运用黄金区域法减少抗菌素不良反应和降低病菌耐药性

Reducing Adverse Drug Reactions and Bacterial Resistance by Gold Zone Method

目的用药剂量在什么范围内对治疗适合?药物不良反应及病菌耐药性与剂量有关系吗?本文研究这三个问题及其关系,并寻求解决的统一之道。方法考察剂量与用药效果的关系,以黄金区域为中段,把经验范围分成三段是研究设计的关键。结果超大容量样本调查表明,两种药分别按公斤体重剂量由小到大给药,不良反应率都由高变低、然后再升高,呈U形规律,U形的底部出现在黄金区域上。通过黄金区域内外合理成本与不合理成本的分析,表明耐药性与用药剂量的关系也符合U形规律。结论抗菌素被滥用、不良反应和耐药性是当今医药界的三大顽疾。用黄金区域法规定用药剂量是探讨当前解决三个难题的一个特殊突破口。

Objective What dose range in treatment is appropriate？ Are adverse drug reactions and resistance related to dose？ These three problems and their relationships were researched to seek solution to the road of reunification in this paper. Methods Study was conducted on the relationship between dose and drug effect, with gold zone as the middle range and empirical range divided into three sections, which are the key to the study design. Results The incidence of drug adverse reactions of both appeared U-shaped rule with dose, namely, with increase of the dose （mg.kg-1· d-1）, the adverse reaction rate first decreased and then rose, and the bottom of U-shaped curve was in the gold zone. The analysis of reasonable cost and unreasonable cost indicates resistance, and the drug dose also show U-shaped rule. Conclusion Abuse of antibiotics, adverse reactions and resistance are three major medical challenges today. Utilizing the gold zone method to determine dose is the current special breakthrough in solving the three problems.