双相抑郁患者药物规范化治疗的回顾性调查与分析  

Retrospective investigation and analysis of standardized drug treatment for patients with bipolar depression

作　　者：胡丽[1] 王玲[2] 赵楠[2] 谭红阳[2] HU Li;WANG Ling;ZHAO Nan;TAN Hongyang(T1 Ward of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Pharmacy Department of Mental Health Cen-ter of Pudong New Area,Shanghai 200124,China)

机构地区：[1]上海中医药大学附属曙光医院T1病区,上海201203 [2]上海市浦东新区精神卫生中心药剂科,上海200124

出　　处：《中国临床药学杂志》2020年第1期29-34,共6页Chinese Journal of Clinical Pharmacy

基　　金：上海市卫生计生系统面上项目(编号201640392)

摘　　要：目的回顾性调查某精神卫生中心双相抑郁患者药物规范化治疗情况,为制定针对性的临床药师干预方案提供依据。方法通过面对面访谈的形式,利用问卷、量表以及病史记录等方式收集相关数据。基于《中国双相障碍防治指南》(第2版)将纳入的病例分为一致组(与指南推荐意见一致)和不一致组(与指南推荐意见不一致)。结果纳入的76例双相抑郁患者中,与指南推荐意见不一致率达到42.1%。一致组患者的汉密尔顿抑郁量表17项疗效、临床疗效总评(CGI)中疗效总评(GI)与疗效指数(EI)均优于不一致组,差异均具有统计学意义(P<0.05);一致组患者的不良反应发生率低于不一致组;2组间用药依从性、CGI中病情严重程度(SI)和治疗方案经比较,差异无统计学意义(P>0.05)。结论双相抑郁患者的药物规范化治疗情况不理想,医疗机构的管理与监控力度、精神科医师业务水平、患者及监护人等因素均对双相抑郁患者的治疗产生影响。临床药师可依据相关的国内外指南,对双相抑郁患者药物治疗进行全程监控与优化干预,从而提高双相抑郁患者药物治疗的规范性、有效性和安全性。AIM To retrospectively investigate the status of standardized drug treatment for bipolar depres-sion patients in a mental health center in Shanghai,and to provide evidence for formulating targeted intervention programs for clinical pharmacists.METHODS According to face-to-face interviews,relevant data were collected by certain questionnaires and medical history records.Based on the Chinese Guidelines for the Prevention and Treatment of Bipolar Disorder(the 2nd edition),the included cases were divided into 2 groups:those were consist-ent with the Guidelines and those were inconsistent with the Guidelines.RESULTS Among 76 patients with bi-polar depression,42.1%disagreed with the recommendation of the Guidelines,and the 17 items of Hamilton de-pression scale and the total efficacy evaluation(GI)and efficacy index(EI)of the patients in the consistent group(hereinafter referred to as the“consistent group”)were better than those in the disagreement group(hereinafter referred to as the“inconsistent group”),and the difference was statistically significant(P<0.05).The in-cidence of adverse drug reactions in consistent group was lower than that in inconsistent group;but there was no significant difference in drug compliance,severity of illness(SI)in clinical global improvement(CGI)and treat-ment programs between the 2 groups(P>0.05).CONCLUSION The current situation of standardized drug treatment for bipolar depression patients is not ideal.The management and monitoring of medical institutions,psy-chiatrists'professional level,patients and guardians all have an impact on the treatment of bipolar depression pa-tients.Clinical pharmacists can monitor and optimize drug treatment for bipolar depression patients in the whole course according to relevant domestic and foreign guidelines,so as to improve the standardization,effectiveness and safety of drug treatment of bipolar depression patients.

关 键 词：双相抑郁 规范化 药物治疗 分析 对策 

分 类 号：R749.4[医药卫生—神经病学与精神病学]