某院IgA肾病门诊患者临床用药特点及合理性探讨

doi:10.19803/j.1672-8629.2021.09.19

摘要/Abstract

摘要： 目的了解我院肾病科系膜增生性IgA肾病（IgA肾病）用药构成、用药特点及处方合理性,为临床合理用药提供参考。方法收集我院2018年1月1日~ 2019年12月31日肾病门诊处方186 111张,用药医嘱809 148条,其中IgA肾病处方4 326张,用药医嘱13 542条。对IgA肾病处方合理性、药品类别、不同药品类别药品构成情况进行统计分析。结果我院IgA肾病门诊用药以中药饮片和中成药为主,其用药比例远超西药（78.4%比21.6%）,中成药治疗以活血化瘀类药物为主,辅以健脾益肾、清热解毒和补肺益肾类药物。西药治疗以降低蛋白尿和降低血压为主。处方合理性分析发现,不合理处方73张,占总处方数1.7%,主要表现为处方书写不规范和处方用药不适宜。结论我院肾病科IgA肾病用药采取中西医结合模式,临床用药结构基本合理,中药饮片和中成药临床用药比例偏高,且存在不合理用药现象;应进一步加强处方管理,规范临床用药。

关键词: 肾病, IgA肾病, 门诊患者, 用药分析

Abstract: Objective To find out about the drug composition, characteristics of medication and rationality of prescriptions among patients with IgA nephropathy so as to provide reference for clinical rational drug use. Methods From January 1, 2018 to December 31, 2019, 18 6111 prescriptions for nephrotic outpatients and 809 148 medication orders were collected, including 4 326 prescriptions and 13 542 medication orders for IgA nephropathy. The drug categories, dosage and composition of different drug categories specified in prescriptions for IgA nephropathy were statistically analyzed. Results The proportion of traditional Chinese medicine and Chinese patent medicine was much higher than that of chemical medicine and western medicine (78.4% vs 21.6%). Chinese patent medicine was mainly used for IgA nephropathy, supplemented by drugs that could invigorate the spleen and kidney, clear heat and detoxification, and tonify the lung and kidney. Chemical medicine and western medicine were mainly used to reduce proteinuria and blood pressure. It was found that there were 73 improper prescriptions, accounting for 1.7% of the total, which were mainly manifested as nonstandard prescription writing and prescriptions of inappropriate drugs. Conclusion Traditional Chinese medicine is combined with western medicine in the treatment of IgA nephropathy in our hospital, and medication is basically well-grounded. The proportion of traditional Chinese medicine and traditional Chinese patent medicine is high, but there are cases of irrational medication. It is critical to keep an eye on prescriptions and standardize clinical medications.

Key words: nephropathy, IgA nephropathy, outpatients, medication analysis

中图分类号:

R969.3

沈静萍. 某院IgA肾病门诊患者临床用药特点及合理性探讨[J]. 中国药物警戒, 2021, 18(9): 883-886.

SHEN Jingping. Clinical Characteristics and Rationality of Medication among IgA Nephropathy Outpatients in a Rehabilitation Center[J]. Chinese Journal of Pharmacovigilance, 2021, 18(9): 883-886.

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