贯叶金丝桃饮片医嘱点评及合理使用研究

Medical-Order Comment and Rational Use of Guanye Jinsitao Decoction Pieces

目的为临床合理使用贯叶金丝桃饮片提供参考。方法采用回顾性分析法,对医院2021年4月至5月含有贯叶金丝桃饮片的住院患者中药处方进行分析。结果使用贯叶金丝桃饮片的54例患者在住院用药期间未发生较明显的联合用药不良事件,以及和饮片自身相关的药品不良反应;联合使用存在相互作用的药物71例次,联用后用药医嘱调整19例(26.76%),调整的药物为降压药、镇静催眠药、抗抑郁药、抗精神病药,药物调整内容以增加品种为主;配伍用药以活血化瘀、疏肝理气、益气安神、健脾消食药为主;贯叶金丝桃饮片中抗抑郁主要成分为金丝桃苷,与圣·约翰草提取物的成分存在差异。结论贯叶金丝桃饮片临床使用的安全性评价工作应单独开展,圣·约翰草及舒肝解郁胶囊的安全性研究及临床案例报道仅能作为参考。

Objective To provide a reference for the rational use of Guanye Jinsitao Decoction Pieces in the clinic.Methods The prescriptions of inpatients using Guanye Jinsitao Decoction Pieces from April to May 2021 were retrospectively analyzed.Results A total of 54 patients using Guanye Jinsitao Decoction Pieces did not have obvious adverse events of combined drug use and adverse drug reactions related to Guanye Jinsitao Decoction Pieces during hospitalization.There were 71 cases of combined use of drugs with drug interaction.The adjusted drugs were antihypertensive drugs,sedative hypnotics,antidepressants and antipsychotic drugs.The main content of drug adjustment was to increase the variety of drugs.The efficacy of compatibility drugs mainly included promoting blood circulation and removing blood stasis,clearing the liver and regulating Qi,invigorating Qi and calming nerves,strengthening spleen and promoting digestion.The main antidepressant component of Guanye Jinsitao Decoction Pieces was hyperoside,which was different from that of Hypericum perforatum extract.Conclusion The safety evaluation of Guanye Jinsitao Decoction Pieces in clinical use should be carried out independently,and the safety study and clinical case report of Hypericum perforatum and Shugan Jieyu Capsules can only be used as reference.