门诊催眠药物不良反应发生情况及其影响因素分析  

Analysis of the occurrence and influencing factors of adverse reactions of hypnotic drugs in outpatient clinic

作　　者：肖腊梅 徐晓菲 蒋林[1] 刘思婧[1] 袁珺[1] 张维[1] 张奇兵[1] XIAO Lamei;XU Xiaofei;JIANG Lin;LIU Sijing;YUAN Jun;ZHANG Wei;ZHANG Qibing(Department of Pharmacy,the Second People′s Hospital of Deyang,Sichuan Province,Deyang 618000,China)

机构地区：[1]四川省德阳市第二人民医院药学部,618000

出　　处：《临床合理用药杂志》2024年第28期26-28,32,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：德阳市科技计划重点研发项目(2021SZZ082)。

摘　　要：目的了解门诊催眠药物不良反应的特点及可能的影响因素,为指导患者安全、合理使用催眠药物提供科学依据。方法选取2021年9月—2022年9月于德阳市第二人民医院门诊因失眠或睡眠障碍开具催眠药物的患者进行回访,根据是否发生催眠药物不良反应分为不良反应组和无不良反应组,采用多因素Logistic回归分析方法,对影响催眠药物不良反应相关因素进行分析。结果共回访1139例患者,190例(16.68%)失眠患者出现不良反应,发生不良反应的催眠药物分别为艾司唑仑97例、右佐匹克隆62例、阿普唑仑23例、氯硝西泮8例。多因素Logistic回归分析结果显示,催眠药物发生不良反应的影响因素包括女性患者(OR=0.595,95%CI:0.418~0.848,P=0.004)、催眠药物为艾司唑仑(OR=2.590,95%CI:1.580~4.245,P<0.001)、睡前进食(OR=2.324,95%CI:1.456~3.708,P<0.001)。结论催眠药物发生不良反应与患者使用的催眠药物品种、睡前进食等因素有关,医师应仔细询问患者失眠情况,根据患者失眠特点开具催眠药物并详细告知患者用药注意事项,睡前避免进食,以减少不良反应。Objective To understand the characteristics of the adverse reactions of outpatient hypnotic drugs and the factors that may cause the adverse reactions,and to provide a scientific basis for guiding patients to use hypnotic drugs safely and rationally.Methods Patients who were prescribed hypnotic drugs for insomnia or sleep disorders in the outpatient department of the Second People′s Hospital of Deyang from September 2021 to September 2022 were selected for a return visit.According to the occurrence of hypnotic drug adverse reaction they were divided into adverse reaction group and no adverse reaction group,multivariate Logistic regression analysis was used to analyze the related factors affecting the adverse reactions of hypnotic drugs.Results A total of 1139 patients were visited,and 190(16.68%)of insomnia patients had adverse reactions.The hypnotic drugs that had adverse reactions were 97 cases of esazolam,62 cases of dexzopiclone,23 cases of alprazolam,and 8 cases of clonazepam.Multiariable Logistic regression analysis results showed that the influencing factors of hypnotic drug adverse reactions included female patients(OR=0.595,95%CI:0.418~0.848,P=0.004),hypnotic drugs for estazolam(OR=2.590,95%CI:1.580~4.245,P<0.001),bedtime food(OR=2.324,95%CI:1.456~3.708,P<0.001).Conclusion The adverse reactions of hypnotic drugs may be related to the variety of hypnotic drugs used by patients,eating before going to bed and other factors,doctors should carefully ask patients about insomnia,prescribe hypnotic drugs according to the characteristics of insomnia of patients and inform patients in detail the precautions for medication,avoid eating before going to bed to reduce adverse reactions.

关 键 词：失眠 催眠药物 不良反应 门诊 因素分析 

分 类 号：R971.3[医药卫生—药品]