目的 调查太原市精神病医院门诊第二类精神药品的使用情况，识别潜在用药风险，为进一步规范第二类精神药品管理和临床合理用药提供数据支撑。方法 运用描述性统计分析方法，采用消耗量、销售金额、用药频度（DDDs）、日均费用（DDC）、药品排序比（B/A）对门诊患者二类精神药品的使用情况进行统计同时比较指标变化情况。结果 2023—2025年，门诊第二类精神药品总消耗量、总销售金额呈逐年增长趋势；总DDDs在2024年有所增长而2025年明显下降；DDD_S排名前5位的第二类精神药品中，苯二氮䓬类有阿普唑仑、艾司唑仑、劳拉西泮、氯硝西泮，非苯二氮䓬类是右佐匹克隆和唑吡坦；在药师干预下氯硝西泮销售量大幅下降，相比2024年降幅达90.6%，DDDs降至第9位，同年唑吡坦DDD_S上升明显，其次为右佐匹克隆，警示药师关注其用药合理性。第二类精神药品DDC排序基本稳定；2025年新增品种咪达唑仑和地达西尼DDC均排名前5位，其中DDC排名第1位的莫达西尼为促醒药，价格最为昂贵；唑吡坦、扎来普隆和奥沙西泮B/A明显＜1；阿普唑仑、右佐匹克隆、艾司唑仑的B/A明显＞1，氯硝西泮2023—2024年的B/A明显＞1，2025年的B/A接近1。结论 太原市精神病医院第二类精神药品的使用基本合理，针对DDDs变化显著且排名靠前的第二类精神药品可能存在潜在不合理用药风险，需继续加强管理，确保患者用药安全、有效、经济。

Objective To investigate the usage of class II psychotropic drugs in the outpatient department of Taiyuan Psychiatric Hospital, identify potential medication risks, and provide data support for further standardizing the management of class II psychotropic drugs and promoting rational clinical drug use. Methods Descriptive statistical analysis was employed, utilizing indicators such as consumption volume, sales amount, DDDs, DDC, and the B/A ratio to analyze the usage of Class II psychotropic substances among outpatients. Changes in these indicators were also compared. Results From 2023 to 2025, the total consumption and total sales amount of Class II psychotropic substances in the outpatient department showed a year-on-year increasing trend. The total DDDs increased in 2024, but decreased significantly in 2025. Among the top five Class II psychotropic substances by DDDs ranking, benzodiazepines included alprazolam, estazolam, lorazepam, and clonazepam, while non-benzodiazepines included dexzopiclone and zolpidem. Under pharmacist intervention, the sales volume of clonazepam decreased sharply, with a decline of 90.6% compared to 2024, and its DDDs ranking dropped to 9th place. In the same year, the DDDs of zolpidem increased significantly, followed by dexzopiclone, alerting pharmacists to pay attention to the rationality of their use. The DDC ranking of Class II psychotropic substances remained relatively stable. In 2025, the newly added midazolam and dimdazenil both ranked among the top five in DDC, with modafinil, a wakefulness-promoting agent, ranking first in DDC and being the most expensive. The B/A ratios of zolpidem, zaleplon, and oxazepam were significantly less than 1, while those of alprazolam, dexzopiclone, and estazolam were significantly greater than 1. The B/A ratio of clonazepam was significantly greater than 1 from 2023 to 2024 but approached 1 in 2025. Conclusion The use of Class II psychotropic substances in Taiyuan Psychiatric Hospital is generally rational. However, for Class II psychotropic substances with significant changes in DDDs and high rankings, there may be potential medication risks. It is necessary to continue strengthening management to ensure safe, effective, and economical medication use for patients.

R971

山西省大健康产业高质量发展科研专项课题(DJKZXKT2023264)