钠注射液与甲钴胺片的协同作用次之（CI=0.07）；盐酸倍他司汀注射液联合盐酸罂粟碱注射液、注射用己酮可可碱联合甲钴胺片、维生素B6片、盐酸乙哌立松片时，需注意可能存在拮抗作用（CI> 1.00）。结论 利用“Chou-Talalay”模型计算配伍药对的CI值并量化药物相互作用强度，可协助医疗机构及时评价药物联合使用时的有效性及安全性，为更好地持续跟踪临床用药情况提供了可行且有力的基线依据。

AIM Based on the "Chou-Talalay" model, the study analyzes the compatibility strength of drug pairs in patients with ischemic cerebral infarction combined with peripheral nerve injury(PNI), providing a rational methodology and evidence-based foundation for comprehensive clinical evaluation of drug efficacy and safety. METHODS The medication information of all patients with ischemic cerebral infarction combined with PNI in the Neurobrain Center from 2022 to 2023 was collected. The top 5 combined medication varieties and specifications for ischemic cerebral infarction and PNI were paired for analysis. Based on the "Chou-Talalay" model and CompuSyn 1.0 software, the CI value of the drug pair compatibility was calculated. Synergistic/antagonistic effects were determined according to CI thresholds:CI<1.00(synergy), CI=1.00(additive) and CI>1.00(antagonism), enabling quantitative assessment of compatibility effects. RESULTS Among patients with ischemic cerebral infarction combined with PNI, the main medications used for ischemic cerebral infarction were betahistine hydrochloride injection(81.23%), pentoxifylline injection(57.43%),edaravone dexbobornol concentrated solution injection(43.83%), butylphthalide sodium chloride injection(43.32%) and betahistine mesylate tablets(21.41%). PNI regulations were papaverine hydrochloride injection(11.96%), pregabalin capsules(10.45%), methylcobalamin capsules(8.56%), vitamin B6 tablets(5.54%) and eperisone hydrochloride tablets(4.41%). Under an 85% drug pair efficacy threshold, betahistine mesylate tablets had the greatest synergistic effect with each medicine for PNI, followed by pentoxifylline injection and butylphthalide sodium chloride injection(P=0.0193).Betahistine mesylate tablets and methylcobalamin tablets exhibited the strongest synergistic effect(CI=0.01), followed by butylphthalide sodium chloride injection and methylcobalamin tablets(CI=0.07). Notably, potential antagonistic interactions(CI>1.00) were identified in the following combinations: betahistine hydrochloride injection combined with papaverine hydrochloride injection, and pentoxifylline injection coadministered with methylcobalamin tablets, vitamin B6tablets, or eperisone hydrochloride tablets. CONCLUSION The application of the "Chou-Talalay" model to calculate the CI values of compatible drug pairs and quantify the intensity of drug interactions enables medical institutions to evaluate the efficacy and safety of combination therapies promptly. This approach establishes a feasible and robust baseline reference for enhanced continuous monitoring of clinical medication practices.