药学门诊对儿童疱疹性咽峡炎用药干预分析

Interventions to medication for children with herpangina in pharmacist clinic

目的总结药学门诊参与儿童疱疹性咽峡炎用药管理的经验。方法选取2020年1月—2022年12月共832例就诊于我院药学门诊及儿科门诊的疱疹性咽峡炎病例,就诊于药学门诊的病例为干预组,就诊于儿科门诊的病例为对照组,干预组按照循证医学原则进行用药建议与指导,对照组不进行干预,所有患儿随访病情直至痊愈。结果832例患儿全部康复,无重症住院病例。干预组与对照组在发热、疼痛、疱疹愈合等时长及血液检查结果均差异无统计学意义(均P>0.05),干预组与对照组在药物使用方面差异有统计学意义(P<0.001),干预组不良反应数量(5例)及治疗费用[(44.30±5.23)元]均显著低于对照组[23例,(178.20±71.40)元](P<0.001)。结论疱疹性咽峡炎属于自限性病毒感染,应按照循证的原则予以对症支持,过度用药并未给儿童带来显著获益,反而增加不良反应风险,增加治疗费用。

Objective To summarize the pharmacists’experience in participating in medication management for the children with herpangina.Methods 832 children with herpangina who were treated in pharmacist clinic and pediatric clinic from January 2020 to December 2022 were enrolled in the study.The children who were treated in the pharmacist's clinic were assigned as the intervention group,and the children who were treated in the pediatric clinic were assigned as the control group.The intervention group was provided medication recommendations and guidance based on evidence-based medicine principles,and the control group was not intervened.A follow-up was carried out for all of the children till the recovery.Results All of the 832 children recovered,and no severe case was hospitalized.There were no significant differences in the duration of fever,pain,herpes healing and result of serological test between the intervention group and the control group(all P>0.05).There was significant difference in the use of drugs between the intervention group and the control group(P<0.001).The number of cases of adverse reactions was 5 cases in the intervention group,remarkably less than 23 cases in the control group,the treatment cost of the intervention group was(44.30±5.23)yuan,remarkably less than(178.20±71.40)yuan in the control group(P<0.001).Conclusion Herpangina belongs to selflimited viral infection and should be given symptomatic supportive treatment based on evidence-based principles.Excessive medication does not bring significant benefits to children,on the contrary,it increases the risk of adverse reactions and treatment costs.