基于面板数据的村卫生室上呼吸道感染处方用药变化规律——以山东省Z县8个村卫生室为例  

Changes in prescriptions for upper respiratory tract infections in Z county of Shandong Province: a panel data analysis of 8 village clinics

作　　者：杨丁 杨鹏[2] 李玉波[2] 孙强 

机构地区：[1]山东大学医药卫生管理学院国家卫生和计划生育委员会卫生经济与政策研究重点实验室(山东大学),山东济南250012 [2]诸城市疾病预防控制中心,山东诸城262200

出　　处：《山东大学学报（医学版）》2017年第12期88-94,共7页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81361138021)

摘　　要：目的分析山东省Z县8个村卫生室连续24个月的上呼吸道感染处方药物使用情况,总结农村地区的药物使用规律和趋势。方法采用等距抽样法收集2015年3月至2017年2月的门诊处方,运用线性回归等方法按月度对上呼吸道感染处方药物的种类及其趋势变化进行统计分析。结果共收集4 359份上呼吸道感染门诊处方,抗菌药物的使用率呈下降趋势(β=-0.009,P<0.001),其中第三代头孢的使用率呈上升趋势(β=0.001,P=0.038);中成药呈上升趋势(β=0.003,P=0.028)。15岁及以下、16~44岁、45~59岁和60岁及以上4个年龄组抗菌药物的处方使用率均呈下降趋势;15岁及以下年龄组和60岁及以上年龄组分别在解热镇痛非甾体类抗炎药和糖皮质激素类药的应用上出现下降趋势。结论山东省农村地区上呼吸道感染处方中抗菌药物的整体应用比例降低,中成药等替代药品应用增加。但是抗菌药物的使用占比仍处于较高水平,且以广谱抗菌药物为主。Objective To analyze prescription patterns of patients with upper respiratory tract infections（ URTIs） at village clinics in Shandong Province and to provide references to promote rational use of drugs in rural areas. Methods Probability-proportional-to-size sampling method was used to select prescriptions with URTIs（ n = 4 359） from 8 village clinics in Z county in Shandong Province between March 2015 and February 2017. Prescription patterns and trends were analyzed using linear regression model. Results Among the 4 359 prescriptions with URTIs,the proportion of antibiotic prescriptions decreased（ β =-0. 009,P〈0. 001）. And the rate of third-generation cephalosporins revealed gradual increase（ β = 0. 001,P = 0. 038）. The proportion of Chinese Patent Medicine prescriptions was increased（ β = 0. 003,P = 0. 028）. The proportion of antibiotic prescriptions decreased in four age groups： under 15 years,16 to44 years,45 to 59 years and above 60 years. Meanwhile,the proportion of prescribing non-steroidal anti-inflammatory drugsand corticosteroids to patients under 15 years old and above 60 years old decreased. Conclusion Antibiotic prescriptions for URTIs decreased notably,while Chinese Patent Medicine prescriptions increased. However,the rate of antibiotics use was still high,especially of broad spectrum antibiotics.

关 键 词：抗菌药物 上呼吸道感染 趋势 山东省 村卫生室 

分 类 号：R951[医药卫生—药学]