2015～2017年我院中药注射剂使用合理性分析
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摘要
目的:对我院近3年中药注射剂使用情况及处方合理性进行调查分析,促进临床合理使用中药注射剂。方法:采用限定日剂量、药品销售金额、用药频度、限定日费用、排序比等指标,统计分析2015～2017年我院中药注射剂使用情况,并对此期间使用中药注射剂的24 356份病历进行处方点评。结果:调查涉及中药注射剂品种17个,销售金额以抗肿瘤药为最高,心脑血管病用药次之;DDDs排序前10个品种为心脑血管、肿瘤、呼吸疾病用药;不合理处方比例为3.31%,其中给药途径不合理病历数最多占57.82%,其次为溶媒剂量不合理及遴选药品不合理。结论:规范中药注射剂的临床应用并发挥临床药师作用,促进中药注射剂的合理使用。
Objective: To investigate and analyze the rationality of the prescriptions containing traditional Chinese medicine injections in a hospital during the past three years in order to master the clinical use situation of traditional Chinese medicine injections and improve the reasonable level. Methods: A retrospective analysis on the use of TCM injections in a hospital during 2015 and 2017 was performed with the defined daily dose,amount of drug sales,defined daily doses,defined daily cost and sorting ratio as the indices,and prescription comment was carried out for the 24 356 medical records containing TCM injections. Results: A total of 17 varieties of traditional Chinese medicine injections were involved,and anti-tumor drugs were with the highest sales amount followed by cardiovascular and cerebrovascular drugs. As for DDDs,the top 10 varieties of TCM injections were used for cardio-cerebrovascular,tumor and respiratory diseases. Nearly 90 percent of them were used in the treatment of tumors,cardiovascular and respiratory diseases. The proportion of unreasonable prescriptions was 3. 31%,and that of unreasonable medical records with unsuitable administration route was as high as 57. 82%,followed by unreasonable solvent dose and drug selection. Conclusion: The clinical application of traditional Chinese medicine injections should be standardized,and clinical pharmacist can play an important role in promoting the rational use of traditional Chinese medicine injections.
Objective: To investigate and analyze the rationality of the prescriptions containing traditional Chinese medicine injections in a hospital during the past three years in order to master the clinical use situation of traditional Chinese medicine injections and improve the reasonable level. Methods: A retrospective analysis on the use of TCM injections in a hospital during 2015 and 2017 was performed with the defined daily dose,amount of drug sales,defined daily doses,defined daily cost and sorting ratio as the indices,and prescription comment was carried out for the 24 356 medical records containing TCM injections. Results: A total of 17 varieties of traditional Chinese medicine injections were involved,and anti-tumor drugs were with the highest sales amount followed by cardiovascular and cerebrovascular drugs. As for DDDs,the top 10 varieties of TCM injections were used for cardio-cerebrovascular,tumor and respiratory diseases. Nearly 90 percent of them were used in the treatment of tumors,cardiovascular and respiratory diseases. The proportion of unreasonable prescriptions was 3. 31%,and that of unreasonable medical records with unsuitable administration route was as high as 57. 82%,followed by unreasonable solvent dose and drug selection. Conclusion: The clinical application of traditional Chinese medicine injections should be standardized,and clinical pharmacist can play an important role in promoting the rational use of traditional Chinese medicine injections.
引文
1原国家食品药品监督管理总局.国家药品不良反应监测年度报告:2017年[R].2017
2 蔡黎,朱磊.2013年某院中药注射剂使用情况分析[J].中国药业,2016,25(1):80-83
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5 张宏丽,许建辉,李新.超说明书用药的安全隐患[J].实用药物与临床,2015,18(9):1140-1142
6 赵瑛,黄璞,张玉,等.喜炎平注射液儿科住院患者临床应用分析[J].中国医院药学杂志,2016,8(36):1388-1391
7 曹建华.中药注射剂临床使用安全性的探讨[J].中华中医药学刊,2007,25(10):2196
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10 赵全凤,路晓钦,董志,等.重庆市689例中药注射剂严重不良反应/事件报告分析[J].中国医院药学杂志,2016,36(16):1402-1406
11 陆斌.86例中药注射剂临床不合理使用情况分析[J].中国药业,2016,25(8):87-89
12 殷生楠,李智勤.中药注射剂不良反应分析[J].辽宁中医药大学学报,2015,17(12):171-172
13 孙玲,裔照国,王明月,等.三级医院5年162例中药注射剂不良反应报告分析[J].现代中药研究与实践,2016,30(2):76-78
14 刘洋,范峥,常馨予,等.我院祛瘀及清热类中药致新的和严重的不良反应298例分析[J].中国药房,2018,29(8):1091-1094
2 蔡黎,朱磊.2013年某院中药注射剂使用情况分析[J].中国药业,2016,25(1):80-83
3 崔学艳,时银萍,时海燕,等.超说明书用药管理及药学服务模式探讨[J].中国医院药学杂志,2016,36(9):751-754
4 广东省药学会.关于印发《药品未注册用法专家共识》的通知[J].今日药学,2010,20(4):1-3
5 张宏丽,许建辉,李新.超说明书用药的安全隐患[J].实用药物与临床,2015,18(9):1140-1142
6 赵瑛,黄璞,张玉,等.喜炎平注射液儿科住院患者临床应用分析[J].中国医院药学杂志,2016,8(36):1388-1391
7 曹建华.中药注射剂临床使用安全性的探讨[J].中华中医药学刊,2007,25(10):2196
8 亢卫华,平贯芳,崔李平.综合医院中药注射剂合理用药分析[J].中成药,2016,4(38):955-957
9 苗明三,李艳,祝侠丽,等.中药注射剂临床应用中存在的问题及安全应用策略[J].中国药师,2015,18(10):1739-1746
10 赵全凤,路晓钦,董志,等.重庆市689例中药注射剂严重不良反应/事件报告分析[J].中国医院药学杂志,2016,36(16):1402-1406
11 陆斌.86例中药注射剂临床不合理使用情况分析[J].中国药业,2016,25(8):87-89
12 殷生楠,李智勤.中药注射剂不良反应分析[J].辽宁中医药大学学报,2015,17(12):171-172
13 孙玲,裔照国,王明月,等.三级医院5年162例中药注射剂不良反应报告分析[J].现代中药研究与实践,2016,30(2):76-78
14 刘洋,范峥,常馨予,等.我院祛瘀及清热类中药致新的和严重的不良反应298例分析[J].中国药房,2018,29(8):1091-1094