三个地区住院精神分裂症患者药物处方方式及影响因素  

Psychotropics Prescription Pattern for the Inpatients with Schizophrenia

作　　者：司天梅[1] 何燕玲[2] 周茹英[3] 汪向东[1] 舒良[1] 刘协和[3] 

机构地区：[1]京大学精神卫生研究所,100083 [2]上海精神卫生中心,200030 [3]四川大学华西医院心理卫生中心,410011

出　　处：《中国心理卫生杂志》2003年第10期705-707,695,共4页Chinese Mental Health Journal

摘　　要：目的 :探讨三个地区大学附属精神卫生机构住院精神分裂症病人的精神药物处方方式和差异 ,以及影响精神药物使用的因素。方法 :北京大学精神卫生研究所、上海精神卫生中心和四川大学华西医院心理卫生中心于 2 0 0 1年 7月 1日至 7月 3 1日同时调查符合CCMD -II -R或ICD -10精神分裂症诊断标准的住院精神分裂症患者的药物使用情况 ,每个中心至少 2 0 0例患者。调查工具为“亚洲精神药物使用调查表“。结果 :共调查了 611例患者 ,74 5 %的患者接受单一药物治疗 ,2 2 9%的患者合并两种药物 ,主要是典型抗精神病药物与非典型药物的合并 ;5例 ( 0 8% )患者合并三种抗精神病药物。经换算等效氯丙嗪剂量后 ,平均剂量为 3 94 68± 2 97 3 2mg 日。按使用频率顺序 ,前六位药物分别是 :氯氮平 ,利培酮 ,舒必利、氯丙嗪、氟哌啶醇和奋乃静。 5 6%的患者合并心境稳定剂 ,3 3 8%的患者合并苯二氮 艹卓 类药物 ,3 4 7%的患者合并使用安坦。结论 :与过去十年比较 ,国内精神药物的使用方式趋于合理 ,多数患者接受单一药物治疗 ,药物剂量在临床推荐的治疗剂量范围内。第二代抗精神病药的使用逐渐增多。氯氮平的广泛应用仍是我国精神药物使用的一个特点。三个医院在药物选择上有些差异 ,受医生的用药习惯影响。Objective: To explore the prescription pattern of antipsychotics in the psychiatric facility affiliated the University from different regions, and analyze factors affecting the prescription habits of psychiatrists. Method: During the 1st July to 31st of 2001, a collaborative investigation were conducted in Beijing, Shanghai and Chengdu, on the use of psychotropic medication for the inpatients with schizophrenia (CCMD-II-R or ICD-10 criteria). This is one part of the'International Collaborative Research on Psychotropic Drug Prescription in Asia'. Each center collected no less than 200 cases. Investigation tool was the data form of psychotropic drug prescription in Asia. Results: 611 cases were collected, 74.5% inpatients were treated with single drug, 22.9% were using two kinds of antipsychotics, combining the atypical and typical agents, and less than 1% with three kinds of drugs. The mean dosage was 394.68±297.32 mg/day (M±SD), after being transformed into the chlorpromazine equivalent dosage. The first six drugs by frequency in use were clozapine, risperidone, sulpride, chlorpromazine, haloperidone and perphanazine. 5.6% patients were adjunctive with mood stabilizers. 33.8% patients were co-administrated with benzodiazepine. 34.7% patients were added with anticholinergic agents, artane. Conclusion: Compared with the situation of past decade, the psychotropic prescription pattern is more reasonable. Monotherapy is the first choice and the mean dosage is in the range of recommended dosage. The second generation drugs are used more frequent than before. In China, clozapine is still popular.

关 键 词：精神分裂症 药物处方方式 影响因素 住院患者 

分 类 号：R749.3[医药卫生—神经病学与精神病学]