目的 基于属性层次模型（AHM）与逼近理想解排序法（TOPSIS）评价白细胞介素类生物制剂在治疗银屑病中的处方适宜性。方法 以药品说明书、指南、共识为依据，通过德尔菲法构建白细胞介素类生物制剂药物利用评价（DUE）标准，并采用AHM量化二级指标权重。采用TOPSIS对河北省中医院2024年1月1日—2025年6月30日279例出院病历进行处方适宜性评价。结果 建立的DUE标准包括3个一级指标（用药指征、用药过程、用药结果）与10个二级指标（适应证、用法用量、疗效评估等）。权重系数最高的二级指标为适应证（0.158 5）与禁忌证（0.158 5）。共纳入279例病历，合理病历有257例（占92.12%），基本合理病历有11例（占3.94%），不合理病历有11例（占3.94%）。不合理用药主要集中于用法用量不适宜、首次用药前筛查缺失、用药监护不足及药物转换欠规范。结论 白细胞介素类生物制剂临床应用较为规范，对于用法用量、用药监护等方面的问题仍需加强管理，进一步规范该类药物的使用。

Objective To evaluate the prescription appropriateness of interleukin biologics in the treatment of psoriasis using the Attribute Hierarchy Model (AHM) and the Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS). Methods Based on drug package inserts, clinical guidelines, and expert consensuses, the Delphi method was employed to establish a Drug Utilization Evaluation (DUE) standard for interleukin biologics. The AHM was used to quantify the weights of secondary indicators. The prescription appropriateness of 279 discharged medical records from January 1st, 2024 to June 30th, 2025 was evaluated using TOPSIS. Results The established DUE standard included three primary indicators (medication indication, medication process, and medication outcome) and 10 secondary indicators (including indication, dosage and administration, efficacy evaluation, etc.). The secondary indicators with the highest weight coefficients were “indication” (0.1585) and “contraindication” (0.1585). A total of 279 medical records were included, of which 257 (92.12%) were rational, 11 (3.94%) were basically rational, and 11 (3.94%) were irrational. Irrational medication use was mainly concentrated in/manifested as dosage and administration, medication monitoring, and pre-medication screening. Conclusion The clinical application of interleukin biologics for psoriasis is generally standardized. However, issues persist in dosage and administration, pre-medication screening, medication monitoring, and drug switching, which require enhanced management to further standardize the use of these agents.

R965

国家药品临床综合评价项目（国卫药政目录便函［2025］56号-NO.258）；河北省医研企联合创新专项课题（LH20250182）