我院苦碟子注射液使用分析

An analysis of the Kudiezi injection in our hospital

目的:分析我院苦碟子注射液使用情况,为临床合理用药提供参考。方法:以药品说明书和循证医学证据为依据,查询我院HIS系统,系统检索中国期刊网全文数据库(CNKI)、维普数据库(VIP)、万方数据库(WANFANG),收集相关文献,对我院2013年-2015年住院患者使用苦碟子的病例从适应证,合并用药,用法疗程等方面进行评价。结果:我院使用苦碟子注射液的病例数和金额逐年增加,涉及多个临床科室,西医诊断中,冠心病使用最多,其次为脑梗死和心绞痛。中医诊断中胸痹和中风使用苦碟子注射液最多。使用中不良反应较少,剂量和疗程基本符合规定。此外,苦碟子注射液在使用中合并用药较多,涉及多种药物,较多的为扩血管药,抗栓药等。其中有些合并用药缺乏循证医学证据支持。在使用苦碟子注射液的1460例临床诊断中,20.2%不符合药品说明书,12.6%缺乏循证医学证据支持。结论:我院在临床使用苦碟子注射液中,剂量和疗程基本符合规定,适应症方面,部分应用不符合药品说明书,少数应用缺乏循证医学证据支持,提示应开展大规模,设计良好的临床研究,进一步为苦碟子注射液的合理应用提供依据。合并用药方面,由于和一些药物合并使用循证医学证据不足,提示应用苦碟子的同时合用其他药物应谨慎。在应用安全性方面,我院苦碟子注射液在临床使用中,虽然未发现有不良反应,但不能过分乐观,医院应加强监测,建立完善的制度,以促进合理用药。

Objective： To analyze the use of the Kudiezi injection in our hospital, and to provide reference for clinical rational drug use. Methods： Based on the instruction of medicine and evidence-based medicine, the query was made in our hospital by HIS system, China Journal Full-text Database Retrieval System （CNKI）, VIP database （VIP）, Wanfang database （WANFANG）. The hospitalized patients in our hospital from 2013 to 2015 were selected, and the effect was evaluated from the perspectives of the indications, drug combination and course of treatment. Results： The number of cases and the amount of money used on the Kudiezi injection in our hospital increased year by year, involving multiple clinical departments. In the diagnosis of Western medicine, coronary heart disease was the most frequently used, which was followed by cerebral infarction and angina pectoris. In the diagnosis of TCM, the Kudiezi injection was the most frequently used in chest and stroke. There was fewer adverse reactions in use, dosage and duration complied with the basic regulations. In addition, the Kudiezi injection was frequently used in the combined medication, which involved a variety of drugs, it was frequently used as a vasodilator, antithrombotic drug. Some combined drugs were lack of evidence-based medical evidence. Out of 1460 cases of clinical diagnosis in which the Kudiezi injection was used, 20.2% did not conform to the drug instructions and 12.6% lacked evidence based medical evidence support. Hospitals should strengthen monitoring and establish a perfect system to promote rational use of drugs. Conclusion： In our hospital, the dosage and duration of the Kudiezi injection were of the basic compliance. As for the indications, part of the application did not comply with the drug instructions and the application was in lack of evidence-based support, which indicated that our hospital should carry out large-scale clinical research and good design to provide the basis for rational use of Kudiezi Injection. As for the combined use of drugs, due to the lack of evidence-based medicine, it was suggested that the combined application of Kudiezi Injection and other drugs should be cautious. As for the application of safety, the clinical use of the Kudiezi injection in our hospital did not have any adverse reactions, but we should not be too optimistic. The hospital should strengthen the monitoring, establish and perfect the system to promote the rational use of drugs.