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[摘要]
目的 分析鄂州中心医院使用活血化瘀类中药注射剂治疗急性脑梗死的临床用药情况,评价其合理性。方法 随机抽取2015—2016年急性脑梗死的住院病历480份,采用药物利用度、药品说明书和不良反应(ADR)监测等评价方法,分析其临床用药合理性。结果 收集到480份病历,用药506例/次,涉及12种中药注射剂;平均用药频度(aDDDs)排名前3位的分别为注射用血塞通、疏血通注射液和丹参注射液,药物利用指数(DUI)均≤1.0;不合理使用为81例/次,不合理用药率为16.0%,主要为单次给药剂量、溶媒种类与说明书推荐不一致、其他药物混合配伍和同时使用两种中药注射剂,西医临床医师不合理率显著大于中医执业医师(P<0.01);11例发生ADR,均为皮肤及附件损害。结论 该院急性脑梗死患者活血化瘀类中药注射剂使用基本合理,但也存在一些不合理现象,需进一步规范中药注射剂的临床合理用药。
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[Abstract]
Objective To analyze the utilization of traditional Chinese medicine (TCM) injections for invigorating blood circulation and eliminating stasis in patients with acute cerebral infarction in Ezhou Central Hospital, and evaluate the rationality of drug use of this type of drugs.Methods Totally 480 patients with acute cerebral infarction from 2015 to 2016 were randomly stratified extraction, and evaluated by criteria according to drug information, drug utilization research and adverse drug reaction (ADR).Results A total of involving 12 kinds of TCM injections and 506 cases in 480. Drug utilization studies have shown that the top 3 drugs for aDDDs values respectively were Xuesaitong Injection, Shuxuetong Injection and Salvia Injection, and DUI values of all drugs were ≤1.0. Evaluation of rational drug use showed irrational use of 81 cases and irrational rate of 16.0%. Mainly for a single dose or the type of solvent instructions for recommended of drug instructions, mixed other drug compatibility or same use of two kinds of TCM injection, irrational rate of Western medicine practitioners was significantly higher than Chinese medicine practitioners (P<0.01). ADR monitoring showed that ADR occurred in 11 cases, main clinical manifestations were skin and accessories damage.Conclusion The utilization of TCM injections for invigorating blood circulation and eliminating stasis in patients with acute cerebral infarction in our hospital is basically rational yet it far from perfect. The clinical rational use of TCM injection needs to be further regulated.
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