基于加权TOPSIS法建立的DUE标准评价注射用益气复脉(冻干)用药合理性

Evaluation of clinical application rationality of Yiqi Fumai injection(lyophilization)based on DUE standard establishing by weighted TOPSIS method

目的基于加权逼近理想解的排序技术(TOPSIS)法建立注射用益气复脉(冻干)药物利用评价(DUE)标准,评价临床用药合理性。方法调取银川市中医医院(以下简称为中医院)、银川市第一人民医院(以下简称为综合性医院)2023年1—12月使用注射用益气复脉(冻干)的归档病历504份,以注射用益气复脉(冻干)药品说明书为基础,参考相关指南和专家共识,通过专家研讨,并通过加权TOPSIS法建立DUE标准,分析2家医院加权TOPSIS法评价结果,并统计医院各评价指标的不合理类型。结果中医院完全合理的病历占19.37%,基本合理病历占90.54%;综合性医院完全合理的病历占7.45%,基本合理病历占98.58%。中医院药物不合理类型前3位分别为配伍禁忌(45.11%)、适应证(31.20%)和给药浓度(19.17%);综合性医院不合理情况前3位分别为适应证(63.19%)、配伍禁忌(36.29%)和用药疗程(0.52%)。结论利用加权TOPSIS法建立的DUE标准可客观、准确地评价注射用益气复脉(冻干)临床使用合理性,中医药和综合性医院用药基本合理。

Objective To evaluate the clinical application rationality of Yiqi Fumai injection(lyophilization)based on DUE standard establishing by weighted TOPSIS method.Methods The DUE standard for Yiqi Fumai injection(lyophilization)was established by referring to the drug instruction,relevant guidelines and expert consensus through expert consultation.Meanwhile,the weighted TOPSIS method was used to retrospectively analyze the archived cases of Yiqi Fumai injection(lyophilization)used in Yinchuan Traditional Chinese Medicine Hospital(which was hereinafter referred to as traditional Chinese medicine hospital)and the First People′s Hospital of Yinchuan(which was hereinafter referred to as general hospital)from January to December 2023 for rationality evaluation.The evaluation results of hospital were analyzed by weighted TOPSIS method,and the unreasonable types of hospital evaluation indexes were recorded.Results In the traditional Chinese medicine hospital,completely reasonable rate was 19.37%,and basic reasonable rate was 90.54%;In the general hospital,completely reasonable rate was 7.45%,and basic reasonable rate was 98.58%.The top three unreasonable applications was incompatibility of medicines(45.11%),indications(31.20%)and drug concentration(19.17%)in the traditional Chinese medicine hospital;The top three unreasonable applications were indications(63.19%),incompatibility of medicines(36.29%)and medication duration(0.52%)in the general hospital.Conclusion DUE established by weighted TOPSIS method can objectively and accurately evaluate the rationality of clinical use of Yiqi Fumai injection(lyophilization),and the drugs used in traditional Chinese medicine and general hospital are basically reasonable.