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Abstract：
Introduction: Xiyanping injection (XYP), a type of Traditional Chinese Medicine, is widely used and often applied in combination with other medications in treating bronchitis, tonsillitis, and bacillary dysentery in China. In recent years, an elevated risk of allergic reactions has been observed following XYP, but whether concomitant medication use contributes to this risk is still unknown. Objective: This study aims to investigate the association between the concomitant use of XYP and the 25 most frequently co-applied medications with suspected allergic reactions for China\'s patients receiving XYP. Methods: A nested case-control study was conducted using the sampling data from 2015 China\'s Urban Employees Basic Medical Insurance and Urban Residents Basic Medical Insurance database. Four anti-allergic marker drugs were used to evaluate suspected allergic reactions. Univariate analyses and multivariable conditional logistic regression were conducted, and results were reported as odds ratios (ORs) with a 95% confidence interval (CI). Sensitivity analyses were performed on the expanded sample by including those prescribed with anti-allergic marker drugs on the same day as XYP and then stopped XYP on the next day. Results: Out of 57,612 participants with XYP prescription, we obtained 949 matched case-control pairs. Multivariable conditional logistic regression revealed that seven concomitant medications including gentamicin [OR = 4.29; 95% CI (2.52, 7.30)], cefoperazone-sulbactam [OR = 4.26; 95% CI (1.40, 13.01)], lidocaine [OR = 2.76; 95% CI (1.79, 4.25)], aminophylline [OR = 1.73; 95% CI (1.05, 2.85)], ribavirin [OR = 1.54; 95% CI (1.13, 2.10)], potassium chloride [OR = 1.45; 95% CI (1.10, 1.91)], and vitamin C [OR = 1.32; 95% CI (1.03, 1.70)] were associated with increased risk, while cefathiamidine [OR = 0.29; 95% CI (0.16, 0.51)] was associated with reduced risk. Sensitivity analysis on 2,438 matched pairs revealed similar findings. Conclusion: Increased risks for suspected allergic reactions were found for the concomitant use of XYP with seven medications. Our data suggest that gentamicin, cefoperazone-sulbactam, lidocaine, and ribavirin should be applied with precautions for patients receiving XYP, and further studies on drug interactions and allergy mechanisms are warranted.
摘要：
简介：喜炎平注射液（XYP），一种中药,被广泛使用，并经常与其他药物联合应用于治疗支气管炎，扁桃体炎,和中国的细菌性痢疾。近年来,在XYP之后观察到过敏反应的风险升高，但合并用药是否会导致这种风险尚不清楚.目的：本研究旨在调查中国接受XYP的患者同时使用XYP和25种最常见的共同使用药物与可疑过敏反应之间的关系。方法:采用2015年中国城镇职工基本医疗保险和城镇居民基本医疗保险数据库的抽样数据进行巢式病例对照研究。使用四种抗过敏标记药物来评估可疑的过敏反应。进行单变量分析和多变量条件逻辑回归，结果报告为比值比(ORs),95%置信区间(CI).通过包括与XYP在同一天用抗过敏标记药物处方的那些对扩大的样品进行敏感性分析,然后在第二天停止XYP。结果：在57,612名XYP处方参与者中，我们获得了949个匹配的病例对照对.多变量条件logistic回归显示，包括庆大霉素在内的7种合并用药[OR=4.29;95%CI(2.52,7.30)]，头孢哌酮-舒巴坦[OR=4.26；95%CI（1.40，13.01）]，利多卡因[OR=2.76；95%CI（1.79，4.25）]，氨茶碱[OR=1.73；95%CI（1.05，2.85）]，利巴韦林[OR=1.54；95%CI（1.13，2.10）]，氯化钾[OR=1.45；95%CI（1.10，1.91）]，和维生素C[OR=1.32;95％CI（1.03，1.70）]与风险增加相关，而头孢硫脒[OR=0.29;95%CI(0.16,0.51)]与风险降低相关.对2,438对配对的敏感性分析显示出类似的发现。结论：发现XYP与七种药物同时使用会增加可疑过敏反应的风险。我们的数据表明庆大霉素,头孢哌酮-舒巴坦,利多卡因,和利巴韦林应与预防措施一起应用于接受XYP的患者，和药物相互作用和过敏机制的进一步研究是必要的。
