临床口服降糖药不良反应发生情况分析

Analysis on the occurrence of adverse reactions of clinical oral hypoglycemic drugs

目的分析本地糖尿病患者应用口服降糖药物后药物不良反应的发生情况,探讨口服降糖药物应用的合理性。方法选取2019年3月至2020年3月榆林市第二医院收治的112例糖尿病患者为研究对象,通过追踪观察患者降糖药物的应用情况及不良反应的发生率、患者用药依从性,分析糖尿病患者用药方案和用药行为的合理性。结果112例糖尿病患者中用药方案以双药联合方案为主71例,占63.39%(71/112),单药方案41例,占36.61%(41/112);双药联合方案不良反应发生率为22.54%,明显低于单药方案的41.46%,差异有统计学意义(P<0.05);用药方案不合理原因中以药物疾病-异常状态相互作用、药物的经济性为主,分别占47.37%、31.58%;用药依从性好43例,依从性中等38例,依从性差31例,用药依从性不佳者占比61.61%;用药依从性差的原因中以忘记用药、不良反应和症状不明显占比较高,分别为20.29%、31.88%、18.84%。结论口服降糖药单药方案和联合用药并存于临床,以双药方案为主流趋势,有较好的疗效和安全性,然而在治疗过程中存在用药方案和用药行为的不合理性,应健全疾病管理体系和规范患者的用药行为,以确保合理用药。

Objective To analyze the occurrence of adverse drug reactions after taking oral hypoglycemic drugs in local diabetic patients,and to investigate application of the rationality with oral hypoglycemic drugs.Methods A total of 112 diabetic patients admitted to the Second Hospital of Yulin City from March 2019 to March 2020 were selected as the research objects.By tracking and observing the application of hypoglycemic drugs,the incidence of adverse reactions,and the compliance of patients with medication,the rationality of medication regimens and medication behaviors in diabetic patients was analyzed.Results Among the 112 patients with diabetes,71 were treated with dual-drug combination regimen,accounting for 63.39%(71/112),and 41 with single-drug regimen,accounting for 36.61%(41/112).The incidence of adverse reactions of dual-drug combination regimen was 22.54%,which was significantly lower than 41.46%of the single-drug regimen(P<0.05).Drug disease-abnormal state interaction and drug economy were the main reasons for the unreasonableness drug regimen,accounting for 47.37%and 31.58%,respectively.There were 43 patients with good medication compliance,38 patients with moderate compliance,and 31 patients with poor compliance,and the proportion of patients not with good medication compliance was 61.61%.Among the reasons for poor medication compliance,forgetting medication,adverse reactions and insignificant symptoms accounted for 20.29%,31.88%,and 18.84%,respectively.Conclusion Single-drug regimen and dual-drug combination regimen of oral hypoglycemic drugs coexist in clinical practice,and dual-drug regimen is the mainstream trend,which has good efficacy and safety.However,there are irrational aspects about drug regimen and drug behavior in the treatment process,so it is necessary to improve the disease management system and standardize the drug behavior of patients to ensure rational drug use.