某院住院患者中药注射剂临床应用的药物相关问题调查
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摘要
目的:调查中药注射剂临床应用的药物相关问题(DRPs),促进临床合理用药。方法:参考西班牙药物相关问题的研究方法 Granada-Ⅱ分类法及《中药注射剂临床使用基本原则》制定中药注射剂临床应用的药物相关问题分类标准,收集某院2017年1月出院患者中使用中药注射剂的全部病例855份并进行调查。结果:855份病例中有608份病例发生DRPs(71.1%),累计发生851 DRPs药次,包括225 DRP2药次,50 DRP4药次,496 DRP5药次,80 DRP6药次。DRP5发生药次最多,主要表现为溶媒选择不合理、溶媒量过少等。DRPs涉及23种中药注射剂,其中红花注射液及灯盏花素注射液位居DRPs前2位。结论:采用中药注射剂临床应用的药物相关问题分类标准来分析中药注射剂合理用药性是可行的,应制定干预措施,规范中药注射剂的合理使用。
Objective: To study drug-related problems of traditional Chinese medicine injections in clinical application of inpatients and to provide reference for clinical medicination. Methods: Classification criteria of drug-related problems of traditional Chinese medicine injections in clinical application was established withreference to drug-related problems of the Spanish Granada-Ⅱ Classification and Basic principles for clinical of traditional Chinese medicine injections,and was used to study the relevant 855 cases of illness that using traditional Chinese medicine injections during 2017 January in one hospital. Results: Among the 855 patients,the total number of DRPs was 608(account for 71. 1%). Traditional Chinese medicine injections accumulated generating 851 DRPs,including 225 DRP2,50 DRP4,496 DRP5,80 DRP6. The DRP5 occured most frequently. The main manifestations were unreasonable choice of solvent,too little quantity of solvent,etc. DRPs involed 23 kinds of traditional Chinese medicine injections,the safflor injection and breviscapine injection ranked top 2. Conclusion: It was reasonable and feasible to analyzing rationality of medication of traditional Chinese medicine injection according to classification criteria of drug-related problems of traditional Chinese medicine injections in clinical application. It was necessary to develop intervention measure to enhance rationality of traditional Chinese medicine injections in clinical application.
Objective: To study drug-related problems of traditional Chinese medicine injections in clinical application of inpatients and to provide reference for clinical medicination. Methods: Classification criteria of drug-related problems of traditional Chinese medicine injections in clinical application was established withreference to drug-related problems of the Spanish Granada-Ⅱ Classification and Basic principles for clinical of traditional Chinese medicine injections,and was used to study the relevant 855 cases of illness that using traditional Chinese medicine injections during 2017 January in one hospital. Results: Among the 855 patients,the total number of DRPs was 608(account for 71. 1%). Traditional Chinese medicine injections accumulated generating 851 DRPs,including 225 DRP2,50 DRP4,496 DRP5,80 DRP6. The DRP5 occured most frequently. The main manifestations were unreasonable choice of solvent,too little quantity of solvent,etc. DRPs involed 23 kinds of traditional Chinese medicine injections,the safflor injection and breviscapine injection ranked top 2. Conclusion: It was reasonable and feasible to analyzing rationality of medication of traditional Chinese medicine injection according to classification criteria of drug-related problems of traditional Chinese medicine injections in clinical application. It was necessary to develop intervention measure to enhance rationality of traditional Chinese medicine injections in clinical application.
引文
1 Strand LM,Morley PC,Cipolle RJ,et al.Drug-related problems:their structure and function[J].DICP,1990,24(11):1093-1097
2 Hanlon JT,Lindblad CI,Gray SL.Can clinical pharmacy services have a postive impact on drug-related problems and health outcomes in community-based older adults?[J].Am J Geratr pharmacother,2004,2(1):3-13
3 Garc2o JA,Cabrita J.Evaluation of a pharmaceutical care program for hypertensive patients in rural portugal[J].J Am Phar Assoc(Wash),2002,42(6):858-864
4 曹凤,吴方建.由药品不良反应/事件看我院中药注射剂临床应用药物相关问题[J].药物流行病学杂志,2016,25(12):777-781
5 国家药品食品监督管理总局.国家药品不良反应监测年度(2014年)[EB/OL].(2015-07-17)[2015-08-10]http://www.sda.gov.cn/WS01/CL0078/124407.html
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8 卫生部,国家食品药品监督管理局,国家中医药管理局.关于印发《中药注射剂临床使用基本原则》的通知[Z].2008-12-24
9 李遐方.灯盏花素对促进四肢骨折愈合的临床观察[J].中国医药指南,2011,9(33):420-421
10 孙佳瑜,李晖,陈蕾,等.红花注射液在创伤性肘关节骨折术后治疗中对异位骨化的影响[J].热带医学杂志,2017,17(5):666-668.
11 欧阳劭,陈伟.红花注射液联合法舒地尔治疗慢性肺源性心脏病的临床研究[J].深圳中西医结合杂志,2017,27(22):16-18
12 国家药品食品监督管理总局.国家食品药品监督管理局修订红花注射液说明书[EB/OL].(2012-09-07)[2018-04 -15]http://www.sda.gov.cn/WS01/CL0844/74551.html.2012-08-27
13 朱春梅,吴民,赵江琳.7种中药注射液在生理盐水中的稳定性考察[J].西北药学杂志,2009,24(5):389
14 杨立英,杨益峰.痰热清临床药物配伍禁忌文献分析[J].中国农村卫生事业管理,2012,32(1):41-42
15 李瑾翡,谭舜,赖宇红,等.注射用丹参不良反应原因筛查的实验研究[J].中药新药与临床药理,2009,20(3):285-287
2 Hanlon JT,Lindblad CI,Gray SL.Can clinical pharmacy services have a postive impact on drug-related problems and health outcomes in community-based older adults?[J].Am J Geratr pharmacother,2004,2(1):3-13
3 Garc2o JA,Cabrita J.Evaluation of a pharmaceutical care program for hypertensive patients in rural portugal[J].J Am Phar Assoc(Wash),2002,42(6):858-864
4 曹凤,吴方建.由药品不良反应/事件看我院中药注射剂临床应用药物相关问题[J].药物流行病学杂志,2016,25(12):777-781
5 国家药品食品监督管理总局.国家药品不良反应监测年度(2014年)[EB/OL].(2015-07-17)[2015-08-10]http://www.sda.gov.cn/WS01/CL0078/124407.html
6 国家药品食品监督管理总局.国家药品不良反应监测年度(2015年)[EB/OL].(2016-07-13)[2016-08-05]http://www.sda.gov.cn/WS01/CL0844/158940.html
7 国家药品食品监督管理总局.国家药品不良反应监测年度(2016年)[EB/OL].(2017-04-28)[2017-05-15]http://www.sda.gov.cn/WS01/CL0844/172167.html
8 卫生部,国家食品药品监督管理局,国家中医药管理局.关于印发《中药注射剂临床使用基本原则》的通知[Z].2008-12-24
9 李遐方.灯盏花素对促进四肢骨折愈合的临床观察[J].中国医药指南,2011,9(33):420-421
10 孙佳瑜,李晖,陈蕾,等.红花注射液在创伤性肘关节骨折术后治疗中对异位骨化的影响[J].热带医学杂志,2017,17(5):666-668.
11 欧阳劭,陈伟.红花注射液联合法舒地尔治疗慢性肺源性心脏病的临床研究[J].深圳中西医结合杂志,2017,27(22):16-18
12 国家药品食品监督管理总局.国家食品药品监督管理局修订红花注射液说明书[EB/OL].(2012-09-07)[2018-04 -15]http://www.sda.gov.cn/WS01/CL0844/74551.html.2012-08-27
13 朱春梅,吴民,赵江琳.7种中药注射液在生理盐水中的稳定性考察[J].西北药学杂志,2009,24(5):389
14 杨立英,杨益峰.痰热清临床药物配伍禁忌文献分析[J].中国农村卫生事业管理,2012,32(1):41-42
15 李瑾翡,谭舜,赖宇红,等.注射用丹参不良反应原因筛查的实验研究[J].中药新药与临床药理,2009,20(3):285-287