苯二氮受体激动剂在失眠症治疗中应用分析及合理性评价

Application analysis and rationality evaluation of BzRAs in treating insomnia

目的调查医院门诊失眠症药物的临床应用状况,评价其应用合理性,为合理选择使用失眠症药物提供科学依据。方法统计医院2018年1~6月门诊10 441张失眠症药品处方中的药品使用情况,分别对失眠症药物的品种、规格、剂量和疗程进行比较分析,并结合患者的基本信息,用EXCEL软件进行统计分析,衡量失眠症药物应用的合理性。结果苯二氮受体激动剂(BzRAs)占失眠症用药的主导地位,处方前3位的是氯硝西泮、劳拉西泮和右佐匹克隆,非苯二氮类药物使用呈上升趋势,苯二氮药物DIU值均<1.0,但非苯二氮类右佐匹克隆和唑吡坦的DIU值分别为0.91和0.92,接近1.0,有滥用的倾向。结论苯二氮药物仍是治疗失眠症的主要用药,新一代的非苯二氮类已被广泛接受,失眠症药物治疗需个体化,按需、间断、足量,特殊人群的个体化,确保失眠症患者用药趋于安全、合理、有效。

Objective To investigate the clinical application of insomnia drugs in hospital outpatient clinics,evaluate the rationality of drug use,and provide scientific basis for rational drug use.Methods 10 441 prescriptions for insomnia were collected from January to June in 2018.The varieties,specifications,dosage and treatment course of insomnia drugs were compared and analyzed to evaluate the rationality of the application of insomnia drugs.Results BzRAs is the main use of insomnia drugs.The top three of the prescription were clonazepam,Laura Si and right zoazepam.The proportion of non-BZDP use is increasing.The DIU values of BZDP are less than 1.0,but the DIU values of right zopiclone and zolpidem are 0.91 and 0.92 respectively,close to 1.0,considering the tendency of drug abuse.Conclusion Benzodiazepines is still the main drug for insomnia,and a new generation of non-benzodiazepines has been widely accepted.The choice of insomnia drugs should follow the principle of individualization,so as to ensure the safety,rationality and effectiveness of drug use.