上海市焦虑障碍首诊患者门诊药物联用现况调查

Present survey on prescription psychotropic drugs in the outpatients with anxiety outpatients in Shanghai

目的了解上海市精神病专科医院焦虑障碍患者首诊精神药物的使用现况。方法对上海市精神卫生中心2010年1月~2015年12月门诊登记就诊的25,040例首诊的焦虑障碍患者病例资料进行回顾性分析。结果 (1)首诊的女性患者数量(59.6%)显著多于男性(40.4%),且年龄较大。(2)门诊焦虑障碍首诊药物治疗共使用17类具有抗焦虑作用的精神药物,其中排名前三位分别为5-羟色胺再摄取抑制剂(SSRI)、苯二氮卓类(BZDS)、去甲肾上腺素和特异性5-羟色胺受体拮抗剂(Na SSA)。(3)单一用药患者7716例,两药合并治疗患者9866例,三药以上合并治疗患者7458例,三者之间差异在统计学上显著(P<0.01),同时,在两药合并治疗中,除三环类药物(TCAs)外,联用苯二氮卓类药物治疗的患者数量均显著少于未联用苯二氮卓类药物治疗患者的数量(P<0.01)。结论上海市精神病专科医院对焦虑障碍首诊的药物治疗在遵守《中国焦虑障碍防治指南》建议的治疗原则基础上,平衡了疗效和安全性,根据患者特点进行针对性用药。

Objective To evaluate the use patterns of psychotropic drugs in treating outpatients with anxiety disorder.Methods A retrospective analysis was made of 25,040 cases of outpatients with anxiety disorder from January 2010 to December 2015 in Shanghai Mental Health Center.Results（1）The percentage of female patients（59.6%）was significantly higher than that of male（40.4%）and which had a higher age.（2）A total of 17 types of psychotropic drugs with anxiolytic effects was used on outpatients with anxiety disorder of which the top three kinds were Selective Serotonin Reuptake Inhibitor（SSRIs）,Benzodiazepines（BZDs）,Noradrenergic and Specific Serotonergic Antidepressant（Na SSA）.（3）7,716 cases were treated with mono-pharmacy.9,866 cases were treated with two kinds of drugs and 7,716 cases were treated with more than three kinds of drugs（P〈0.01）.In the combination therapy of two drugs,all kinds of psychotropic drugs combined with benzodiazepine drug treatment were significantly less than the combination of other psychotropic drugs.Conclusion The first treatment of patients with anxiety disorders in Shanghai psychiatric hospital is based on 《Guidelines for the Prevention and Treatment of Anxiety Disorders in China》 and has balanced the efficacy and safety,and use targeted drugs according to the characteristics of each patient.