2015—2017年常熟市第一人民医院抗抑郁药应用分析
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摘要
目的:了解常熟市第一人民医院(以下简称"我院")抗抑郁药的应用状况及趋势,为临床合理用药提供参考。方法:采用回顾性方法,参照世界卫生组织推荐的限定日剂量,对2015—2017年我院抗抑郁药的销售金额、用药频度(defined daily dose system,DDDs)、限定日费用(defined daily cost,DDC)及其构成比、年增长率等进行统计分析。结果:2015—2017年,我院抗抑郁药的销售金额分别为234.01万、240.27万和256.16万元,2016年、2017年分别比上年增长2.68%和6.61%,抗抑郁药销售金额占西药总销售金额的比例平均为0.74%。3年来,抗抑郁药的销售金额为730.44万元,选择性5-羟色胺再摄取抑制剂、5-羟色胺及去甲肾上腺素再摄取抑制剂的销售金额分别为549.73万、180.71万元,其占抗抑郁药销售金额的比例分别为75.26%、24.74%;国产、合资和进口抗抑郁药的销售金额分别为339.09万、95.06万、296.29万元,其占抗抑郁药销售金额的比例分别为46.42%、13.01%和40.56%;销售金额排序居前3位的药品依次为帕罗西汀、艾司西酞普兰和文拉法辛;DDDs排序居前3位的药品依次为帕罗西汀、文拉法辛和艾司西酞普兰;度洛西汀的DDC最大,为16.77元。结论:抗抑郁药的使用日益增长,新型抗抑郁药已成为临床首选,基本符合目前的用药趋势;但应加大国产新药的开发和应用,使用药更加安全、有效、经济。
OBJECTIVE: To investigate the application and its trend of antidepressants in Changshu No.1 People's Hospital(hereinafter referred to as "our hospital"), so as to provide references for clinical rational medication. METHODS: By reference of the defined daily dose recommended by WHO, the data of consumption sum, defined daily dose system(DDDs), defined daily cost(DDC) and its constituent ratio and annual growth rate during 2015-2017 were collected and retrospectively analyzed. RESULTS: During 2015-2017, the consumption sums of antidepressants were respectively 2.340 1 million, 2.402 7 million and 2.561 6 million yuan, with growth rates of 2.68% in 2016 and 6.61% in 2017, the average proportion of the consumption sum of antidepressants accounted for 0.74% of the total consumption sum of western medicine. In the past 3 years, the total consumption sum of antidepressants were 7.304 4 million yuan, the consumption sums of selective serotonin reuptake inhibitors(SSRIs), serotonin and norepinephrine reuptake inhibitors(SNRIs) were respectively 5.497 3 million and 1.807 1 million yuan, which respectively accounted for 75.26% and 24.74%; the consumption sums of domestic, joint venture and imported antidepressants were respectively 3.390 9 million, 0.950 6 million and 2.962 9 million yuan, which respectively accounted for 46.42%, 13.01% and 40.56%; the top 3 drugs ranked in consumption sum were paroxetine, escitalopram and venlafaxine in turn; the top 3 drugs ranked in DDDs were paroxetine, venlafaxine and escitalopram in turn; duloxetine had the largest DDC of 16.77 yuan. CONCLUSIONS: The application of antidepressants is ever-growing, and the new antidepressants have become the first clinical choice, which basically conforms to the current trend of drug application; however, the development and application of domestic new drugs should be strengthened to make the application of drugs safer, more effective and economical.
OBJECTIVE: To investigate the application and its trend of antidepressants in Changshu No.1 People's Hospital(hereinafter referred to as "our hospital"), so as to provide references for clinical rational medication. METHODS: By reference of the defined daily dose recommended by WHO, the data of consumption sum, defined daily dose system(DDDs), defined daily cost(DDC) and its constituent ratio and annual growth rate during 2015-2017 were collected and retrospectively analyzed. RESULTS: During 2015-2017, the consumption sums of antidepressants were respectively 2.340 1 million, 2.402 7 million and 2.561 6 million yuan, with growth rates of 2.68% in 2016 and 6.61% in 2017, the average proportion of the consumption sum of antidepressants accounted for 0.74% of the total consumption sum of western medicine. In the past 3 years, the total consumption sum of antidepressants were 7.304 4 million yuan, the consumption sums of selective serotonin reuptake inhibitors(SSRIs), serotonin and norepinephrine reuptake inhibitors(SNRIs) were respectively 5.497 3 million and 1.807 1 million yuan, which respectively accounted for 75.26% and 24.74%; the consumption sums of domestic, joint venture and imported antidepressants were respectively 3.390 9 million, 0.950 6 million and 2.962 9 million yuan, which respectively accounted for 46.42%, 13.01% and 40.56%; the top 3 drugs ranked in consumption sum were paroxetine, escitalopram and venlafaxine in turn; the top 3 drugs ranked in DDDs were paroxetine, venlafaxine and escitalopram in turn; duloxetine had the largest DDC of 16.77 yuan. CONCLUSIONS: The application of antidepressants is ever-growing, and the new antidepressants have become the first clinical choice, which basically conforms to the current trend of drug application; however, the development and application of domestic new drugs should be strengthened to make the application of drugs safer, more effective and economical.
引文
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[2] 刘晓晴,佟富禹.抗抑郁药的合理应用[J].中国卫生产业,2016,13(31):192-193.
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[5] 姜巧巧.2011—2013年北京市垂杨柳医院门诊抗抑郁药应用分析[J].中国医院用药评价与分析,2016,16(4):515-518.
[6] 牛雅娟.《中国抑郁障碍防治指南》药物治疗解读[J].临床药物治疗杂志,2018,16(5):6-8.
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[9] 钟彩妮,曾环思,张璇,等.医院2014年至2016年抗抑郁药应用分析[J].中国药业,2018,27(3):75-78.
[10] 范毅.选择性5-羟色胺再摄取抑制剂类药物的研究进展[J].药物评价研究,2012,35(2):126-129.
[11] 王申捷,孙凡,朱亮.选择性5-羟色胺再摄取抑制剂的临床应用进展[J].现代生物医学进展,2014,14(3):571-574.
[12] 张霞,刘士丽,王翠芹.选择性5-HT再摄取抑制剂与5-HT、NE再摄取双重抑制剂治疗围绝经期情绪障碍疗效[J].中国健康心理学杂志,2014,22(12):1777-1779.
[13] 刘小林,符巍.氟西汀和帕罗西汀改善青少年抑郁症患者认知功能比较研究[J].中国药业,2017,26(23):31-33.
[14] 李惠春,谭庆荣,司天梅,等.氟西汀治疗抑郁症的疗效综述[J].中国心理卫生杂志,2017,31(S2):7-15.
[15] 单若莹.帕罗西汀与舍曲林改善脑卒中后抑郁障碍的疗效和安全性[J].中国实用神经疾病杂志,2014,17(22):112-113.
[16] 李伟.舍曲林与氟西汀治疗老年脑梗死后抑郁的对照研究[J].北方药学,2017,14(12):149-150.
[17] 杨锦霞.艾司西酞普兰治疗难治性抑郁症的临床研究[J].中国处方药,2017,15(11):72-73.
[18] 陆德青,肖刚,姜宝顺.艾司西酞普兰与西酞普兰治疗女性老年抑郁症伴焦虑患者的随机对照研究[J].中国健康心理学杂志,2014,22(5):656-658.
[19] 张宇.文拉法辛联合盐酸吗啡缓释片治疗中、重度癌性疼痛患者效果及安全性分析[J].医学理论与实践,2018,31(2):232-234.
[20] 贡联兵.选择性5-羟色胺和去甲肾上腺素再摄取抑制剂临床应用与评价[J].中国医院用药评价与分析,2009,9(5):323-325.
[21] 邓晶.度洛西汀缓解强迫症临床症状的效果分析[J].神经损伤与功能重建,2016,11(5):467-468.
[2] 刘晓晴,佟富禹.抗抑郁药的合理应用[J].中国卫生产业,2016,13(31):192-193.
[3] 国家药典委员会.中华人民共和国药典·临床用药须知:化学药和生物制剂卷[S].2015年版.北京:中国医药科技出版社,2017:160-175.
[4] 黄好武,孟倩,周春仲.珠海市人民医院抗抑郁药应用分析[J].中国医院用药评价与分析,2016,16(5):655-658.
[5] 姜巧巧.2011—2013年北京市垂杨柳医院门诊抗抑郁药应用分析[J].中国医院用药评价与分析,2016,16(4):515-518.
[6] 牛雅娟.《中国抑郁障碍防治指南》药物治疗解读[J].临床药物治疗杂志,2018,16(5):6-8.
[7] 吴斌,刘慧.南京地区34家医院2011—2014年抗抑郁药使用分析[J].中国药房,2016,27(17):2326-2328.
[8] 秦娟娟,张勇,梁艳.2012—2016年解放军总医院抗抑郁药物应用分析[J].解放军医学院学报,2017,38(8):802-806.
[9] 钟彩妮,曾环思,张璇,等.医院2014年至2016年抗抑郁药应用分析[J].中国药业,2018,27(3):75-78.
[10] 范毅.选择性5-羟色胺再摄取抑制剂类药物的研究进展[J].药物评价研究,2012,35(2):126-129.
[11] 王申捷,孙凡,朱亮.选择性5-羟色胺再摄取抑制剂的临床应用进展[J].现代生物医学进展,2014,14(3):571-574.
[12] 张霞,刘士丽,王翠芹.选择性5-HT再摄取抑制剂与5-HT、NE再摄取双重抑制剂治疗围绝经期情绪障碍疗效[J].中国健康心理学杂志,2014,22(12):1777-1779.
[13] 刘小林,符巍.氟西汀和帕罗西汀改善青少年抑郁症患者认知功能比较研究[J].中国药业,2017,26(23):31-33.
[14] 李惠春,谭庆荣,司天梅,等.氟西汀治疗抑郁症的疗效综述[J].中国心理卫生杂志,2017,31(S2):7-15.
[15] 单若莹.帕罗西汀与舍曲林改善脑卒中后抑郁障碍的疗效和安全性[J].中国实用神经疾病杂志,2014,17(22):112-113.
[16] 李伟.舍曲林与氟西汀治疗老年脑梗死后抑郁的对照研究[J].北方药学,2017,14(12):149-150.
[17] 杨锦霞.艾司西酞普兰治疗难治性抑郁症的临床研究[J].中国处方药,2017,15(11):72-73.
[18] 陆德青,肖刚,姜宝顺.艾司西酞普兰与西酞普兰治疗女性老年抑郁症伴焦虑患者的随机对照研究[J].中国健康心理学杂志,2014,22(5):656-658.
[19] 张宇.文拉法辛联合盐酸吗啡缓释片治疗中、重度癌性疼痛患者效果及安全性分析[J].医学理论与实践,2018,31(2):232-234.
[20] 贡联兵.选择性5-羟色胺和去甲肾上腺素再摄取抑制剂临床应用与评价[J].中国医院用药评价与分析,2009,9(5):323-325.
[21] 邓晶.度洛西汀缓解强迫症临床症状的效果分析[J].神经损伤与功能重建,2016,11(5):467-468.