活血化瘀类中药注射剂治疗缺血性脑卒中不良反应分析

Analysis on Adverse Reactions of Chinese Medicine Injection of Promoting Blood Circulation for Removing Blood Stasis in Treating Ischemic Stroke

目的研究活血化瘀类中药注射剂在缺血性脑卒中治疗中的不良反应(ADR)发生状况。方法选取南昌三三四医院神经内科2020年1月—2021年12月收治的缺血性脑卒中患者400例作为研究对象,记录患者的ADR分级、临床表现、涉及中药注射剂品种等,分析ADR发生的特点。结果400例患者的ADR发生率为20.50%(82/400),其中仅有4.88%(4/82)的ADR为2级,其余95.12%(78/82)的ADR均为3~4级,ADR的临床表现以胸闷、皮疹、恶心呕吐、局部水肿等为主。应用注射用灯盏花素、注射用血塞通、丹红注射液和丹参注射液治疗患者的ADR发生率差异无统计学意义(P>0.05);4种中药注射液的不合理用药发生率均偏高,组间差异有统计学意义(P<0.05);4种中药注射液均以超适应证使用引起的ADR发生率最高,高于超剂量使用和超疗程使用的ADR发生率(P<0.05);而在同类不合理用药中,4种中药注射液的ADR发生率差异无统计学意义(P>0.05)。结论临床用药时应加强对医嘱的审核管理,严格把控,减少不合理用药现象,减少ADR发生,保证患者用药的安全性。

Objective To study the adverse reactions(ADR)of Chinese medicine injection of promoting blood circulation for removing blood stasis in treating ischemic stroke.Methods Four hundred patients with ischemic stroke admitted to the Department of Neurology of Nanchang 334 Hospital from January 2020 to December 2021 were selected as the study objects.ADR grades,clinical manifesta-tions and varieties of TCM injections involved were recorded to analyze the characteristics of ADR occurrence.Results The incidence of ADR in 400 patients was 20.50%(82/400),of which only 4.88%(4/82)were grade 2 ADRs,and the remaining 95.12%(78/82)were grade 3-4 ADRs.The clinical manifestations of ADR were mainly chest tightness,rash,nausea,vomiting,and local edema.There was no significant difference in the incidence of ADR among patients treated with breviscapine for injection,Xuesaitong for injection,Dan-hong injection and Danshen injection(P>0.05).The incidence of irrational drug use of 4 kinds of Chinese medicine injection was higher,and the difference between groups was statistically significant(P<0.05).The incidence of ADR caused by over-dosage and over-course was higher than that caused by over-dosage and over-course(P<0.05).There was no significant difference in the inci-dence of ADR among 4 kinds of Chinese medicine injection among similar irrational drug use(P>0.05).Conclusion In clinical medi-cation,the audit and management of medical orders should be strengthen and strictly controlled,so as to reduce irrational medication,reduce the occurrence of ADR,and ensure the safety of patients’medication.