慢性阻塞性肺疾病患者院外用药情况的调查研究

Clinical Survey on Drug Use in Patients with Chronic Obstructive Pulmonary Disease Outside the Hospital

目的总结慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者院外用药情况,并分析其院外用药情况、痰真菌检出率以及激素不良反应发生率的变化。方法调查2011年1 6月住院的161例COPD患者院外用药情况,将其分为遵医嘱使用糖皮质激素组(A组,包括口服和吸入激素)、使用非准字号药物组(B组)和未使用以上两种药物组(C组),对各组的痰真菌检出率进行统计学分析,并对A、B组激素不良反应的发生率进行分析。再将现阶段的调查结果与2006年同样研究结果进行比较。结果 161例患者中使用口服糖皮质激素6例,使用吸入激素29例,使用非准字号药物32例,未使用以上两种药物94例。痰真菌检出率情况:B组检出率为62.5%,明显高于A组的17.14%、C组的27.66%;组间比较有统计学意义(P<0.001)。B组的药物不良反应发生率为37.5%;A组中口服激素发生率为50%,而使用吸入激素发生率为0%。与2006年同样研究结果比较,B组患者的比例明显下降,A组患者明显增多。结论使用非准字号药物的患者,真菌感染的危险性及激素不良反应的发生率较高,健康教育对于减少这些不良现象的发生发挥了重要作用。

Objective To investigate the use of drugs in patients with chronic obstructive pulmonary disease(COPD) outside the hospital,and analyze the detection rate of fungus and the side effects of glucocorticosteroids(GCs),and their changes.Methods We investigated the drugs used outside the hospital in 161 patients with stable COPD between January and June 2011,who were divided into prescribed medication GCs group(group A,including oral GCs group and inhaled GCs group),drugs without authorization by SFDA(DWAS) group(group B) and other drugs group(group C).Then we made a statistical analysis on the detection rate of fungus,and the incidence rate of the side effects of GCs in the three groups.Finally we compared the present findings with the similar studies five years ago.Results Among the 161 patients,6 took oral GCs,29 used inhaled GCs,32 used DWAS,and 94 used other drugs.The detection rate of fungus in group B was 62.5%,obviously higher than the other groups(17.14% in group A,and 27.66% in group B,P<0.05).The rate of side effects of GCs in group B was 37.5%,and 50% in oral GCs group,while no side effects of GCs was found in the inhaled GCs group.Compared with the similar study five years ago,the use of DWAS decreased,and the use of prescribed medication GCs among the patients increased significantly.Conclusions Patients taking DWAS have a high incidence rate of mycotic infection and side effects of GCs.Health education plays an important role in reducing the occurrences of these undesirable phenomena.