佛山市南海区慢病患者中药使用情况调查与分析

Investigation and Analysis on the Use of Traditional Chinese Medicine in Chronic Disease Patients in Nanhai District of Foshan City

目的通过了解社区慢病患者中药临床应用的现状,提出安全使用中药的风险管理建议。方法收集佛山市南海区5个不同社区家庭药师所建立的慢病用药档案,调查慢病建档人群的疾病结构、用药种类和不合理使用中药情况。结果 601位慢病患者中,所患疾病按系统分排前三位的分别是心血管系统疾病占94.2%,主要是高血压和冠心病等;内分泌系统疾病占59.9%,主要是糖尿病;精神疾病占5.3%,主要是失眠;平均使用药品品种数为5.6种,最多为12种;联用药品品种数≥5种的占77.5%;198例使用了中药,多为1种中成药,共160例,占80.8%;43例使用的中成药含有毒中药材成分;163例不合理使用中成药,其中排前三位的分别是:超适应证用药占63.6%、中西药不适宜联用占21.2%、用药频次不当占18.7%。结论本区域慢病患者不合理使用中成药现象突出,对家庭药师开展"西学中"教育培训,加强对患者使用中成药的知识宣教,有利于提高患者用药的安全、有效和合理性。

OBJECTIVE To put forward the risk management recommendation for safe use of Traditional Chinese medicines,we investigated the current situation of clinical application of Traditional Chinese medicines in community patients with chronic diseases.METHODS We investigated and analyzed the disease structure,types of medicine,unreasonable use of traditional Chinese medicine by collecting the chronic disease medication archives established by family pharmacist from 5 different communities in NanHai district,FoShan city. RESULTS Among the 601 patients with chronic disease,the top three diseases were cardiovascular diseases( accounted for 94.2%,mainly hypertension and coronary heart disease),endocrine system diseases( accounted for 59. 9%,mainly diabetes) and mental illness( accounted for 5. 8%,mainly insomnia) by system. At the same time,average number of medication was 5. 6,and the maximum number was 12 species. The number of drugs used 5 species or above accounted for 77. 5%. There were 198 patients using traditional Chinese medicine,of which 160 cases used only one Chinese patent medicine and 43 patients used toxic Chinese herbal medicin. 163 cases used Chinese patent medicines unreasonably,unreasonably,including: over-indication( 63. 6%),improper combination of Chinese and Western medicines( 21. 2%),improper frequency of medication( 18. 7%). CONCLUSION There is necessary for family pharmacists to study the knowledge of TCM and patients to be educated how to use TCM,which is beneficial for patients to use drug rationally,effectively and safely.