开展药学监护对中风类中成药合理应用的影响

The influence of pharmaceutical care on the rational use of traditional Chinese patent medicines for stroke

目的分析开展药学监护对中风类中成药合理应用的影响。方法180例中风患者,按照时间先后顺序分成无药学监护组(2021年1~6月,未开展药学监护)和药学监护组(2021年7~12月,开展药学监护),每组90例。比较两组中风类中成药的注射剂型、口服剂型、两者兼有比例;用药不合理情况(用药剂量不合理、给药方式不合理、用药配伍禁忌、药物与辨证不符、用药疗程不合理、超适应证用药);疗效指标[住院时间、出院时格拉斯哥预后(GOS)评分、出院时日常生活活动能力(ADL)评分]。结果药学监护组中风类中成药的注射剂型比例52.22%低于无药学监护组的67.78%,口服剂型比例37.78%高于无药学监护组的23.33%,差异具有统计学意义(P<0.05);两组中风类中成药的两者兼有比例比较,差异无统计学意义(P>0.05)。药学监护组的用药剂量不合理比例1.11%、给药方式不合理比例0、总用药不合理比例2.22%低于无药学监护组的7.78%、5.56%、18.89%,差异具有统计学意义(P<0.05);两组用药配伍禁忌、药物与辨证不符、用药疗程不合理、超适应证用药比例比较,差异无统计学意义(P>0.05)。药学监护组的住院时间(8.65±0.83)d短于无药学监护组的(10.92±1.05)d,出院时GOS评分(3.75±0.32)分、ADL评分(65.92±5.03)分高于无药学监护组的(3.06±0.29)、(57.31±5.16)分,差异具有统计学意义(P<0.05)。结论开展药学监护能降低中风类中成药注射剂型使用比例,减少不合理用药发生率,提高疗效。

Objective To analyze the influence of pharmaceutical care on the rational use of traditional Chinese patent medicines for stroke.Methods 180 stroke patients were divided into non-pharmacological supervision group(January-June 2021,no pharmacological supervision)and pharmacological supervision group(July-December 2021,pharmacological supervision)according to chronological order,with 90 cases in each group.Both groups were compared in terms of proportion of injectable dosage form,oral dosage form,and both forms of traditional Chinese patent medicines for stroke;the unreasonable use of medication(unreasonable dosage of medication,unreasonable mode of administration,contraindication of medication combination,inconsistency between medication and identification,unreasonable medication regimen,and use of medication beyond indications);and the efficacy indexes[hospital stay,Glasgow outcome scale(GOS)score at discharge,and activities of daily living(ADL)score at discharge].Results The proportion of injectable dosage form of traditional Chinese patent medicines for stroke in the pharmacological supervision group was 52.22%,which was lower than 67.78%in non-pharmacological supervision group;the proportion of oral dosage form in the pharmacological supervision group was 37.78%,which was higher than 23.33%in the non-pharmacological supervision group;the differences were statistically significant(P<0.05).There was no statistically significant difference in the proportion of both forms of traditional Chinese patent medicines for stroke in the two groups(P>0.05).In the pharmacological supervision group,the proportion of unreasonable dosage of medication 1.11%,unreasonable mode of administration 0,and unreasonable total dosage 2.22%were lower than 7.78%,5.56%,and 18.89%in non-pharmacological supervision group,and the differences were statistically significant(P<0.05).The differences between the two groups were not statistically significant(P>0.05)when comparing the proportions of contraindication of medication combination,inconsistency between medication and identification,unreasonable medication regimen,and use of medication beyond indications.The hospital stay(8.65±0.83)d in the pharmacological supervision group was shorter than(10.92±1.05)d in the non-pharmacological supervision group;the GOS score at discharge(3.75±0.32)points and ADL score at discharge(65.92±5.03)points in the pharmacological supervision group were higher than(3.06±0.29)and(57.31±5.16)points in the non-pharmacological supervision group;the differences were statistically significant(P<0.05).Conclusion Pharmacological care can reduce the proportion of injectable dosage forms of traditional Chinese patent medicines for stroke,reduce the incidence of irrational drug use and improve the efficacy.