丁苯酞在七城市78家医院用药情况调查与合理性评价

Investigation and rationality evaluation of Butyphthalide use in 78 hospitals of 7 cities

目的调查我国7个城市(北京、杭州、广州、上海、天津、成都和郑州)丁苯酞的使用现状及用药趋势,初步评价其使用的合理性。方法对7个城市78家医院2013~2017年丁苯酞的销售金额、用药频度、日均费用等进行统计分析。结果 5年间,7个城市应用丁苯酞患者男女比例约为2∶1,用药年龄主要集中在71~90岁(41%);原始诊断占前3名的是脑梗死(15.6%)、脑血管病(2.4%)、脑梗死后遗症(1.7%)。药物利用指数(DUI):北京>天津>成都>杭州>上海>广州>郑州。用药频度(DDDs):北京>杭州>广州>上海>天津>成都>郑州。日均费用(DDDc):郑州>上海>广州>北京>成都>天津>杭州。结论丁苯酞消耗量最大的城市是北京、杭州、广州和上海;在郑州、上海和广州地区丁苯酞的价格水平较高、经济负担最重;郑州地区医生用药过于谨慎,或剂量过小、未达到治疗效果,存在用药不合理性;用药符合中国指南推荐且日处方计量最为合理的城市排序:北京>天津>成都>杭州,这4个城市用药情况良好。

Objective To investigate the current situation and trend of Butyphthalide use in 7 cities of China（Beijing,Hangzhou, Guangzhou, Shanghai, Tianjin, Chengdu and Zhengzhou） and preliminarily evaluate the rationality of its use.Methods Statistical analysis was carried out on the sales amount, defined daily doses and Defined daily dose consumption of Butyphthalide in 78 hospitals of 7 cities from 2013 to 2017. Results In the 5 years, the proportion of male and female patients using Butyphthalide was about 2 ∶1 in the 7 cities, and their age was mainly between 71-90 years old（41%）. The top three primary diagnoses were cerebral infarction（15.5%）, cerebrovascular disease（2.4%） and cerebral infarction（1.7%）. Drug utilization index（DUI）： Beijing〉 Tianjin 〉Chengdu〉 Hangzhou 〉Shanghai 〉Guangzhou 〉Zhengzhou. Defined daily doses（DDDs）： Beijing〉 Hangzhou 〉Guangzhou 〉Shanghai〉 Chengdu 〉Zhengzhou. Defined daily dose consumption（DDDc）： Zhengzhou 〉Shanghai 〉Guangzhou〉 Beijing 〉Tianjin〉 Hangzhou. Conclusion Beijing, Hangzhou, Guangzhou and Shanghai are the biggest cities in consuming Butyphthalide. In Zhengzhou, Shanghai and Guangzhou, the price level is the highest and the economic burden is the heaviest. The doctors in Zhengzhou area were too cautious, or the dose was too small, and did not reach the therapeutic effect. The drugs are in accordance with the recommended Chinese guidelines and the most reasonable prescriptions of dosage are in order： Beijing 〉Tianjin 〉Chengdu 〉Hangzhou, and these 4 cities are in good condition.