目的 了解我国辅助用药的应用现状,初步探索辅助用药的管理措施。方法 通过查阅文献及相关资料,总结归纳我国辅助用药的应用现状及全球合理化用药需求,通过德尔菲法设计调查问卷,对全国范围内的药学专家有关辅助用药相关内容进行3轮调查,初步探索辅助用药管理措施。结果 调查中98%的医疗机构中存在辅助用药使用不合理/不规范的情况,药学专家认为如中药注射剂、肿瘤患者化疗以外的药物等都存在不合理使用情况,应该由国家对辅助用药的应用进行统一管理。结论 我国过度使用辅助用药情况普遍,应设定辅助用药重点监测品种目录并进行应用评价,限定辅助用药使用指标,定期由专项点评小组对辅助用药的使用进行点评,以期规范辅助用药的临床应用。
Abstract
OBJECTIVE To know the current application status of the adjuvant drugs in our country, and preliminary explore the management measures of adjuvant drugs. METHODS Through searching, reading, and summarizing the relevant content and literature, the application status of adjuvant drugs in China and the global demand for rationalization of drug use were reviewed. A few questionnaires that associated with adjuvant drugs were designed by Delphi method to investigate the medicine experts nationwide and to explore the management countermeasures of adjuvant drugs. RESULTS The survey showed that 98% of medical institutions existing adjuvant drugs use of unreasonable/no specification. The medicine experts believe that there are unreasonable usages such as traditional Chinese medicine injections, cancer drugs except for chemotherapy drugs, etc. The unified management of adjuvant drugs application should determined by the state. CONCLUSION The excessive use of adjuvant drugs ubiquitous in our country. Key monitoring varieties directory of adjuvant drugs and the limit to the drugs′ use indicators to evaluate the rationality of drug use should be set. And there can be a special review team to review the use of adjuvant at regular intervals in order to standardize the clinical application of adjuvant drugs.
关键词
辅助用药 /
合理用药 /
应用现状 /
管理对策 /
重点监测
{{custom_keyword}} /
Key words
adjuvant drug /
rational drug use /
application status /
management countermeasure /
key monitoring
{{custom_keyword}} /
中图分类号：
R954
{{custom_clc.code}}
({{custom_clc.text}})
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] LAI Y J. Discussion on the value of adjuvant drug in clinical drug treatment[J]. Guide China Med(中国医药指南),2014,12(13):389-390.
[2] WHO. The Pursuit of Responsible Use of Medicines: Sharing and Learning from Country Experiences [EB/OL]. [2015-10] Geneva,2012, http://www. who. int/medicines/publications/responsible_use/en/
[3] General Office of the State Council. Guiding opinions of the general office of the State Council on improving the work of centralized procurement of drugs in public hospitals[EB/OL]. 2015 [2015-10-21]. http://www. gov. cn/zhengce/content/2015-02/28/content_9502. htm
[4] SUN D K. Discussion on the management mode of the use of adjuvant medicine in hospital[J]. Herald Med(医药导报), 2014,33 (1): 128-129.
[5] LIANG A H, YI Y, ZHANG Y S, et al. Pseudoallergic reactions of traditional Chinese medicine injections and the approaches for risk prevention and control [J]. Chin Pharm J(中国药学杂志),2015,50(15):1301-1308.
[6] FEI R Q. Study on incidence rate and influencing factors of adverse drug reaction of traditional Chinese medicine injection[D]. Hunan: Central and Southern University, 2013.
[7] ZHOU H M, LI Y P, ZHANG M H,et al. Current situation and countermeasures of adverse drug reaction of traditional Chinese medicine injection[J]. Manage Tradit Chin Med(中医药管理杂志),2015, 23(16): 88-89.
[8] ZHANG H N, XU J. Traditional Chinese medicine injection adverse reaction on the causes and countermeasures[J]. J Pract Tradit Chin Med(实用中医内科杂志),2014,28(12): 145-147.
[9] TANG J, WANG G J. The adverse reactions analysis of TCM injections[J]. Chin J Clin Rat Drug Use(临床合理用药),2015,8(2A): 38-39.
[10] SHEN B, ZHOU Y H. Analysis and disscussion of the adverse drug reactions of 127 cases induced by traditional Chinese medicine injections[J]. Chin J Tradit Chin Med Pharm(中国中医药杂志),2015,30 (2): 428-431.
[11] WANG D, CHENG G. Analysis on the annual data of adverse drug reaction monitoring[J]. Chin J Pharmacoepidemiol(药物警戒与合理用药),2013,22 (5):238-241.
[12] LI W Y. Clinical observation of the effect of thrombus injection in treating angina pectoris of coronary heart disease[J]. Chin Foreign Med Res(中外医学研究),2015,13(3):32-33.
[13] SHEN H B, WENG J. Clinical efficacy of Xueshuantong Injection in patients with acute ischemic cerebrovascular disease[J]. China Mod Doc(中国现代医生),2015,53(12):71-77.
[14] ZHEN J C, CHEN Z G,CHANG Z R,et al. Comparative study on quality of Xueshuantong Injection produced by different manufactures[J]. Chin Pharm J(中国药学杂志),2001,36(12):847-850.
[15] China Health Statistics Yearbook 2013[S]. 2013:162-324.
[16] LIU X L, WANG H F. Investigation and analysis of 180 cases of patients with anti-tumor drugs [J]. Herald Med(医药导报),2013,8(32):261-262.
[17] GU H J, FENG P, NI M X. Analysis of clinical pharmacists participating in the intervention effect of anti cancer drugs[J]. Shanxi Med J(山西医药), 2015,44(1):56-58.
[18] JIA L H, ZHAO Z M, JIA N N, et al. Participation of clinical pharmacists in medical order check and effect analysis of anti-tumor adjuvant medication[J]. J China Pharm(中国药房),2013,24(39):3739-3742.
[19] SHAO Y, WU G S. Analysis of anti-tumor drugs in cancer hospital[J]. J Mod Oncol(现代肿瘤医学), 2007,15(9): 1333-1335.
[20] WANG W L, ZHU M, GUO D H. Off-label and off-NCCN guidelines uses of antineoplastic drugs in China[J]. Iranian J Publ Health, 2013,42(5):472-479.
[21] Medical management office〔2010〕191, Notice of the general office of the Ministry of health on printing and distributing the guidelines for the standardized diagnosis and treatment of common tumor in the city and county level hospitals[EB/OL],2010. http://www. nhfpc. gov. cn/yzygj/s3590/201012/325fdbaf4f46402680518dab22665760. shtml
[22] ZHEN J C. Analysis of the use of anti-tumor drugs in Beijing medical insurance in 2011-2013[J]. Med Insurance Beijing(北京医保),2014,12(suppl):92-97.
[23] WEN Y, YANG T Y, WAN R R, et al. The biological function and clinical application of thymosin[J]. Seek Med Ask Med(求医问药),2013,11(2):479-506.
[24] LI A H, YU Y H. A report of the clinical application of thymosin[J]. J Pract Med Tech(实用医技杂志),2005,12(2):527-528.
[25] XIE H L, LING Y W, LIU L. The observation of thymosin injection in the treatment of allergic rhinitis with double inferior turbinate[J]. Pract Clin Med(实用临床医学),2009,10(4):84-87.
[26] JI M X, SI X S, HE J X, et al. Efficacy of thymosin-α 1 for patients with severe pneumonia[J]. Zhejiang Med J(浙江医学),2015,37(9):738-740.
[27] LIU C B, LV S H, ZHANG X Z,et al. Progress in the role of thymosin β4 in heart injury repair[J]. Chin J Clin(Electronic Edition)(中华临床医师), 2014,8(1):141-144.
[28] YAN L W. A Meta analysis of the effect and safety of monosialo four hexose ganglioside in the treatment of Parkinson's disease[D]. Guangxi: Guangxi Medical University,2014.
[29] XU X Z, TIAN F Z, PU D X, et al. Time and effect of domestic use of the nerve to improve the clinical symptoms in patients with Parkinson's disease: A retrospective analysis of 6 344 cases with multiple regions and multiple centers[J]. Chin J Tissue Engineering Res(中国组织工程与临床康复),2007,11(4):682-684.
[30] WU B, LI L. The clinical analysis of 80 cases of GM-1 in the treatment of diabetic peripheral neuropathy[J]. Chin J Geront(中国老年学),2011,31(5): 885-886.
[31] ZHANG C G. GM-1 Combined with ganciclovir in the treatment of herpes zoster neuralgia with clinical observation[J]. Chin J Mod Drug Appl(中国现代药物应用), 2015,9 (8): 98-99.
[32] RUAN C J. Effect of 60 cases of acute idiopathic facial palsy treated with seven aescinate combined with GM-1[J]. Chin J Pract Nervous Diseases(中国实用神经疾病), 2014,17 (16): 98-99.
[33] HE H J. Adjuvant drugs cannot be overwhelming[N]. Med Economic News(医药经营报), 2013-06-12(007).
[34] WHO. Health systems financing: the path to universal coverage[EB/OL]. Geneva,World health report 2010. http://www. who. int/whr/2010/zh/
[34] CHISHOLM D, EVANS D B. Improving health system efficiency as a means of moving towards universal coverage[EB/OL]. Geneva,World health report 2010 background paper, no. 28 http://www. who. int/healthsystems/topics/financing/healthreport/whr_background/en/ .
[36] HOLLOWAY K, DIJK E. Rational use of medicines. In: The world medicines situation[EB/OL]. Geneva, World Health Organization, 2010 http://dosei. who. int/.
[37] BUSFIELD J. Assessing the overuse of medicines[J]. Soc Sci Med, 2015,131: 199-206.
[38] ZHANG B, WU J R, CHEN Y X, et al. Investigation of principles and ideas of variety selection for intensive safety monitoring of traditional Chinese medicine[J]. Chin J Pharmacoepidemiol(药物流行病),2008,17(5):298-301.
[39] YE Q Q. Application status and rationality evaluation of immune enhancing agent in a hospital[D]. Changsha: Central South University, 2013.
[40] LIU X J, WEI S Y, WU Y P, et al. Study on comprehensive evaluation index system of hospital drug treatment quality[J]. Chin Hosp Pharm J(中国医院药学),2005,25(5):462-463.
{{custom_fnGroup.title_cn}}
脚注
{{custom_fn.content}}
PDF(890 KB)
