中国七城市78家医院帕金森病患者处方用药现状研究

Study on the situation of drug use prescribed for Parkinson's disease in 78 hospitals of seven cities in China

目的了解近年中国七城市医院帕金森病患者处方用药现状,医生的治疗方案是否遵从中国帕金森病治疗指南(第3版)。方法数据来自《医院处方分析合作项目》中的北京、天津、上海、广州、成都、杭州和郑州78家三级医院,2014-2015年每家医院每月随机抽取3~4 d,2年共80 d的门诊处方和住院医嘱,提取诊断为帕金森病(PD)患者的用药信息,用Visual Fox Pro 8.0数据库软件进行统计分析。结果中国七城市医院PD患者为106 029人次,男女就诊比例为1.3∶1。年龄为70~79岁患者人次数占总数的32.5%,其处方金额占全部帕金森患者的31.2%。PD患者按例次计排在前3位的抗帕金森药物分别是多巴丝肼、普拉克索和卡比多巴/左旋多巴,分别占全部患者的40.4%、25.5%和16.1%。用药金额排序第1位的抗帕金森药是普拉克索,占抗帕金森药用药金额的45.1%。按金额排序前20位药品中,抗帕金森药占75.8%,神经营养剂占9.6%,抗痴呆药占4%。治疗方案中,单用复方左旋多巴和单用非麦角类多巴胺受体激动剂占帕金森患者的比例分别为24.0%和14.9%。联合用药中,主要是复方左旋多巴和非麦角类多巴胺受体激动剂联合应用,占帕金森患者的比例为15.3%。结论中国七城市医院的医生为患者治疗时遵循中国帕金森病治疗指南,医生诊治过程兼顾运动症状与非运动症状的改善。

Objective To understand the status of prescribed drugs for PD patients in seven cities in China. To knowwhether the doctor comply with the treatment guidelines of PD in China（ the third edition）. Methods The data were from 78 tertiary hospitals of seven cities（ including Beijing,Tianjin,Shanghai,Guangzhou,Chengdu,Hangzhou and Zhengzhou） in China,which were involved in the Hospital Prescription Analysis Cooperative Project. Prescriptions from department of outpatient and doctor＇s orders of inpatients in 80 days in each hospital in each month from 2014 to2015 were selected randomly. The information of medication use for PD was extracted and analyzed using Visual FoxPro 8. 0 software. Results There were 106 029 PD patients in seven cities in China. The ratio of male to female was1. 3∶ 1. The patients aged between 70 to 79 years old accounted for 32. 5% of the total PD patients,those drug cost accounted for 31. 2% of the total amount of drug in PD patients. The top three drugs used frequenctly were levodopa/benserazide,pramipexole and carbidopa/levodopa,accounting for 40. 4%,25. 5% and 16. 1% of all. The first cose of anti-Parkinson＇s drug was in pramipexole,accounting for 45. 1%. Of the top 20 drugs according to the drug cost,antiParkinson＇s drug accounted for 75. 8%,neural nutrition agent accounted for 9. 6%,and anti-dementia drugs accounted for 4%. The ratio of single use of compound levodopa and single non-ergot dopamine agonists in PD patients was24. 0% and 14. 9%. Combination use of compound levodopa and non-ergot dopamine agonists was the main treatment,accounting for 15. 3%. Conclusion Doctor＇ s treatment option complies with the treatment guideline of PD in China and they consider both motor and non-motor symptoms in the diagnosis and treatment of PD.