基于属性层次模式赋权联合优劣解距离法评价玻璃酸钠注射液药物利用的合理性  

Evaluation on rationality of sodium hyaluronate injection based on AHM weighting combined with TOPSIS method

作　　者：金飞燕 黎铁华 柯燕平 庄伟[2] Jin Feiyan;Li Tiehua;Ke Yanping;Zhuang Wei(Department of Pharmacy,Traditional Chinese Medical Hospital of Xiaoshan District of Hangzhou,Jiangnan Hospital Affliated to Zhejiang Chinese Medical University,Hangzhou,Zhejiang 311201,China;Department of Orthopaedics,Traditional Chinese Medical Hospital of Xiaoshan District of Hangzhou,Jiangnan Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou,Zhejiang 311201,China)

机构地区：[1]杭州市萧山区中医院浙江中医药大学附属江南医院药剂科,浙江杭州311201 [2]杭州市萧山区中医院浙江中医药大学附属江南医院骨科,浙江杭州311201

出　　处：《中国药物与临床》2025年第7期447-454,共8页Chinese Remedies & Clinics

基　　金：浙江省中医药科技计划项目(2020ZA095);杭州市萧山区重大计划项目(2019222)。

摘　　要：目的调查杭州市萧山区中医院玻璃酸钠注射液临床应用情况,探讨属性层次模式(AHM)赋权联合优劣解距离(TOPSIS)法在玻璃酸钠注射液药物利用合理性评价中的应用。方法以玻璃酸钠注射液药物说明书为依据,经药物合理应用评价小组研讨,制定药物利用评价标准;采用AHM法确立二级指标相对权重,联合TOPSIS模型建立玻璃酸钠注射液药物利用合理性评价方法。对2021年1月至2022年12月175例(干预前)使用玻璃酸钠注射液病例进行评价,挖掘临床不合理用药关键指标;制定药学干预措施并予以干预(2023年1月至6月);对2023年7月至2024年7月104例(千预后)使用玻璃酸钠注射液患者病例进行再次评价,对比干预前后玻璃酸钠注射液用药合理情况。结果15个二级指标的相对权重依次为0.1227,0.1043、0.1124,0.0939,0.0424,0.0610,0.0479,0.0836,0.0765,0.0681、0.0543,0.0306,0.0317、0.0374和0.0333。玻璃酸钠注射液用药不合理的主要问题有适应证、给药途径、给药频率、用药疗程、特殊人群、药品不良反应(ADR)监测与处理、注意事项、症状及体征、辅助检查和病程记录。药学干预前后用药合理病历占比(Ci≥0.8,29.71%与42.31%)、用药基本合理(0.6≤Ci<0.8,56.00%与54.81%)、用药不合理(Ci<0.6,14.29%与2.88%),差异具有统计学意义(P<0.05),药学干预后临床应用合理性得到提升。结论AHM赋权联合TOPSIS法可用于玻璃酸钠注射液的药物利用合理性评价,通过评价和药学干预,玻璃酸钠注射液用药合理性提升。Objective To investigate the clinical application of sodium hyaluronate injection in Hangzhou Xiaoshan District Hospital of Traditional Chinese Medicine,and to explore the application of attribute hierarchy model(AHM)weighting combined with TOPSIS method in the evaluation of drug utilization rationality of sodium hyaluronate injection.Methods Based on the drug instructions of sodium hyaluronate injection,the evaluation criteria of drug utilization were formulated through the discussion of the rational drug application evaluation group.The AHM method was used to establish the relative weight of the secondary indicators,and the TOPSIS model was used to establish the evaluation method of the rationality of drug use of sodium hyaluronate injection.From January 2021 to December 2022,175 patients(before intervention)using sodium hyaluronate injection were evaluated,and the key indicators of clinical irrational drug use were excavated.To formulate and intervene pharmaceutical interventions(January 2023 to June 2023);from July 2023 to July 2024,104 patients(after intervention)using sodium hyaluronate injection were reevaluated,and the rationality of sodium hyaluronate injection before and after intervention was compared.Results The relative weights of the 15 secondary indicators were 0.1227,0.1043,0.1124,0.0939,0.0424,0.0610,0.0479,0.0836,0.0765,0.0681,0.0543,0.0306,0.0317,0.0374 and 0.0333,respectively.The main problems of sodium hyaluronate injection included disease diagnosis,route of administration,frequency of administration,course of treatment,special population,ADR monitoring and treatment,precautions,symptoms and signs,auxiliary examination and course record,etc.Before and after pharmaceutical in-tervention,the proportion of rational medical records(Ci≥0.8,29.71%vs.42.31%),the basic rationality of medication(0.6≤Ci<0.8,56.00%vs.54.81%),and the unreasonable medication(Ci<0.6,14.29%vs.2.88%)were statistically significant(P<0.05).The rationality of clinical application was improved after pharmaceutical intervent

关 键 词：玻璃酸钠注射液 属性层次模型 优劣解距离法 药物利用 合理性评价 

分 类 号：R969.3[医药卫生—药理学] R95[医药卫生—药学]