门超 周玉刚 马国库

[摘要] 目的 探讨临床药师干预对2型糖尿病患者合理用药及健康管理效果。 方法 选择2014年1月～2015年6月在廊坊市中医医院就诊的90例2型糖尿病（T2DM）患者，由专门人员登记并建立患者个人档案，对所有患者开展健康宣教和合理用药指导，随访1年，观察患者干预前后不合理用药状况、空腹血糖、血压、体重及自我管理改变状况。 结果 干预后药物不合理用法用量、不合理药物选择、重复给药及超适应证用药均低于干预前，差异有统计学意义（P < 0.05）；干预后空腹血糖、餐后2 h血糖、糖化血红蛋白及收缩压均低于干预前，差异均有统计学意义（P < 0.05）；干预后用药依从、监测血糖、调整饮食和加强锻炼者占比均高于干预前，差异有统计学意义（P < 0.05）。 结论 临床药师的参与有利于T2DM患者合理用药，提高患者健康管理的临床效果。

[关键词] 2型糖尿病；临床药师；管理；用药安全

[中图分类号] R587.1 [文献标识码] A [文章编号] 1673-7210（2018）04（c）-0163-04

Effect of clinical pharmacist intervention on rational drug use and health management in patients with type 2 diabetes

MEN Chao1 ZHOU Yugang2 MA Guoku3

1.Department of Pharmacy， Langfang TCM Hospital， Hebei Province， Langfang 065000， China； 2.Medical Department， Langfang TCM Hospital， Hebei Province， Langfang 065000， China； 3.Department of Internal Medicine， Langfang TCM Hospital， Hebei Province， Langfang 065000， China

[Abstract] Objective To analyze the clinical pharmacist intervention in rational use of medicine and health management on patients with type 2 diabetes. Methods From January 2014 to June 2015， in Langfang TCM Hospital， 90 T2DM patients were selected， specialized personnel registered and established the patients' personal files， all patients were given health education and proper medication guidance. Followed-up for 1 year， unreasonable medication， fasting blood glucose， blood pressure， body weight and self-management changes before and after intervene of patients were observed. Results The dosage of unreasonable drugs， unreasonable choice of drugs， drug administration of repeated administration and hyper-indications after intervention were lower than those before intervention， the differences were statistically significant （P < 0.05）； fasting blood glucose， 2-hour postprandial blood glucose， hemoglobin and systolic blood pressure after intervention were lower than before intervention， the differences were statistically significant （P < 0.05）. The Proportion of medication compliance， blood glucose monitoring， diet and exercise to improve the number after intervention were higher than before intervention， the differences were statistically significant （P < 0.05）. Conclusion The participation of clinical pharmacists is conducive to rationally use drugs in patients with T2DM， and improve the clinical efficacy of patient health management.

[Key words] Type 2 diabetes mellitus； Clinical pharmacists； Management； Drug safety

慢性疾病管理的醫学理念近年来在我国慢慢兴起，国内研究领域也逐渐重视相关研究，在实施对慢性病管理过程中，仍需要很多实践以及深入探索去解答所遇到的问题[1]。2型糖尿病（T2DM）是众多慢性疾病中的一种，各种糖尿病的急慢性并发症可能会导致患者伤残甚至是死亡。目前国内大多数医院住院的病房和床位都很缺少，而需要治疗的患者又很多，慢性病患者需要一个长期的治疗时间，对糖尿病等慢性疾病患者进行治疗干预和科学管理才能充分利用医疗资源为更多需要的患者进行治疗。糖尿病防治的关键是学会自我控制，患者能够按照正确的生活方式进行生活；其次治疗方法要正确，患者需要掌握一些糖尿病防治的技能与知识[2]。现在对糖尿病患者进行健康知识教育、各项指标的定期监测、患者饮食上的控制、督促患者多运动以及关注患者平时的药物治疗等方法是防治T2DM及其并发症的主要措施。……