脑病科中药注射剂临床使用合理性与药物利用研究  

Research on Rationality and Utilization of the Traditional Chinese Medicine Injections of Department of Encephalopathy

作　　者：宋毅斐[1] 孙世光[1,2] 刘健[1] 

机构地区：[1]山东中医药大学第二附属医院/山东省中西医结合医院,济南250001 [2]山东中医药大学药学院

出　　处：《药物流行病学杂志》2016年第9期573-577,共5页Chinese Journal of Pharmacoepidemiology

基　　金：山东省中医药科技发展计划项目(编号:2013-104;2015-128;2015-134);山东省药学会临床药学奥赛康中青年科研资助项目(编号:Sdpa-ask-2013-07);山东省医务职工科技创新项目[编号:鲁医工字〔2014〕32号-32;鲁医工字〔2015〕33号-33]

摘　　要：目的：了解某医院脑病科中药注射剂临床使用合理性与药物利用情况，探讨临床中药师药学服务模式对其的影响。方法：分层随机抽取某医院脑病科2014年1～12月临床住院病历120份，采用用药合理性评价、药物利用研究等综合方法，初步探讨某医院脑病科中药注射剂临床使用合理性问题；比较·临床中药师实施药学服务前后各项指标的变化情况。结果：该医院脑病科2014年中药注射剂临床病例使用率89．17％，其中功效主治以理血剂（94．54％）为主，联合用药以1品种（55．14％）和2品种（32．71％）为主，使用人群以老年患者为主。中药注射剂用药合理性百分率各项赋值中，中医辨病（42．25％）、中医辨证（0％）、溶媒选择（11．32％）和给药剂量（41．51％）相对偏低，总得分百分率波动幅度与平均值基本保持一致（54．24％）。药物利用研究提示中药注射剂超浓度使用情况严重（aDDDs／aDDCs=18．90／59．21，dDUI／cDUI=1．16／3．63）；所开展药学服务后药物利用指数（dDUI／CDUI）趋于合理。结论：临床中药师应加强该医院脑病科中药注射剂合理用药监测，尤其是中医辨病、中医辩证、溶媒选择、给药剂量以及给药浓度，在中药注射剂临床合理使用中发挥积极作用。Objective： To revaluate the rationality and utilization of the traditional Chinese medicine injections （TCMIs） of the department of encephalopathy, and to search the benefit and model of traditional Chinese medical clinical pharmacist services. Methods ：120 medical records from the department of eneephalopathy in certain hospital during 2014 were selected stratified randomly. Medication rationality evaluation, drug utilization study comprehensive method, were used to evaluat some rationality encephalopathy of TCMIs in clinical use in certain hospital; the change of the indicators be- fore and after the implementation of pharmaceutical care by traditional Chinese medical clinical pharmacist were compared. Results：The usage rate of TCMIs in the hospital was 89.17% , among which blood-regulating recipes took the major effica- cy（94.54% ）, drug combination given priority with 1 species （55.14%） and 2 species （32.71%）, those were given pri- ority to elderly patients. Among each assignment of TCMIs use reasonable percentage, differentiation of Traditional Chinese medicine disease （ 42.25% ） , TCM differentiation （ 0% ） , Solvent selection （ 11.32% ） and dosage of administration （41.51%） were relatively low. Average total score percentage swings was consistent with the basic value（54.24% ）. Drug utilization study suggested that Traditional Chinese medicine over concentration was severe （ aDDDs/aDDCs = 18.90/ 59.21 ,dDUI/eDUI = 1.16/3.63 ） ;The drug utilization index（dDUI/cDUI） after carry out pharmaceutical care tended to be rational. Conclusion：h should strengthen that the Pharmacist monitoring TCMIs in clinical use, espacially differentia- tion of Traditional Chinese medicine disease, TCM differentiation, Solvent selection, dosage of administration and carnitine concentration, played a positive role in clinical rational use of TCM injections.

关 键 词：中药注射剂 用药合理性 药物利用研究 药物利用指数 限定日剂量 限定日浓度 临床中药师 

分 类 号：R286[医药卫生—中药学]