上海市某社区卫生服务中心203例心脑血管病患者活血化瘀中成药应用现状

The Application Status of Chinese Patent Medicine for Promoting Blood Circulation to Remove Blood Stasis in 203 Cases of Patients with Cardiovascular and Cerebrovascular Diseases in a Community Health Service Center in Shanghai

目的了解上海市某社区卫生服务中心有关心脑血管疾病患者活血化瘀中成药使用现状,以为临床合理应用提供依据。方法以真新社区卫生服务中心为例,从上海市家庭医生门诊系统中调取有缺血性心脑血管疾病诊断的患者203例,通过系统的历史处方记录,查询2018年1月份开具的活血化瘀中成药,进行整理、归纳、总结。结果真新社区卫生服务中心常用活血化瘀、通络平肝的药物有26种,使用频率居前8位的分别是麝香保心丸、银杏叶片、培元通脑胶囊、银杏酮酯片、复方丹参滴丸、脑心通胶囊、丹参片、血塞通胶囊;药物联合使用较为普遍,最多使用8种相关药物;同时使用3种及以上的患者为30例,占14.78%。结论该中心活血化瘀类药物种类较多,绝大多数使用规范,但存在缺少辨证论治、药物配伍不当等不合理使用现象,应加强全科医师相关知识培训,进一步加强合理用药。

Objective To investigate the application status of Chinese patent medicine for promoting blood circulation to remove blood stasis in patients with cardiovascular and cerebrovascular diseases in a community health service centre in Shanghai,and provide evidence for rational clinical application.Methods Taking Zhenxin community health service center as an example,select 203 patients with ischemic cardiovascular and cerebrovascular diseases from the family doctors outpatient system of Shanghai,and query the Chinese patent medicine for promoting blood circulation to remove blood stasis prescribed in January 2018 from the systemic history prescription records,and then sorting and summarizing these data.Results There are 26 kinds of common drugs for promoting blood circulation to remove blood stasis and Tongluo Pinggan in Zhenxin community health service center.Among them,the top eight users are Shexiang Baoxin pill,Ginkgo leaf tablets,Peiyuan Tongnao capsule,Ginkgo ketoester tablet,compound Danshen dripping pill,Naoxintong capsule,Danshen tablet and Xuesetong capsule;the combination using of drugs is more common,and 8 related drugs are used together at most.30 cases of patients use 3 or more kinds of drugs at the same time,accounting for 14.78%.Conclusion There are many kinds of drugs for promoting blood circulation to remove blood stasis in this center.Most of them are used normatively.But there are some confusion phenomenons such as lacking of syndrome differentiation and treatment,improper drug compatibility,etc.It is necessary to strengthen the training of general practitioners and further strengthen the rational using of drugs.