我院217例中成药不良反应报告中不合理用药情况分析

Analysis of Irrational Drug Use in 217 Cases of Adverse Reaction Reports on Chinese Patent Medicines in Our Hospital

目的:了解中成药不合理使用对用药安全性的影响。方法:回顾性分析我院2013年1月~2016年10月上报的中成药(含中药注射剂)不良反应报告。从适应证、用法用量、中成药联用、中西药联用、用药疗程等5个方面分析评价处方或医嘱中的用药合理性,计算不合理用药比例。结果:共收集中成药不良反应报告217份,涉及患者217例,用药原因排前3位为心脑血管疾病、消化系统疾病及呼吸系统疾病。共涉及药品81个品种,发生例数最多的为参麦注射液(37例)。217份不良反应报告中适应证、用法用量、中成药联用、中西药联用、用药疗程的不合理比例分别为6.45%,5.99%,2.76%,0.92%,1.84%,共计17.97%。结论:不合理用药可能是引起中成药不良反应的重要因素之一。中成药使用需根据中医辨证,规范使用,加强用药监护,降低ADR的发生率。

Objective ： To investigate the effect of irrational use of traditional Chinese patent medicines （CPM） on medication safe- ty. Methods： The adverse drug reaction （ADR） reports on traditional CPM （including traditional Chinese medicine for injection） in our hospital during January 2013 to October 2016 were collected and analyzed retrospectively. After finding the corresponding prescrip- tions, the situation of irrational drug use in the reports including indications, usage and dosage, combination of traditional CPM, com- bination of Chinese and western medicines and course were analyzed, and the rate of irrational drug use was calculated. Results： A to- tal of 217 reports were collected including 217 patients. The primary diseases ranked top three were cardio-cerehral vascular system dis- eases, digestive system diseases and respiratory system diseases. The cases involved 81 kinds of drugs, and among them, 37 cases were induced by Shenmai injection. The rate of irrational drug use associated with indications, usage and dosage, combination of tradi- tional Chinese patent medicines, combination of Chinese and western medicines and course was 6.45%, 5.99% , 2.76% , 0.92% and 1.84%, respectively, and the total rate was 17.97% （39/217）. Conclusion： The irrational drug use maybe one of the important fac- tors related to ADR of CPM. According to syndrome differentiation, CPM should be used rationally, and pharmaceutical care should be strengthened to reduce the incidence of ADR.