1469例门诊糖尿病患者药物治疗方案调查分析

Investigation and Analysis on the Drug Treatment Protocols Among 1469 Out-patients with Diabetes

目的调查上海市杨浦区长白社区卫生服务中心2009年全年糖尿病病人降糖药物使用情况,了解本中心糖尿病患者降糖治疗方案,评估本中心门诊糖尿病患者降糖治疗方案的合理性,为本中心医务人员的培训提供培训重点,同时也为循证医学提供参考数据。方法调出数据库中所有糖尿病病人使用的降糖药物,整理出糖尿病病人降糖治疗方案,剔除所有降糖治疗方案不确定的患者（包括换药过频方案不确定的患者和偶尔来本中心就诊尚不能确定降糖方案的患者）,进行统计分析。结果在1469例糖尿病患者中,药物使用情况为：磺脲类占28.7%,双胍类占25.2%,α-糖苷酶抑制剂占20.6%,胰岛素占17.4%,中成药占8.1%;降糖方案为：单药降糖占58.5%,二联降糖占35.1%,三联降糖占6.2%,四联降糖占0.2%,联合降糖药物控制血糖的共占41.5%,联合用药比例较高。在使用的各种类降糖药物中胰岛素出现频次占17.4%,共有378人次,占所有被调查者的25.7%,胰岛素使用比例高。结论本中心门诊糖尿病病人降糖药物使用合理,联合用药及胰岛素使用比例均较高,利于理想控制血糖,中成药在降糖方面占有一定比例,在中医药降糖方面有待进一步研究。

Objective Investigate the situation of using the hypoglycemic drugs throughout the year in 2009 against the diabetes patients of Changbai Community Health Service Center of Shanghai Yangpu District, and get the information on the hypoglycemic treatment protocols the diabetes patients used in the center, and then evaluate if the hypoglycemic treatment protocols the diabetes patients used in the centre are reasonable, it not only provides the training keystone for the medical staffs in the center, but also provides the reference data to the evidence-based medicine. Methods To extract the data related to the hypoglycemic drugs all diabetes patients used, and then sort out and statistical analysis the hypoglycemic treatment protocols that all hypertension patients used, certainly the diabetes patients with indeterminate hypoglycemic treatment protocols should be eliminated （including the patients that frequently change the treatment protocols and the treatment protocols can＇t be correctly determined as well as the patients that occasionally see the doctor in the center and can＇t determine the treatment protocols）. Results In 1469 diabetes patients, the use situation of the drugs： Sulfonylureas （SU） 28.7%, Biguanides 25.2%, α-glucosidase inhibitom 20.6%, Insulin 17.4%, Chinese patent drugs 8.1%. The use situation of the hypoglycemic treatment protocols： single-drug consisted of 58.5%, two-drug 35.1%, three-drug 6.2%, and four-drug 0.2%, the joint hypoglycemic drugs accounted for 41.5%, the rate of combining use of the hypoglycemic drugs is higher. In all kind of hypoglycemic drugs, the frequency of Insulin used accounted for 17.4%, total is 378 people which accounted for 25.7% of all respondents; the using rate of Insulin is high. Conclusion The hypoglyccmic drugs diabetes patients used in the outpatient centre are reasonable, the using rate of the joint hypoglycemic drugs and Insulin are higher, it is helpful to control the blood glucose ideally, Chinese patent drugs take some proportions in the way of hypoglycemic, and it requires further research in the way of traditional Chinese medicine.