舒肝解郁胶囊在某院门/急诊使用情况分析及干预建议  

Analysis on the Use of Shugan Jieyu Capsule in the Outpatient Clinic and Emergency Department of a Hospital and Intervention Suggestions

作　　者：朱海斌 于佳竹 ZHU Hai-bin;YU Jia-zhu(Department of Pharmacy,Yangpu Hospital,School of Medicine,Tongji University,Shanghai 200090,China)

机构地区：[1]同济大学附属杨浦医院药学部,上海200090

出　　处：《中国合理用药探索》2023年第10期89-95,共7页Chinese Journal of Rational Drug Use

摘　　要：目的:通过收集某院门/急诊开具的含舒肝解郁胶囊处方,分析其临床应用现状,以期促进舒肝解郁胶囊的临床合理使用。方法:从前置审方系统中提取2021年1月~2022年10月该院开具的含舒肝解郁胶囊处方,分析患者年龄、性别、诊断信息、用法用量、疗程、联合用药、科室分布等信息。结果:收集含舒肝解郁胶囊处方共1392张。其中,老年女性患者较多(664例,47.70%);前3位的临床诊断为焦虑状态(470例,33.76%)、抑郁状态(372例,26.72%)、失眠(262例,18.82%);科室分布以神经内科(533例,38.29%)、心理科(316例,22.70%)、中医科(200例,14.37%)为主。处方不合理率为8.12%,其中不规范处方26张(23.01%)、不适宜处方70张(61.95%)、超常处方17张(15.04%),主要涉及联合用药不适宜、适应症不适宜等问题。其中联合用药不适宜中,以CYP3A4的底物(如非洛地平、艾司奥美拉唑)及抗抑郁药(如艾司西酞普兰、舍曲林、帕罗西汀)最为多见。舒肝解郁胶囊的相互作用多与其成份贯叶金丝桃的酶诱导作用及其产生抗抑郁作用的机制有关。结论:舒肝解郁胶囊的使用仍有待继续规范,应不断优化前置审方系统,以促进舒肝解郁胶囊的临床合理使用。Objective:To analyze current clinical application of Shugan Jieyu capsule based on the collected prescriptions containing the drug in the outpatient clinic and emergency department of a hospital,so as to promote the rational use of Shugan Jieyu capsule in clinic.Methods:The prescriptions containing Shugan Jieyu capsule prescribed from January 2021 to October 2022 in the hospital were retrieved from the prescription pre-review system to analyze information regarding patients' age,sex,diagnosis,usage and dosage,course of treatment,combined medication and department distribution,etc.Results:A total of 1392 prescriptions containing Shugan Jieyu capsule were collected.Of which,the elderly female patients were more commonly seen(664 patients,47.70%).The top 3 clinically diagnoses were anxiety state(470patients,33.76%),depressed state(372 patients,26.72%) and insomnia(262 patients,18.82%).The main department distribution included neurology(533 patients,38.29%),psychology(316 patients,22.70%),traditional Chinese medicine(200 patients,14.37%).The irrationality rate of prescription was 8.12%,including 26 nonstandard prescriptions(23.01%),70 inappropriate prescriptions(61.95%) and 17abnormal prescriptions(15.04%),mainly involving inappropriate combined medication and inappropriate indications.Among them,the most common inappropriate combined medication were CYP3A4 substrates(such as felodipine,esomeprazole) in combination with antidepressants(such as escitalopram,sertraline,paroxetine).The interaction of Shugan Jieyu capsule is mostly related to the enzyme-inducing effect of its component herba hyperici perforati and the mechanism of its antidepressant effect.Conclusion:Continuing standardization of the use of Shugan Jieyu capsule is required,and the prescription pre-review system needs constant optimization,to promote relevant clinical rational drug use.

关 键 词：舒肝解郁胶囊 用药分析 贯叶金丝桃 药物相互作用 处方点评 

分 类 号：R749.4[医药卫生—神经病学与精神病学]