2014—2015年南京市胸科医院门诊结核患者口服保肝药使用情况分析

Analysis on use of liver protectants for outpatients with tuberculosis in Nanjing Chest Hospital from 2014 to 2015

目的对东南大学医学院附属南京胸科医院(南京市胸科医院)门诊结核患者口服保肝药的使用情况和变化趋势进行分析,为临床合理用药提供依据。方法调取南京市胸科医院2014年1月—2015年12月门诊结核患者的保肝药使用数据,进行统计和分析。结果 2014—2015年门诊结核患者口服保肝药销售总金额略有上升,变化不大。各类保肝药构成比基本不变,排序相同,依次是保肝降酶药、其他保肝中成药、水飞蓟类、保肝抗炎药、保肝解毒药、肝细胞膜保护剂。而保肝降酶类药的销售金额几乎占了所有保肝药销售金额的一半。年增长率最高的是保肝抗炎药,增长30%。销售金额和使用例次排名前6位分别为双环醇片、水飞蓟宾葡甲胺片、水飞蓟宾胶囊、甘草酸二铵肠溶胶囊、复方甘草酸苷胶囊和九味肝泰胶囊,而双环醇片的销售金额、使用例次和每例平均金额均排名第一。结论南京市胸科医院保肝药的使用结构基本合理,但尚存在某些药物销量异常的现象,需进一步规范临床应用,确保结核患者保肝药用药安全。

Objective To analyze the use and tendency of liver protectants in outpatients with tuberculosis in Nanjing Chest Hospital Affiliated to Medical College of Southeast University（Nanjing Chest Hospital） so as to provide a reference for rational clinical use of these drugs. Method The data of liver protectants in Nanjing Chest Hospital from January 2014 to December 2015 were collected and analyzed statistically. Results From 2014 to 2015, the consumption sum of liver protectants increased slightly year by year. There was no significant change in the proportion of consumption sum of liver protectants each year, and the proportion rank（from high to low） were hepatoprotective enzyme reduction medicines, hepatoprotective Chinese patent medicines, silymarins, hepatoprotective anti-inflammatory drugs, hepatoprotective detoxification drugs, and liver cell membrane protective agents. The consumption sum of hepatoprotective enzyme reduction medicine accounted for almost half of all drug sales amounts. The annual growth rate of hepatoprotective anti-inflammatory drugs was the highest（30%）. Both consumption sum and use case ranking from high to low were Bicyclol Tablets, Silybin Meglumine Tablets, Silymarin Capsules, G]yeyrrhizin Diamine Enteric-coated Capsules, Compound Glycyrrhizin Capsules, and Jiuwei Gantai Capsules. The consumption sum, use case ranking, and average cost per case of Bicyclol Tablets ranked first. Conclusion The utilization of liver protectants is basically reasonable in Nanjing Chest Hospital, but there are some degree phenomena of irrational, which still needs to be further standardized to ensure patient medication safety.