本院门诊处方CYP450介导常见中成药及其成分相互作用调查分析  

Investigation and Analysis of CYP450 Enzyme Mediated Interaction from Chinese Patent Drug in Outpatient Prescriptions of Our Hospital

作　　者：金晓玲 李鑫 周洵 谷晓蕾 马飞 邬蓉 张凤 JIN Xiao-ling;LI Xin;ZHOU Xun;GU Xiao-lei;MA Fei;WU Rong;ZHANG Feng(Department of Pharmacy,Changzheng Hospital,Naval Medical University,Shanghai 200003,China)

机构地区：[1]海军军医大学附属长征医院药学部,上海200003

出　　处：《中国合理用药探索》2020年第9期21-24,共4页Chinese Journal of Rational Drug Use

基　　金：国家自然科学基金资助项目(81573793);上海技术委员会资助项目(18401931600);上海市卫生计生系统重要薄弱学科建设项目(2016ZB0303);上海市临床药学重点专科建设项目(2016-40044-002)。

摘　　要：目的:分析本院门诊处方中细胞色素P450(CYP450)介导的常见中成药及其所含成分相互作用情况,为临床合理用药提供参考。方法:通过收集本院2018年7月~2018年12月的门诊处方,筛选出包含CYP450抑制剂或诱导剂的处方,以代谢酶学理论为指导,以文献及资料报道为基础,分析是否存在潜在药物的代谢性相互作用。结果:筛选出含中成药联合用药的相互作用处方3768张,涉及CYP450的相互作用处方共2879张,占比76.41%。其中,与CYP3A抑制剂相关的处方2648张,占CYP450相互作用处方的91.98%;与CYP3A诱导剂相关的处方171张,占比5.94%;与CYP1A2诱导剂相关的处方35张,占比1.22%;与CYP3A4抑制剂相关的处方13张;与CYP2C19诱导剂相关的处方10张;与CYP2C9诱导剂相关的处方2张。结论:本院门诊处方涉及CYP450相互作用的处方较多。为促进临床安全合理用药,临床医生应根据用药情况避免开具存在有害代谢性相互作用的处方。Objective:To analyze CYP450 enzyme involved drug interactions from Chinese patent drug in outpatient prescriptions of our hospital and promote clinical rational drug use.Methods:Outpatient prescriptions from July to December 2018 were collected in our hospital.The prescriptions containing CYP450 inhibitors or inducers were screened,and the potential metabolic interactions of drugs were analyzed based on the theories of metabolic enzymatic,literature and data reports.Results:A total of 3768 prescriptions containing Chinese patent drugs were included and 2879 prescriptions involving CYP450 were screened out,accounting for 76.41%.Among them,2648 prescriptions were related to CYP3A inhibitors,accounting for 91.98%of prescriptions with CYP450 interaction;there were 171 prescriptions related to CYP3A inducer,accounting for 5.94%;there were 35 prescriptions related to CYP1A2 inducer,accounting for 1.22%;there were 13 prescriptions related to CYP3A4 inhibitors,10 prescriptions related to CYP2C19 inducer and 2 prescriptions related to CYP2C9 inducer.Conclusion:A large proportion of the outpatient prescription of our hospital involved the interaction of CYP450.In order to promote the safe and rational drug use in clinical practice,doctors should avoid prescribing drugs with adverse metabolic drug interactions of CYP450.

关 键 词：代谢性相互作用 细胞色素P450 酶抑制剂 酶诱导剂 合理用药 

分 类 号：R969.9[医药卫生—药理学]