摘要
目的分析复方甘草酸苷注射液的使用特点及规律,促进临床合理用药。方法调取电子病历系统住院部皮肤科2016年至2018年使用复方甘草酸苷注射液患者的诊断、用量、溶剂和合并用药等信息。结果 691例患者中,男425例,女266例;主要用于治疗湿疹(25. 90%)、银屑病(22. 58%)和药物性皮炎(11. 58%);均采用静脉滴注,86. 46%的患者日使用剂量为40～60 m L,13. 07%的患者为80 m L,0. 46%的患者为20 m L;溶剂多采用5%葡萄糖注射液(81. 23%),其次为木糖醇注射液(18. 13%)、0. 9%氯化钠注射液(0. 43%)、10%葡萄糖注射液(0. 16%); 5 369例次(95. 64%)与维生素C注射液同瓶静脉滴注,6例患者合并使用氨溴索,10例患者合并使用呋塞米;可见精神欠佳、乏力等症状,疑与药物相互作用相关。结论复方甘草酸苷注射液临床使用日剂量普遍大于药品说明书皮肤病推荐剂量,但未超过慢性肝炎推荐剂量。该注射液药品说明书对溶剂未作明确要求,临床使用多种不同溶剂,常与维生素C同瓶注射。存在超适应证用药及配伍禁忌现象,有待干预,以促进临床合理用药。
Objective To analyze the characteristics and rules of clinical use of Compound Glycyrrhizin Injection to promote rational drug use in the clinic. Methods By electronic medical record system,inpatients who used Compound Glycyrrhizin Injection were collected from 2016 to 2018 in the Department of Dermatology to analyze the diagnosis,dosage,solvent and concomitant medication.Results Among 691 patients,425 were males and 266 were females. Compound Glycyrrhizin Injection was mainly used for the treatment of eczema( 25. 90%),psoriasis( 22. 58%) and drug-induced dermatitis( 11. 58%). All patients used intravenous drip with the daily dose of 40-60 m L( 86. 46%),80 m L( 13. 07%) and 20 m L( 0. 46%). 5% Glucose Injection( 81. 23%) was the used most solvent,followed by Xylitol Injection( 18. 13%),0. 9% Sodium Chloride Injection( 0. 43%),and 10% Glucose Injection( 0. 16%). Totally 5 369 cases( 95. 64%) were intravenously dripped with Vitamin C Injection in the same bottle,6 cases were combined with ambroxol,10 cases were combined with furosemide,and symptoms such as poor spirit and fatigue were found,which were suspected to be related to drug interactions. Conclusion The daily dose of Compound Glycyrrhizin Injection in clinical use is generally higher than the recommended dose of skin disease,but not chronic hepatitis in drug instructions. The drug instructions for this injection don't explicitly requirements for the solvent,while it is aften injected with vitamin C in the same bottle,and also with a variety of different solvents in the clinic.Also,inappropriate use such as medication without indication and incompatibility are found during clinical treatment,which need to be intervened to promote the rational use of drugs in the clinic.
引文
[1]涂碎萍,侯雅琴,边原,等. 6种甘草酸盐乳膏中甘草酸的体外经皮渗透特性比较[J].中国药房,2018,29(9):1205-1208.
[2]李立文,张嘉丽,董杨,等.甘草酸、甘草次酸假性醛固酮作用和药物相互作用研究进展[J].辽宁中医药大学学报,2018,20(10):216-220.
[3]张明发,沈雅琴.甘草酸及其苷元甘草次酸的糖皮质激素样作用[J].现代药物与临床,2011,26(1):33-35.
[4]高贵元,陈丽华,张芳,等.复方甘草酸苷致不良反应文献分析[J].中国药房,2016,27(14):1932-1935.
[5]王一铮,郑英杰,刘飞飞.复方甘草酸苷的皮肤科临床应用探讨[J].临床医药文献电子杂志,2018,5(13):170.
[6]肖佐环,周小军,苟新敏.复方甘草酸苷联合雷公藤多甙治疗原发性红皮病9例分析[J].中国实用医药,2010,25(21):175.
[7]蒋小月,钱佳慧,潘敬珍.复方甘草酸苷联合皮损内封闭治疗结节性痒疹的疗效观察[J].西部医学,2013,25(12):1865-1866.
[8]刘样满,王国安,陈俊杰,等.复方甘草酸苷片联合综合疗法治疗变应性皮肤血管炎34例临床观察[J].中国皮肤性病学杂志,2016,30(11):1208-1210.
[9]张云颖,任小平,陈玉芬.复方甘草酸苷在皮肤科的应用进展[J].中国药物滥用防治杂志,2015,21(4):246-248.
[10]韦无边,卢柳伊,覃崇宁.复方甘草酸苷在皮肤性病科的应用与研究进展[J].医学综述,2014,20(16):2988-2991.
[11]田姣龙.氨溴索注射液与复方甘草酸苷注射液存在配伍禁忌[J].当代护士(下旬刊),2018,25(10):191.
[12]路霞林,宋熙薇,喻志阳,等.静脉联合用药中门冬氨酸钾镁注射液的配伍禁忌与预防对策[J].中南药学,2018,16(10):1472-1475.
