目的 研究氨溴索静脉用药联合不同通气方式治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法 选取2019年2月—2021年1月我院收治的98例NRDS患儿,根据治疗方案不同分为对照组(49例)和观察组(49例)。2组均给予常规治疗,对照组采用氨溴索静脉用药、常规机械通气治疗,观察组采用氨溴索静脉用药、高频振荡通气(HFOV)治疗。比较2组临床疗效、胸部X线评分、新生儿评分(Apgar评分)、不同时间点(治疗前、治疗后2 h、治疗后12 h)动脉血气指标[氧合指数(OI)、动脉氧分压(PaO₂)、动脉血二氧化碳分压(PaCO₂)]、呼吸力学指标[呼吸指数(RI)、呼吸道阻力(R)、肺动态顺应性(Crs)]、并发症发生率、死亡率。结果 2组治疗后总有效率比较,观察组93.88%高于对照组77.55%(P＜0.05);治疗后,观察组胸部X线评分、Apgar评分均高于对照组(P＜0.05);治疗后2 h、治疗后12 h时观察组OI、PaCO₂均低于对照组,PaO₂高于对照组(P＜0.05);治疗后,观察组RI、AR水平低于对照组,Crs水平高于对照组(P＜0.05);观察组死亡率2.04%低于对照组14.29%(P＜0.05)。结论 氨溴索静脉用药联合HFOV治疗NRDS的临床疗效显著,可有效促进患儿呼吸功能、动脉血气改善,降低新生儿死亡率。

目的 探究中医药治疗盆腔炎的用药规律,为中医临床辩证用药提供借鉴。方法 采用主题词联合自由词相,全面检索CNKI、VIP、Wangfang、CBM、PubMed和EMbase、数据库及Cochrane图书馆,收集中、西药对比治疗盆腔炎的随机对照试验。严格按照纳入、排除标准挑选随机对照试验中涵盖的中药药方,采用Excel表格统计分析药方中药的四气、五味、归经和用药频率,随后利用系统聚类软件对使用频率高的中药开展关联、聚类和主成分分析。结果 本文共纳入235个随机对照试验,涉及320首中药处方,平均用药味数13.29味,使用频率前五位的药分别为延胡索、赤芍、当归、蒲公英、丹参;关联规则共得出41对高关联药对,其中包括赤芍-延胡索、莪术-三棱-败酱草等。高频率使用的前30味中药可分为五大类,获取的9个主成分分析结果与系统聚类中的结果一致。结论 本研究采用循证医学和系统聚类分析方法,剖析中医药治疗盆腔炎的用药规律,为临床用药提供参考。

Objective To discuss the medication regularity of traditional Chinese medicine (TCM) in the treatment of pelvic inflammatory disease, and provide new thinking for effective medication in clinical medicine. Methods Keywords combined with free word were used to comprehensively search CNKI, VIP, Wangfang, CBM, PubMed and EMbase, databases and Cochrane library to collect randomized controlled trials of comparative treatment of pelvic inflammatory disease between Chinese and Western drugs. The TCM prescriptions covered in the randomized controlled trial were selected in strict accordance with the standard inclusion and exclusion criteria. Excel was used to statistically analyze the four properties, five flavors, meridian and medication frequency of TCM prescriptions. Then, systematic clustering software was used to carry out correlation, clustering and principal component analysis for the Chinese medicines with high using frequency. Results The study included 235 randomized controlled trial and 320 prescriptions of traditional Chinese medicine were involved, the average number of herbs was 13.29, which Yanhusuo, Chishao, Danggui, Pugongying, Danshen were with top five frequency. A total of 41 drug pairs with high association were obtained by association rules, including Chishao-Yanhusuo, Eshu-Sanleng-Baijiangcao, etc. Thirty traditional Chinese medicine with high using frequency can be divided into 5 categories according to the effect. The obtained results of 9 principal component analysis were consistent with those in the system cluster. Conclusions In this study, evidence-based medicine and systematic cluster analysis were used to analyze the medication regularity of traditional Chinese medicine in the treatment of pelvic inflammatory disease, so as to provide reference for the clinical medication.

目的 探讨药物服务干预对老年高血压患者的治疗及用药安全性的影响。方法 选取2020年6月—2021年12月潮州市中医药研究所门诊部和潮州市中医医院高血压患者90例为研究对象,采用随机数字表法分为观察组45例（给予药物服务干预）,对照组45例（给予常规用药指导）。比较干预后血压控制水平、健康知识认知、治疗依从性、自我管理行为、生活质量及药物不良反应等情况。结果 干预后,观察组舒张压、收缩压、不良反应发生率均低于对照组（P<0.05）。干预后,观察组健康知识认知水平、治疗依从率、自我管理行为评分、生活质量评分均高于对照组（P<0.05）。结论 采用药物服务干预的方式能够较好控制老年高血压患者血压水平,提升其健康知识认知水平与治疗依从性,改善自我管理行为状况,提高生活质量。

Objective To investigate the effect of drug service intervention on the treatment and drug safety of elderly patients with hypertension．Methods From June 2020 to December 2021,a total of 90 patients with hypertension from Chaozhou Institute of traditional Chinese Medicine and Chaozhou Hospital of Traditional Chinese Medicine were selected as the study objects,and were divided into observation group（45 cases,given drug service intervention）and control group（45 cases,given routine drug guidance）by random number table method．The blood pressure control level,health knowledge cognition level,treatment compliance,self-management behavior,quality of life and adverse drug reactions of elderly patients with hypertension were compared after intervention．Results After intervention,the incidence of diastolic blood pressure,systolic blood pressure and adverse drug reactions in the observation group were lower（P<0.05）．After intervention,the health knowledge cognition level,treatment compliance rate,self-management behavior score and quality of life score of the observation group were higher（P<0.05）．Conclusions The use of drug service intervention can better control the blood pressure level of elderly patients with hypertension,improve their health knowledge cognition and treatment compliance,improve self-management behavior and improve quality of life．

目的 调查分析老年精神疾病住院患者潜在不适当用药(PIM)现状。方法 回顾分析2021年3月老年住院患者临床诊断、用药情况等资料,依据2017年版《中国老年人潜在不适当用药判断标准》分析处方PIM情况。结果 125例研究对象中,平均年龄(73.31±7.87)岁,平均用药(6.62±2.68)种。101例(80.80%)患者存在140项PIM,81例(64.80%)患者使用了A级警示药物共103项,33例(40.74%)患者使用了B级警示药物共37项;高风险药物39项(27.86%),低风险药物101项(72.14%);PIM发生率排名前3位的药物是奥氮平、利培酮、劳拉西泮;12例患者存在4项与疾病状态相关的PIM。结论 该院PIM发生率偏高,医生和药师应加大力度降低PIM比例,减少不良反应,提高用药安全,促进合理用药。

Objective To investigate the current status of potentially inappropriate medications (PIM) for elderly inpatients with mental illness in a psychiatric hospital. Methods Based on the 2017 edition of “Judgment Standards for Potentially Inappropriate Medications for the Elderly in China”, we retrospectively analyzed the PIM by investigating the clinical diagnosis and medication status of 125 elderly psychiatric inpatients in March 2021. Results Among 125 subjects, the average age was (73.31±7.87) years, and the average medication was (6.62±2.68). There were 101 patients (80.80%) had 140 items of PIM, 81 patients (64.80%) used a total of 103 items of A-level warning drugs, 33 patients (40.74%) used a total of 37 items of B-level warning drugs; there were 39 high-risk drugs(27.86%), 101 low-risk drugs (72.14%); the drugs with top three PIM incidence were olanzapine, risperidone and lorazepam; 12 patients had 4 PIMs related to the disease state. Conclusions The incidence of PIM in this hospital is relatively high. Doctors and pharmacists should be advised to increase their efforts to reduce the proportion of PIM, reduce the incidence of adverse reactions, improve medication safety, and promote rational drug usage.

目的 探讨家庭药师与药物治疗管理对签约患者用药依从性及不合理用药干预效果。方法 选取2017年3月—2021年3月我院收治的慢性病患者100例作为前瞻性研究对象,按照随机余数法分为对照组和研究组各50例。其中,对照组实施首次随访调查,收集患者健康信息建立用药档案,末次随访评价。研究组采用收集患者健康信息,建立用药档案,填写调查表,对在用的药物治疗方案进行评价,家庭药师与家庭医生协作共同干预或直接干预,制定具体的解决方案,帮助患者达到治疗目标。比较2组患者干预前后的药物依从性、生活质量及用药情况的变化。结果 干预前,2组患者的药物依从性评分比较无统计学意义(P ＞0.05),干预后,2组患者药物依从性评分比较随时间增加而改善,而研究组的药物依从性评分显著高于对照组,统计学显示差异有统计学意义(P＜0.05)。2组患者的选择合理、给药频率合理、滴定合理、换药合理、联合用药合理均有明显改善且研究组多于对照组,比较差异有统计学意义(P＜0.05)。结论 家庭药师及药物治疗管理干预能够有效提高患者用药依从性及生活质量,改善用药情况,对慢性病患者干预具有一定参考价值。

Objective To explore intervention the effect of family pharmacist and medication management on medication compliance and unreasonable drug use in contracted patients. Methods A total of 100 patients with chronic diseases from March 2017 to March 2021 in our hospital were selected as prospective study subjects. According to the random remainder method,they were divided into control group and research group with 50 cases in each group. Among them,the control group was surveyed in the first followed-up,and the health information of patients was collected to establish drug use files,and evaluation was performed in the final follow-up. Family pharmacists and family physicians intervened together or directly to formulate specific solutions to help patients achieve the treatment goals and explain the treatment goals. The changes of medication compliance,quality of life and drug use before and after intervention were compared between the two groups. Results Before the intervention,the medication compliance scores of the two groups were not significantly different (P>0.05).After the intervention,the medication compliance scores of the two groups improved with time,while the medication compliance scores of the research group were significantly higher than the control group,statistics analysis showed that the difference was significant (P<0.05).The reasonable selection,the reasonable frequency,the reasonable titration,the reasonable drug change,and the reasonable combined medication in research group were significantly more than the control group,and the differences were statistically significant (P<0.05).Conclusions Family pharmacist and medication management intervention could effectively improve medication compliance and quality of life of patients,improve drug use,had a certain reference value for chronic disease patients.

目的 分析广州市某精神病院住院病人精神药物用药的情况变化,为该类药物药费控制、合理应用和科学管理提供参考。方法 统计2015年7月15日—2019年7月14日精神药物的销售金额、用药频度、日用药金额并进行分析。结果 该院4类精神药物共40种,抗精神病药销售金额先升后降,DDDs小幅度增加,非典型抗精神病药销售金额占97%以上,DDDs占87%以上;抗抑郁药销售金额和DDDs逐年增长,新型抗抑郁药占99%以上;抗焦虑药销售金额先升后降;心境稳定药销售金额先升后降,DDDs小幅度减少;65%精神药品排序比趋近1;62%精神药品DDDc下降;取消加成后,销售总金额减少,DDDs总和却增加。结论 取消药品加成对抗精神病药影响较大,对抗抑郁药、抗焦虑药以及心境稳定药影响较小;药品零加成可明显减轻患者经济负担,促进用药合理化。

Objective To analyze the changes in the use of psychotropic drugs by inpatients in a psychiatric hospital in Guangzhou, and to provide reference for the control, rational application and scientific management of the drugs. Methods The sales amount, frequency of use, and daily use of psychotropic drugs from July 15, 2015 to July 14, 2019 were counted and analyzed. Results There were a total of 40 kinds of psychotropic drugs of 4 types in this hospital. In the past 4 years, the sales of antipsychotic drugs increased first and then decreased, and DDDs increased slightly. The sales amount of atypical antipsychotic drugs accounted for more than 97% of the total drug cost, and DDDs accounted for more than 87%. The sales amount of antidepressants DDDs were increasing year by year, and new generation antidepressants account for more than 99% of the antidepressants. The sales of anti-anxiety drugs increased first and then decreased. The sales of mood stabilizer increased first and then decreased, and DDDs decreased slightly. 65% of psychotropic drug's rank closes to 1. DDDc in 62% of the psychotropic drugs decreased; after abolishing additional cost of drugs, the total sales amount decreased, but the total DDDs increased. Conclusion Abolishing additional cost of drugs had a greater impact on antipsychotic drugs, but little effect for antidepressants, anxiolytics, and mood stabilizers, which may greatly reduces patient's drug cost and promote rational use of drugs.

目的 对我院静脉用药调配中心2017年1月—2019年12月期间的不合理医嘱情况进行汇总及分析,以提高合理用药水平。方法 收集2017年1月—2019年12月广州市第一人民医院静脉用药调配中心的不合理医嘱资料进行回顾性分析,归纳不合理医嘱类型、汇总分析不合理医嘱表现以及改正不合理情况。结果 主要不合理医嘱类型包括溶媒选择错误、溶媒量过多或过少、药物剂量不合理、药物配伍禁忌、其他(用药频次错误、药物选择错误、重复用药等)。结论 根据不合理医嘱情况的汇总分析,及时与临床科室沟通改正,保证合理用药。

Objective To summarize and analyze their rational prescriptions in pharmacy intravenous admixture services(PIVAS)of our hospital from January 2017 to December 2019,so as to improve the level of rational drug use. Methods The data of irrational prescriptions from January 2017 to December 2019 in the pharmacy intravenous admixture services of Guangzhou First People's Hospital were collected for retrospective analysis, and the types of irrational prescriptions were summarized, the performance of irrational prescriptions was analyzed and the irrational situation was corrected. Results The main types of irrational prescriptions include incorrect selection of solvent, improper consumption of solvent, improper drug dosage, incompatibility and others(improper frequency of administration, incorrect selection of drug, repeated administration, etc.). Conclusion According to the summary and analysis of irrational prescriptions, we timely communicate with clinical departments and ensure rational drug use.

目的 统计分析中医治疗胎动不安的用药规律,为临床中医治疗胎动不安提供用药参考。方法 严格按照标准筛选中医治疗胎动不安的中药处方,采用 excel表格对处方基本用药信息进行统计,然后再采用 SPSS19.0软件以中药的功效作为评价指标进行分析,以确定处方中用药味数、用药天数、以及中药的使用频次。并对使用频次前30位的药物进行归类,确定药物使用频次高的特征值、贡献率和综合得分。结果 所选取的356例患者中药处方中,平均用药药味数15.7味,平均剂量226.7 g,使用频次最高的前5位药分别为菟丝子、桑寄生、续断、白芍、白术;30味中药通过按照功效可分为5类,所提取的10个主成分能反映系统聚类中的分类结果。结论 对中医治疗胎动不安患者处方进行分析,为中医治疗胎动不安提供了用药参考,对指导临床合理用药有重要指导意义。

Objective To analyze the medication experience in treating fetal irritability and provide medication reference of clinical traditional Chinese medicine in treatment of fetal irritability. Methods The prescription of traditional Chinese medicine treats was screened according to the standard. The information of prescription basic were statisticed with Excel and processed the data by SPSS19.0, to determine the frequency of medicine the number of drugs and medication days. The Chinese medicines used in the top 30 were classified to determine the characteristic of eigenvingue,rate of contribution and synthesis score. Results The top 5 highest frequency medicines were Tusizi, Sanjisheng, Xuduan, Baishao, Baishu; and the average drug taste was 15.7,the average dose was 226.7 g,after analyzing the screened 356 prescriptions. 30 Chinese medicines could be clustered into 5 kinds. The extraction of 10 principal components of principal component scores and comprehensive scores may reflect the classification results of system clustering. Conclusion To analyze the prescriptions of traditional Chinese medicine for fetal irritability, provide the reference for medicine combination in treating different syndromes of fetal irritability. It had the extremely vital significance for guiding the clinical medication.

目的 了解我区慢性阻塞性肺疾病(COPD)稳定期患者药物使用现状,为临床规范治疗COPD指明方向。方法 对在我院治疗的COPD患者采取问卷调查的方式对其稳定期自我用药情况进行调查分析,调查内容包括吸烟史、病程、稳定期用药的种类、用药方式等。结果 我区COPD患者稳定期治疗药物种类繁多,应用LABA/ICS、吸入LAMA比例较低,存在滥用口服抗生素及无指征使用口服激素等不规范用药情况。结论 我区COPD患者稳定期药物部分符合COPD指南推荐,但存在不规范用药。