辅助用药临床应用情况分析

Analysis of utilization of adjuvant drugs

目的:分析某院2013-2014年临床辅助用药使用情况,了解国内外使用及研究现状,指导临床合理用药。方法:对该院2013-2014年临床辅助用药的用量、不良反应进行统计;评价金额排名第一的药品使用合理性,并通过文献检索了解该药物国内外研究及使用现状。结果:该院2013-2014年辅助治疗药物不良反应报告呈上升趋势;辅助用药金额排名靠前的主要是活血化瘀类、神经营养类药物,中、西药排名第一的药品分别为注射用血栓通及单唾液酸四己糖神经节苷脂,临床不合理使用分别为21例(70%)、6例(20%),其中超适应证用药和用量不适宜为主要问题。查阅国内外相关文献,涉及临床治疗的疾病有几十种,远远超出了药品说明书规定的适应证范围;且Meta分析证据强度不足、可靠性差,不足以支持其超说明书用药情况。结论:医院辅助用药使用的增加,需要进一步加强管理,促进临床合理用药,因病施治。

OBJECTIVE To evaluate the characteristics of adjuvant drugs in our hospital from2013 to 2014,and guide rational drug use in the clinic.METHODS The utilization and the adverse reactions of adjuvant drugs in our hospital from2013 to 2014 were analyzed statistically.Rationality was evaluated for drugs with the first expense.Literatures at home and abroad were retrieved to understand use of this drug.RESULTS Report of adverse drug reactions increased in our hospital from2013 to 2014.Top ranked adjuvant drugs were mainly blood circulation promoting drugs and neurotrophic drugs.The first traditional Chinese medicinal drug and western drugs were Xueshuantong and monosialotetrahexosyl ganglioside,which were irrationally used in 21 cases（70%）and 6 cases（20%）,respectively.Off label use and improper dose were the main problems.Dozens of diseases were treated by the drug as retrieved in literatures at home and abroad,and far beyond the indications specified in the drug insert.However,the insufficient intensity and poor reliability of Meta analysis were not sufficient to support the off-label drug uses.CONCLUSION Adjuvant drug use is increased,its management should be further enhanced to promote clinical rational use.