临床诊疗

影响老年患者用药依从性的原因及对策

Influence causes and counterplan of medication compliance for senile patients

:90-92
 
目的 探讨影响老年患者用药依从性的原因及对策。方法 随机抽取我院区门诊就诊的老年患者进行问卷调查,了解其用药依从性及影响依从性原因,根据调查结果结合临床分析,实施相应的干预措施,评价实施对策前后患者用药依从性及影响依从性的原因。结果 实施干预措施后老年患者用药依从率从60.06%上升至84.39%,P<0.05,差异有统计学意义。结论 通过对老年患者加强医药知识教育及医患沟通;简化用药方案;医院、社区、家庭给予支持等措施可提高老年患者用药依从性。
论著

药学服务对门诊中老年COPD患者用药依从性的影响

The influence of pharmaceutical care on medication compliance of middle aged and elderly patients with chronic obstructive pulmonary disease COPD

:41-43
 
目的 探讨开展药学服务干预对中老年COPD患者用药时间以及剂量的准确性的影响。方法 选取100名中医科门诊中老年COPD患者,随机分为干预组与对照组,干预组开展参与中医药治疗方案的确立、用药的衡量以及对患者进行用药指导、疾病健康宣教、定期随访等药学服务。对照组不作相关的药学服务干预。结果 干预组服药时间依从性(97.89±1.11)%,剂量准确率(99.95±0.05)%,干预组患者用药依从性比对照组有提高;平均疗程(11.12±2.1)天,比对照组缩短,差异有统计学意义(P<0.05)。结论 药师通过药学服务提高了中老年COPD患者的用药依从性及准确性,从而缩短疗程,值得推广。
Objective To investigate the time of drug use and dose accuracy in middle aged and elderly patients with COPD to develop pharmaceutical care intervention. Methods 100 middle aged and elderly patients with COPD were selected from the department of traditional Chinese medicine, randomly divided into intervention group and control group, the intervention group was developed pharmaceutical care including taking part in setting of therapeutic schedule, pharmaceutical measurement and guide of drug use in patients, health education, regular visit etc. The control group did not have pharmaceutical care intervention. Results The time of taking medicine compliance was (97.89±1.11)% and dose accuracy was(99.95±0.05)% in the intervention group. The intervention group had significantly improved compared with the control group. The course of treatment was(11.12±2.1)days. The average course of treatment was shorter than the control group. The difference was statistically significant (P<0.05). Conclusion Medication compliance of middle aged and elderly patients with COPD is higher by pharmaceutical care from the pharmacists. The course of treatment is shortened. It is worth using widely.
临床诊疗

对300份注射剂说明书中有关老年人用药情况的调查分析

The Investigation and Analysis of the Drug Injection Instruction for the Elderly

:92-94
 
目的 调查分析注射剂药品说明书中有关老年人用药描述,为完善和修订注射剂药品说明书提供参考依据。方法 收集某医药公司经营300个品种注射剂的药品说明书,按药理作用、国内外生产厂家和所含成份等统计药品说明书中老年人用药内容的标注情况。结果 在所调查的注射剂药品说明书中,284份(95%)注射剂说明书标注有老年用药项,其中48份(17%) 标注老年人具体用量;236份(83%)标注模糊,标注有“老年人药代动力学”仅39份(占13%);国内外厂家的注射剂在老年人用药标注情况有差异(P<0.01)。结论 注射剂药品说明书在老年人用药方面描述不足,需引起政府和各方面的关注,相关部门应加强对注射剂药品说明书的安全监管,完善说明书的内容,以保证药品说明书的科学性、合理性和有效性。
临床诊疗

不同用药方案治疗慢性阻塞性肺病所致肺部感染的药物经济学分析

Pharmacoeconomics Analysis of Pulmonary Infection Caused by Chronic Obstructive Pulmonary Disease in Different Prescription

:62-63
 
目的 探讨不同用药方案治疗慢性阻塞性肺病所致肺部感染的药物经济学。方法 本次医学研究选择我院2012年1月—2014年1月收治的200例慢性阻塞性肺病所致肺部感染患者为观察对象,随机将其分为A组、B组、C组和D组,A组观察对象接受盐酸莫西沙星治疗,B组观察对象接受硫酸依替米星治疗,C组观察对象接受头孢哌酮钠治疗,D组观察对象接受他唑巴坦钠/哌拉西林钠治疗,回顾分析四组观察对象药物经济学。结果 四组观察对象药物敏感度对比差异有统计学意义(P<0.05),而临床治疗效果和不良反应发生率对比则差异无统计学意义(P>0.05)。结论 慢性阻塞性肺病所致肺部感染患者接受C方案治疗,具有理想的临床效果和较高的药物经济学效率。
论著

惠州市区医院三七总皂苷制剂用药与安全性分析

Analysis of the usage and safety of Panax Notoginseng Saponins Drugs of hospitals in Huizhou

:23-25
 
目的 分析2009—2011年惠州市区医院三七总皂苷制剂的用药情况,并评价其安全性。方法 根据惠州市区医院2009—2011年三七总皂苷制剂的用药金额和用药量以及药品DDD值,计算其DDDs,分析药品的用药金额排序、DDDs排序以及用药金额排序与DDDs排序的比值;从药物不良反应报告评价其安全性。结果 三七总皂苷制剂用药金额和DDDs逐年增加,口服制剂安全性优于注射剂。结论 三七总皂苷制剂用药金额和用药频度逐年增加,其安全性较好。
Objective To analyse the usage and safety of Panax Notoginseng Saponins Drugs of hospitals in Huizhou from 2009 to 2011. Methods Calculate the DDDs and analyse the sequence of consumption sum, the sequence of DDDs, the ratio of the sequence of consumption sum to the sequence of DDDs according to the consumption sum, the consumption amount and DDD of Panax Notoginseng Saponins Drugs of hospitals in Huizhou from 2009 to 2011. We evaluated its safety according to adverse event reports. Results The consumption sum and DDDs increased year by year, oral medication was safer than injection. Conclusion The consumption sum and DDDs of Panax Notoginseng Saponins drugs of hospitals in Huizhou increase year by year, and they are safe.
医院管理

某医院临床试验用药品规范管理体系的构建与实践

Construction and practice of standardized management system of drugs for clinical trials from a hospital

:1000-1005
 
       目的   通过分析广州某三甲医院临床试验用药品规范管理体系构建前后试验用药品超温次数及质控发现缺陷项数量变化情况,为药物临床试验规范开展提供参考。方法   结合某医院临床试验用药品管理实践,以试验用药品超温次数、质控发现缺陷项数量占项目比为评价指标,使用卡方检验进行比较。结果   某医院实施临床试验用药品规范管理体系后,发生试验用药品超温次数由实施前的9次下降至3次,呈明显下降趋势,2018—2020年试验用药品管理方面质控发现缺陷项数量占项目比为70.25%,2021—2023年占项目比为18.90%,实施前后组间比较差异有统计学意义(P<0.001)。结论   构建临床试验用药品规范管理体系,可以减少试验用药品超温次数和试验用药品管理方面质控发现缺陷项数量,从而保证药物临床试验的质量。
       Objective   To analyze the changes in the number of excessive temperature incidents and the proportion of quality control issues in drug management before and after the establishment of construction and practice of standardized management system in a tertiary hospital in Guangzhou,to provide a reference for drug clinical trials standard development.Methods  Based on the management practice of investigational medicinal products from a hospital,the number of excessive temperature incidents and the proportion of quality control issues in drug management were taken as evaluation index and compared using chi-square tests.Results  After implementing the standardized management system for investigational drugs,the number of temperature exceeding incidents decreased from 9 times to 3 times,showing an obvious decreasing trend,and from 2018 to 2020,the  proportion of quality control issues in drug management accounted for 70.25%,while from 2021 to 2023,it accounted for 18.90%.There was a statistically significant difference between the groups before and after the implementation(P<0.001).Conclusions  The establishment of  standardized management  system for investigational medicinal  products can  reduce the  number of excessive temperature incidents and the proportion of quality control issues in drug management,and ensure the quality of drug clinical trials.
论著

基于 Python 语言探析《圣济总录》中腰痛病用药规律研究

Study on medication rule of low back pain in Shengji Zonglu based on Python language

:99-105
 
      目的   应用 Python语言对《圣济总录》中腰痛病篇中的中药进行用药规律分析,提取腰痛病治疗方法及用药特色指导临床腰痛病治疗思路。方法   运用 Python语言中的语言提取对《圣济总录》中腰痛篇章中的所有中药方剂识别,提取方剂组成,统计并分析方剂中中药的规律并将其结果可视化呈现。结果   最终共纳入62首方剂,包含药物86味。其中使用频次≥7次、频率≥1.6%的药物共20味,频次频率最高的为桂枝;所用中药四气以温性为主,占56.74%;五味以辛、甘、苦为主,共约占90%,归经以肝肾经为主;药物功效以补虚类为主,占27.13%;关联规则分析显示提升度最高的组合为麻黄-独活,置信度最高的组合为巴戟天-牛膝、牵牛子-牛膝,支持度最高的组合为川芎-当归、川芎-杜仲;通过聚类分析得到3个聚类结果。结论   《圣济总录》治疗腰痛病方面善用通法和补法,强调活血通络,补益肝肾,尤擅长治疗肝肾亏虚或风寒所客等腰痛病证。
       Objective Python language was used to analyze the rules of traditional Chinese medicine in the chapter of low back pain in Shengji Zonglu,and to extract the treatment methods and medication characteristics of low back pain to guide the clinical treatment of low back pain.Methods The language extraction in Python language was used to identify all the Chinese medicine prescriptions in the chapter of low back pain in Shengji Zonglu,extract the composition of the prescription,and analyze the rules of Chinese medicine in the prescription to visually present the results.Results A total of 62 prescriptions were included,including 86 drugs.Among them,with there were 20 kinds of drugs,the frequency of use ≥7 times,the frequency ≥1.6%,and cmnamomi Mmulus highest frequency.Four gas used in traditional Chinese medicine is given priority to with warm,accounted for 56.74%.The five flavors were mainly pungent,sweet and bitter,accounting for about 90%,and the liver and kidney meridians were the main meridians.The drug efficacy was mainly deficiency tonic,accounting for 27.13%.The association  rule analysis showed that the combination with the highest improvement was Ephedrae Herba- Angelicae Pubescentis Radix,the combination with the highest confidence was Morindae Officinalis Radix- Achyranthis Bidentatae Radix,Pharbitidis Semen- Achyranthis Bidentatae Radix.and the combination with the highest support was Chuanxiong Rhizoma- Angelicae Sinensis Radix,Chuanxiong Rhizoma- Eucommiae Cortex.Three clustering result is obtained by cluster analysis.Conclusions In the treatment of low back pain,Shengji Zonglu is good at using both blocking methods and reinforcing methods,emphasizing circulating blood and unblocking meridians supplementing liver and kidney,especially in the treatment of low back pain syndrome caused by liver and kidney deficiency or wind and cold.
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