546例患者安脑片临床应用合理性分析  

Analysis on the Rationality of Clinical Application of Annao Tablets in 546 Patients

作　　者：贾春伶[1] 赵奎君 王秀娟[3] 胡强 JIA Chunling;ZHAO Kuijun;WANG Xiujuan;HU Qiang(Dept.of Pharmacy,Fuxing Hospital Affiliated to Capital Medical University,Beijing 100038,China;Dept.of Traditional Chinese Medicine Pharmacy,Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China;College of Traditional Chinese Medicine,Capital Medical University,Beijing 100069,China;Dept.of Cardiopulmonary Bypass,Fuwai Hospital of Chinese Academy of Medical Sciences,Beijing 100037,China)

机构地区：[1]首都医科大学附属复兴医院药剂科,北京100038 [2]首都医科大学附属友谊医院中药剂科,北京100050 [3]首都医科大学中医药学院,北京100069 [4]中国医学科学院阜外医院体外循环科,北京100037

出　　处：《中国医院用药评价与分析》2021年第3期338-342,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：中央本级重大增减支项目(No.2060302);北京市西城区2018—2019年度优秀人才项目(No.201924);北京市西城区第二批中医药传承工程;北京市西城区赵奎君名医工作室项目。

摘　　要：目的:了解安脑片的临床应用现状和不良反应,并分析其用药过程中潜在的风险因素,为进一步规范临床用药提供参考依据。方法:从医院信息系统数据库,选取2019年首都医科大学附属复兴医院(以下简称"我院")546例使用安脑片患者的病案和医嘱信息,运用回顾性研究分析方法,统计分析患者自然情况、疾病诊断、应用科室、用法与用量、联合用药和不良反应等信息,对安脑片的临床应用进行合理性分析,寻找发生不良反应的相关因素。结果:546例使用安脑片的患者中,男性患者257例(占47.07%),女性患者289例(占52.93%);平均年龄(75.18±18.23)岁,年龄>60岁患者占72.34%(395例);主要分布于中医科(195例,占35.71%)、神经内科(170例,31.14%)和ICU(136例,24.91%);高频诊断依次为脑血管病及相关诊断(295例,占54.03%),另外,高热及相关诊断165例(占30.22%),高血压病及相关诊断56例(占10.26%);用法与用量方面,单日剂量在药品说明书规定范围内者占比为92.31%(504例);用药疗程集中分布于7~30 d(442例,占80.95%)。用药记录中,98.17%的患者(536例)存在联合用药,平均联合应用8.53种药物;安脑片与西药联合应用方面,频次数较高的西药依次为抗血小板药、调节血脂药和脑血管疾病用药,并发感染时联合应用频次数最高的抗菌药物为头孢菌素类抗菌药物;安脑片与中药联合应用方面,频次数较高的中药依次为活血化瘀类、清热解毒类和平肝熄风类。发生不良反应/事件9例,发生率为1.65%;适应证不合理、用法与用量不合理以及联合用药不合理可能是安脑片发生不良反应的潜在风险因素。结论:安脑片在我院使用中存在无中医适应证用药、超剂量服用与联合用药不合理等问题,应加强该药的用药点评、合理用药宣教和有效的药学干预等,监测患者的肝肾功能,减少不良反应的发生,促进临床合理应用。OBJECTIVE:To investigate the clinical application and adverse drug reactions of Annao tablets,and to analyze its potential risk factors in the course of drug administration,so as to provide reference for further standardizing clinical medication.METHODS:Medical record and medical orders of 546 patients treated with Annao tablets in Fuxing Hospital Affiliated to Capital Medical University(hereinafter referred to as"our hospital")in 2019 were retrieved from hospital information system,retrospective research was adopted to analysis the basic information,disease diagnosis,clinical department,usage and dosage,drug combination and adverse drug reactions of patients,rationality analysis was conducted on the clinical application of Annao tablets in order to look for the relevant factors to adverse drug reactions.RESULTS:Among the 546 patients treated with Annao tablets,257 cases were male(47.07%),289 cases were female(52.93%);with the average age was(75.18±18.23)years old,72.34%(395 cases)were aged over60 years old;mainly distributed in department of traditional Chinese medicine(195 cases,35.71%),department of neurology(170 cases,31.14%)and department of ICU(136 cases,24.91%);the high frequency diagnoses were respectively cerebrovascular disease and related diagnosis(295 cases,54.03%),high fever and related diagnosis(165 cases,30.22%),hypertension and related diagnosis(56 cases,10.26%);in terms of usage and dosage,92.31%(504 cases)had a single daily dose within the prescribed range of drug instruction;the course of treatment was concentrated in 7-30 days(442 cases,80.95%).In the medication records,98.17%of patients(536 cases)were given combined medication,with an average of 8.53 drugs for combination;in terms of combined application of Annao tablets and western medicines,the high frequently used western medicines were respectively antiplatelet drugs,blood lipid regulating drugs and cerebrovascular drugs,the high frequently used antibiotics in drug combination was cephalosporins for accompanying infection;in the combined

关 键 词：安脑片 临床用药 合理性分析 

分 类 号：R932[医药卫生—生药学]