中国住院患者祛痰药使用现状的描述性分析

Descriptive analysis of current use of expectorants in Chinese inpatients

目的了解祛痰药物在中国住院患者中的使用现状,为规范祛痰药使用提供参考。方法采用横断面研究。提取全国193家医院2015年1月至2017年12月期间处方祛痰药的住院患者医嘱数据,对患者的基本特征和祛痰药使用情况进行描述性分析。结果共提取2304748例次住院患者祛痰药使用信息,其中男性61.12%(1408749/2304748)比例高于女性38.87%(895999/2304748),29.97%(207038/690816)的患者诊断为呼吸系统疾病。12种祛痰药中氨溴索、溴己新、糜蛋白酶和N-乙酰半胱氨酸(NAC)临床应用最广泛,合计占比94.27%(2172618/2304748)。调查3年中氨溴索和糜蛋白酶应用呈下降趋势,溴已新和NAC应用呈上升趋势。61.64%(1242402/2015559)的注射剂型祛痰药用作雾化吸入。结论氨溴索、溴己新、糜蛋白酶和NAC是临床中最为常用的祛痰药物,最常用的给药途径是静脉注射和雾化吸入。注射剂型用于雾化吸入的比例仍然很高,特别是儿童和老年患者雾化祛痰的规范性仍需重视。

Objective To understand the current status of the use of expectorant drugs in the hospitalized patients in China for reference in standardizing use of expectorant drugs.Methods This was a cross-sectional study.The medication data were retrieved from 193 hospitals between January 2015 and December 2017 in China mainland,and then the demographics and the pattern of expectorants usage were analyzed.Results The informations of expectorant use in 2304748 inpatients were extracted,and the proportion of male patients(61.12%,1408749/2304748)was higher than that of female patients(38.87%,895999/2304748).29.97%(207038/690816)patients were diagnosed with respiratory diseases.Among 12 expectorants,ambroxol,bromohexene,chymotrypsin,and N-acetylcysteine(NAC)were the most widely used in clinical practice,accounting for 94.27%(2172618/2304748).In three-years study,ambroxol and chymotrypsin showed downward trend,while the application of bromine and NAC showed upward trend.61.64%(1242402/2015559)in vein injected dosage form of expectorant for atomization inhalation.Conclusions Ambroxol,bromohexene,chymotrypsin and NAC are the most commonly used expectorant drugs in clinic,and the most commonly used route of administration is intravenous injection and atomization inhalation.The proportion of injection dosage forms used for atomization inhalation is still very high,especially the standardization of atomization expectoration in children and elderly patients needs more attention.