中药注射剂在心血管疾病治疗中的合理使用探析
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摘要
目的对中药注射剂在心血管疾病治疗中的使用情况进行分析,为临床合理用药提供参考。方法利用某医院HIS系统调取2017年6月～2018年6月心内科住院病历,筛选含中药注射剂的病历212份,对使用情况进行回顾性分析,总结中药注射剂在心血管疾病治疗中的合理使用情况。结果心内科中药注射剂使用量排在前5位的分别是丹红注射液、参麦注射液、参附注射液、舒血宁注射液、注射用血塞通。中药注射剂不合理使用问题主要集中在无适应症用药、溶媒不当、超量用药、疗程过长、药物浓度过高、配伍禁忌等方面。结论某院心内科中药注射剂的使用总体上比较合理,但仍存在一些不合理用药现象。中药临床药师应加强对中药注射剂医嘱的审核点评,并采取积极有效的干预措施,以促使中药注射剂在治疗心血管疾病方面的应用更加合理。
Objective To investigate the use of traditional Chinese medicine(TCM) injection in the treatment of cardiovascular diseases, and to provide reference for clinical rational drug use. Methods A hospital HIS system is used to retrieve inpatient prescriptions from June 2017 to June 2018 in cardiology department and the prescriptions containing TCM injections are selected. Data of inpatients(212 cases) using TCM injections are retrospectively analyzed to evaluate the reasonable use of TCM injections in the treatment of cardiovascular diseases. Results The top 5 drugs with highest incidence of TCM injections are danhong injection, shenmai injection, shenfu injection, shuxuening injection and xuesaitong for injection. The problems of unreasonable use of TCM injections mainly focused on the use of off-label drugs, idmproper solvent, over dosage, too long treatment period, too high concentration of drugs and incorrect compatibility. Conclusion The use of TCM injections in cardiology department of a hospital is generally reasonable, but there are still some phenomena of irrational use of drugs. Clinical pharmacists of TCM should strengthen the prescription review and take positive and effective intervention measures to promote rational drug use in the cardiology department.
Objective To investigate the use of traditional Chinese medicine(TCM) injection in the treatment of cardiovascular diseases, and to provide reference for clinical rational drug use. Methods A hospital HIS system is used to retrieve inpatient prescriptions from June 2017 to June 2018 in cardiology department and the prescriptions containing TCM injections are selected. Data of inpatients(212 cases) using TCM injections are retrospectively analyzed to evaluate the reasonable use of TCM injections in the treatment of cardiovascular diseases. Results The top 5 drugs with highest incidence of TCM injections are danhong injection, shenmai injection, shenfu injection, shuxuening injection and xuesaitong for injection. The problems of unreasonable use of TCM injections mainly focused on the use of off-label drugs, idmproper solvent, over dosage, too long treatment period, too high concentration of drugs and incorrect compatibility. Conclusion The use of TCM injections in cardiology department of a hospital is generally reasonable, but there are still some phenomena of irrational use of drugs. Clinical pharmacists of TCM should strengthen the prescription review and take positive and effective intervention measures to promote rational drug use in the cardiology department.
引文
[1]沈斌,周月红. 127例中药注射剂不良反应分析及原因探讨[J].中华中医药杂志, 2015, 30(2):428-431。
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[5]杜莹,贾连群,王列,等.冠心病心绞痛证型分布及辨证规律系统综述[J].实用中医内科杂志, 2014, 28(3):1-11.
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[10]李然.中药注射剂安全性“四性”[J].中国医院用药评价与分析,2012, 12(5):471-474.
[11]李明.临床药师干预对活血化瘀类中药注射剂合理使用的影响[J].中国药物经济学, 2018, 3:51-53.
[12]樊莉,李婉姝,何国浓.我院住院医嘱中药注射剂点评分析[J].中国乡村医药, 2017, 12(23):40-42.
[2]冯宇飞,吕邵娃,王艳宏,等.中药注射剂安全性问题分析及对策[J].中国实验方剂学杂志, 2011, 17(9):278-281.
[3]何巍,张仲苗,周权,等.静脉用药调配中抗肿瘤药物不合理应用分析[J].中国现代应用药学杂志,2009, 26(3):252-255.
[4]王英花.丹红注射液联合冠心舒通胶囊治疗缺血性脑卒中的疗效观察[J].中国实用医药, 2013, 8(21):183-184.
[5]杜莹,贾连群,王列,等.冠心病心绞痛证型分布及辨证规律系统综述[J].实用中医内科杂志, 2014, 28(3):1-11.
[6]任应秋.任应秋论医集[M].北京:人民军医出版社, 2008:508.
[7]卫生部,国家食品药品监督管理局,国家中医药管理局.关于进一步加强中药注射剂生产和临床使用管理的通知[S]. 2008.
[8]张军,马静,李学林.试论中成药的辨证与辨病[J].中国药房,2011, 22(39):3649-3650.
[9]黎刚,刘颂华,蔡洁云,等.静脉药物配置中心520例中药注射剂不合理医嘱分析[J].中国医院用药评价与分析, 2011, 11(7):662-664.
[10]李然.中药注射剂安全性“四性”[J].中国医院用药评价与分析,2012, 12(5):471-474.
[11]李明.临床药师干预对活血化瘀类中药注射剂合理使用的影响[J].中国药物经济学, 2018, 3:51-53.
[12]樊莉,李婉姝,何国浓.我院住院医嘱中药注射剂点评分析[J].中国乡村医药, 2017, 12(23):40-42.