免费抗结核药物使用情况及相关因素分析

Usage of Antituberculotic for Free and Analysis on Relative Factors

目的分析免费抗结核药物的使用情况及相关因素。方法采用回顾性现况调查方法,选择鄞州区2008年登记的肺结核病人一年内治愈和完成治疗的患者作为本次调查对象,包括抗结核药物使用种类、服药情况、复查情况、副反应等。结果调查381例患者,男性250例、女性131例;有家族史及密切接触史136例(35.70%);使用免费抗结核药物方案占总数54.07%,使用免费和自费混合抗结核药物方案占总数22.57%,使用自费抗结核药物方案占总数23.36%;使用抗结核药物产生副反应病例占总数27.56%;产生副反应病例中,坚持用免费抗结核药物方案占36.19%;用免费和自费混合抗结核药物方案占50.48%,用自费抗结核药物方案占13.33%;抗结核药物使用产生副反应肝损害为主,占44.7%。结论有65.35%的肺结核病例使用国家免费抗结核药物,享受国家对肺结核病人免费药物。发现影响免费抗结核药物使用的因素有:医院在经济利益驱动下医生对肺结核病例使用了自费抗结核药物;近几年"农保"、"医保"比例不断增大,也有一小部分病例自己要求使用自费抗结核药物;抗结核药物的副反应影响免费抗结核药物的使用。建议要生产、推广适合病人使用、质优低毒、副反应少的免费抗结核药物,并纳入到农保、医保机制中;让病人真正享受到国家对肺结核病治疗的经济补助的实惠。

Objective To investigate the usage of antituberculotic for free,and analyze the influence factors in Yinzhou district.Methods Retrospective survey on usage of antituberculotic for free among the tuberculosis patients who had been registered in 2008 and had been cured or completed treatment in Yinzhou was conducted.The contents of the survey included category,usage,adverse reactions of the drug,and recheck for patients.Results Among the 381 patients,250 were male,and 131 were female.One hundred and thirty six patients reported to have a history of close contact with tuberculosis patients.54.07% were treated with anti-TB drug for free,23.36% with own expense anti-TB drug,and 22.57% with both of them.27.56% had adverse reactions of anti-TB drug,and 36.19% the patients who had adverse reactions were treated with anti-TB drug for free,13.33% with own paying anti-TB drug,and 50.48% with both of them.The main adverse reactions was with hepatic lesion,taking about 44.70%.Conclusion 65% of the tuberculosis patients used anti-TB drug for free,had benefit from the policy.The factors influencing the usage of antituberculotic for free in Yinzhou were doctor’s guide,growth of patients’payment capacity,adverse reactions of antituberculotic.Government should extend the medicine adapted to patients,high quality,lack of adverse reactions,plentiful supply,and can pay by Farmers Health Insurance or Medical Insurance.