罗宏丽 肖顺林 李芹 叶云 李荣

中圖分类号 R969.3 文献标志码 A 文章编号 1001-0408（2018）06-0847-05

DOI 10.6039/j.issn.1001-0408.2018.06.29

摘 要 目的：为促进中药注射剂的合理应用提供参考。方法：按随机数字表法分别抽取泸州市9家医院行政干预和药学干预（以下简称“干预”）前（2015年1-3月）、后（2017年1-3月）各660份病历资料，并就干预前后9家医院10种中药注射剂销售金额、用药频度（DDDs）、排序比（B/A）、使用情况、人均药品费用和人均中药注射剂费用及合理、不合理使用情况进行比较。结果：干预后，7家医院10种中药注射剂销售总金额和DDDs 较干预前均有所降低，但有2家医院略有升高。干预前后，注射用血栓通销售金额均位居首位；DDDs排序前5位基本一致，均为注射用血塞通、注射用血栓通、参麦注射液、丹参川芎嗪注射液和注射用红花黄色素；B/A均大于1的品种有注射用血塞通、丹参川芎嗪注射液、红花注射液、天麻素注射液。干预后，9家医院10种中药注射剂使用率（24.70%）显著低于干预前（32.42%），使用合理率（61.35%）显著高于干预前（41.59%），差异均有统计学意义（P<0.01）。干预后，人均中药注射剂费用及与功能主治不符、用药剂量偏大、溶剂选择不当、溶剂用量不足、未单独注射的不合理使用率均显著低于干预前，差异均有统计学意义（P<0.05）；干预前后人均药品费用及重复给药、疗程过长的不合理使用率比较，差异均无统计学意义（P>0.05）。结论：行政干预和药学干预相结合的干预措施可使中药注射剂的使用更加趋于安全、合理、经济。

关键词 泸州市；中药注射剂；临床药师；干预；分析

ABSTRACT OBJECTIVE： To provide reference for rational use of TCM injection. METHODS： Each 660 medical records were selected from 9 hospitals of Luzhou city before （Jan.-Mar. in 2015） and after （Jan.-Mar. in 2017） administrative intervention and pharmaceutical intervention （called “intervention” for short） according to random number tablet. The consumption sum， DDDs and B/A， utilization， per capita， cost of drug and TCM injection， rational and irrational use were compared before and after intervention. RESULTS： After intervention， total consumption sum and DDDs of 10 TCM injections were decreased in 7 hospitals compared to before intervention， but those of 2 hospitals were increased slightly. Before and after intervention， consumption sum of Xueshuangtong for injection took up the first place among 10 kinds of TCM injection. Top 5 injections in the list of DDDs were the same generally， i.e. Xuesaitong for injection， Xueshuangtong for injection， Shenmai injection， Salviae miltiorrhizae and ligustrazine hydrochloride injection and Safflower yellow for injection. 10 kinds of TCM injections with B/A>1 included Xuesaitong for injection， Salviae miltiorrhizae and ligustrazine hydrochloride injection， Safflower yellow for injection and Gastrodin injection. After intervention， utilization rate of 10 TCM injections （24.70%） was significantly lower than before intervention （32.42%）， rational rate of TCM injection （61.35%） was significantly higher than before intervention （41.59%）， with statistical significance （P<0.01）. After intervention， the per capita cost of TCM injection， the incidence of function inconsistency， excessive dose， irrational solvent selection， insufficient solvent amount and non-individual injection were significantly lower than before intervention， with statistical significance （P<0.05）. There was no statistical significance in per capita cost of drug， the irrational utilization rate of repeated medication or excessive long treatment course before and after intervention （P>0.05）. CONCLUSIONS： The administrative intervention combined with pharmaceutical intervention promote more safe， rational and economical use of TCM injection.

KEYWORDS Luzhou city； TCM injection； Clinical pharmacist； Intervention； Analysis

中药注射剂是指采用现代科学技术和方法，从中药材中提取、纯化精制有效成分后制成的供患者注入的无菌制剂。……