社区老年人镇静催眠类药物处方分析

Analysis of the Prescriptions of Sedative and Hypnotic Drugs for the Elderly in Community

目的对塘桥社区老年失眠患者的镇静催眠类药物处方进行分析,了解全科医生使用镇静催眠类药物的现状。方法利用本中心的信息化系统,选取2013年12月1日—2018年11月30日期间所有诊断为失眠症的60岁及以上老年患者的镇静催眠类药物处方进行数据分析。结果2013、2014、2015、2016、2017年度的镇静催眠类药物处方数分别为14008张、14292张、16032张、17244张、19105张。各年度老年人镇静催眠类药物用药人数分别为2928人、3129人、3300人、3468人、3740人。5年来,老年人镇静催眠类药物日剂量2片的处方数74712张,占所有此类药物处方的92.6%。5年来,肝功能损害的老年人数共374人,肾功能损害的老年人数共120人,肝肾功能损害的老年人镇静催眠类药物的日均处方剂量达到2片。5年来,镇静催眠类药物与地高辛合用处方数62张,与镇痛药合用处方数232张,与高血压药合用处方数2650张,镇静催眠类药物与以上药物合用时日剂量均为2片。结论需要使用镇静催眠类药物的老年失眠患者数量逐年增多。全科医生使用镇静催眠类药物治疗老年失眠时给药剂量偏大;镇静催眠类药物与其他药物合用时日剂量未见减少;有肝肾功能损害的老年人在处方镇静催眠类药物时日剂量未减少。全科医生应通过培训或自我学习,合理使用镇静催眠类药物。

Objective To analyze the prescriptions of sedative and hypnotic drugs for elderly insomniacs in TangQiao community so as to understand the status quo of prescriptions of the sedative and hypnotic drugs by general practitioners.Methods Using the information system of our center,the prescriptions of all elderly patients aged 60 and over diagnosed with insomnia from December 1,2013 to November 30,2018 were extracted for data analysis.Results From December 1,2013 to November 30,2018,the annual prescriptions for sleeping pills were 14008,14292,16032,17244 and 19105.The number of sedative and hypnotic drugs used was 2928,3129,3300,3468 and 3740.For 5 years,the number of prescriptions of 2 tablets daily was 74712,which amounts to 92.6%of all prescriptions.The average daily dose of sedative and hypnotic drugs for elderly people with abnormal liver and kidney function is 2 tablets every day,374 elderly people with abnormal liver function,120 elderly people with abnormal kidney function.There were 62 prescriptions for sedative and hypnotic drugs combined with digoxin,232 prescriptions for analgesics and 2650 prescriptions for hypertension,the daily dose of sedative and hypnotic drugs in combination with the above drugs reached 2 tablets.Conclusion With the increasingly severe aging of the population,the number of elderly insomniacs requiring sedative and hypnotic drugs is increasing year by year.General practitioners use sedative and hypnotic drugs to treat senile insomnia patients with high dosage.The daily dose of sedative and hypnotic drugs in combination with other drugs did not decrease,elderly people with impairment of liver and kidney function take sedative and hypnotic drugs in large doses every year.They are dangerous for the elderly.General practitioners should use sedative and hypnotic drugs reasonably through training or self-learning.