55例雷公藤多甙片/雷公藤多苷片致不良反应文献分析

Literature Analysis of 55 Cases of Adverse Drug Reaction by Glucoside Tripterygium Total

目的通过对55例雷公藤多甙片/雷公藤多苷片致不良反应文献进行分析,探讨其引起不良反应的规律和原因,为临床安全、合理用药提供参考。方法对1984～2013年中国期刊全文数据库文献进行检索,对其中涉及雷公藤多甙片/雷公藤多苷片致药品不良反应的28篇文献中报道的55例病例报告进行统计与分析。结果类风湿性关节炎16例,肾炎6例,肾病综合症11例,系统性红斑狼疮17例,口腔扁平苔藓2例,银屑病1例,神经性皮炎1例,结节性回归性发热性非化脓性脂膜炎1例;不良反应发生率女性明显多于男性,20～39岁患者发病率最高;不良反应出现时间从服药后1天至服药半年时间不等;不良反应可累及多个系统-器官,主要以血液系统为主,其次为胃肠道系统、生殖系统等,有3例死亡病例,其他大部分药品不良反应临床表现轻微,即使有症状较重或严重者,经及时停药或对症治疗处理,大多数症状可好转消失。结论临床医师、药师应重视雷公藤多甙片/雷公藤多苷片所致药品不良反应的发生,根据病情严格控制服药剂量,并且在服药前和服药期间检查血、尿常规和肝肾功能,加强临床检测,以减少不良反应的发生。

Objective Through analysing 55 adverse drug reaction（ADR） cases of Glucoside Tripterygium Total（GTT）, explore the rules and causes of ADR, provide a reference for clinical rational use of drugs. Methods By searching fiterature in Chinese Journal Full-text Database from 1984 to 2013, 28 ADR literatures of Glucoside Tripterygium Total（GTT） involving 55 cases, were statistically analyzed. Results The involving disease types included 16 rheumatoid arthritis（R_A） cases, 6 nephritis cases, 11 nephrotic syndrome cases, systemic lupus erythematosus（sle） cases, 2 oral squamous moss cases, 1 psoriasis case, 1 neurodermatitis case, 1 nodular regression febrile and non suppurative panniculitis case. The adverse reaction incidence of women was more than men, the 20-39 years old patients with the highest incidence; the appeared time of ADR was from 1 day to half one year; the adverse reactions involved many systems and organs, the blood system was the first, followed by the gastrointestinal system, reproductive system, etc. The most adverse reactions were slight, even if some symptoms were severe, through withdrawing the drugs timely or symptomatic drug treatment, the most symptoms could be improved and disappeared. Conclusion The doctors and pharmacists should pay attention to the adverse reactions caused by Glucoside Tripterygium Total（GTT）. The dosages were strictly controlled according to the disease conditions. The routine blood, routine urine and hepatic function were detected before and during taking the medicine. The clinical care should be strengthened so as to prevent the occurrence of adverse reactions.