中药注射剂在临床配伍中不合理应用情况及改进策略分析

Analysis of irrational application of traditional Chinese medicine injections in clinical compatibility and improvement strategies

目的分析中药注射剂在临床配伍中不合理应用情况及改进策略。方法选取8000例应用中药注射剂治疗的患者为研究对象,对患者临床资料进行回顾性分析,统计患者不合理用药类型、不良反应发生情况及各科室不合理用药情况。结果8000例患者中,不合理用药667例,占比为8.34%,其中用药不对证占比为1.65%,与其他药物联用占比为1.60%,单次用药剂量过大占比为1.51%,溶媒选择或者用量不当占比为1.39%,给药途径不当占比为1.13%,静脉滴注速度过快占比为1.06%。8000例患者中,发生不良反应患者328例,不良反应发生率为4.10%,皮肤及附件损害发生率为1.19%,消化系统反应发生率为1.10%,心血管系统损害发生率为0.94%,神经系统损害发生率为0.50%,全身性损害发生率为0.38%。不合理用药情况主要集中于手足外科、心血管病科,占比分别为2.36%、2.33%。结论在中药注射剂治疗中,应加强对临床配伍不合理情况的分析,结合临床实际情况,提出有效的改进策略,以此提高用药合理性,为中药注射剂的应用提供指导依据。

Objective To analyze the irrational application of traditional Chinese medicine injections in clinical compatibility and improvement strategies.Methods 8000 patients treated with traditional Chinese medicine injections were selected as the study subjects,and the clinical data of the patients were retrospectively analyzed,and the types of unreasonable drug use,the occurrence of adverse reactions and the unreasonable drug use in each department were counted.Results Among the 8000 patients,there were 667 cases of irrational drug use,accounting for 8.34%among them,1.65%were improper drug use,1.60%were combination with other drugs,1.51%were excessive single dose,1.39%were improper choice of solvent or dosage,1.13%were improper route of administration,and 1.06%were fast intravenous infusion speed.Among the 8000 patients,328 cases had adverse reactions,accounting for 4.10%,1.19%were skin and accessory damage,1.10%were digestive system reaction,0.94%were cardiovascular system damage,0.50%were nervous system damage,and 0.38%were systemic damage.Irrational drug use mainly concentrated in hand-foot surgery department and cardiovascular disease department,accounting for 2.36%and 2.33%,respectively.Conclusion In the treatment of traditional Chinese medicine injections,the analysis of irrational clinical incompatibility should be strengthened,and effective improvement strategies should be put forward based on the clinical practice,so as to improve the rationality of drug use and provide guidance for the application of traditional Chinese medicine injections.