北京地区老年患者使用中药注射剂的不良反应分析

Analysis of Adverse Reactions to Traditional Chinese Medicine Injections Used by Elderly Patients in Beijing

目的:分析北京地区老年患者使用中药注射剂发生不良反应的情况,了解不良反应发生特点,促进临床合理使用药品,规避用药风险。方法:整理2013年1月至2017年12月北京市不良反应监测中心数据库中中药注射剂不良反应(Adverse Drug Reaction,ADR)信息,筛选出60岁及以上老年患者使用中药注射剂出现的ADR数据,进行统计归类,并对发生人群、ADR严重程度、涉及药品及预后、合并用药等情况进行回顾性分析。结果与结论:共收集到中药注射剂不良反应756例次(年龄范围为0岁~95岁),其中60岁及以上老年患者使用中药注射剂发生的不良反应共415例次,占54.89%。415例不良反应共涉及中药注射剂36种,其中祛瘀剂占比最高(15种药品;涉及233例患者发生不良反应,占比56.15%),其次为清热剂(7种药品;涉及71例患者发生不良反应,占比17.11%)。排名前12位的中药注射剂引起不良反应共353例次,占所有不良反应的85.06%,其中祛瘀剂占比最高(4种药品;涉及210例患者发生不良反应,占比59.49%)。415例次不良反应中,严重不良反应13例次,涉及中药注射剂7种。415例次不良反应中,174例(占比41.93%)提及患者同时使用多种药物。因此,应重视和规范老年患者合理使用中药注射剂,药师要发挥专业特长,加强对中药注射剂不良反应监测,促进合理用药。

Objective:To analyze the adverse reactions of elderly patients treated with traditional Chinese medicine injections in Beijing,to understand the characteristics of the adverse reactions,to promote the rational use of drugs and to avoid the risk of drug use.Methods:Based on the database of Beijing Center for ADR Monitoring,the adverse drug reactions(ADR)of traditional Chinese medicine injections occurred from January,2013 to December,2017 were analyzed,and the ADR data of elderly patients older than 60 years treated with traditional Chinese medicine injections were collected and classified.The involved population,ADR severity,drugs involved,prognosis and combined use of drugs were retrospectively analyzed.Results and Conclusion:A total of 756 cases of adverse reactions of traditional Chinese medicine injections were collected,(the age ranging from 0 to 95 years old).Among them,415 cases(54.89%)of adverse reactions of traditional Chinese medicine injections occurred in patients of aged 60 and over.The adverse reactions of 415 cases involved 36 kinds of traditional Chinese medicine injections,among which the proportion of dispelling stasis agents was the highest(15 kinds of drugs,233 patients involved,accounting for 56.15%),followed by heat clearing agents(7 kinds of drugs,71 patients involved,accounting for 17.11%).There were 353 cases of adverse reactions caused by the top 12 injections of traditional Chinese medicines,accounting for 85.06%of all adverse reactions,among which the highest proportion was dispelling stasis agents(4 kinds of drugs,210 patients involved,accounting for 59.49%).Among 415 adverse reactions,13 were serious,involving 7 kinds of traditional Chinese medicine injections.Among 415 reported cases of adverse reactions of traditional Chinese medicine injections,174 cases(41.93%)involved multiple drugs to be used simultaneously.Therefore the rational use of traditional Chinese medicine injections for elderly patients should be paid attention to.Pharmacists should apply their professional knowledge to the enhancement of monitoring of adverse reactions of traditional Chinese medicine injections and promotion of the rational use of traditional Chinese medicine.