刘英 梅小冰 张信杰 仇展聪

[摘要] 目的 点评广东医科大学附属第三医院（佛山市顺德区龙江医院）辅助用药临床应用的合理性，为加强辅助用药的管控和规范临床合理用药提供依据。方法 抽查2019年1—9月该院使用金额排名前10位的辅助用药，每个药物抽取排名前3位的科室，每个科室随机抽查50条医嘱进行辅助用药专项点评，分析其用药的合理性。结果 该院辅助用药的应用存在不合理现象，其中适应证不适宜所占比重较大，其次为用法用量不适宜、重复用药、存在用药禁忌、配伍禁忌以及疗程不当等。结论 针对辅助用药的不合理使用，医院展开对辅助用药的综合干预，包括加强对临床科室全覆盖管控以及对临床医师和患者的宣教等，以此降低药品费用，减轻患者经济负担，促进合理用药。

[关键词] 辅助用药;合理用药;专项点评;综合干预

[中图分类号] R969 [文献标识码] A [文章编号] 1672-5654（2020）08（b）-0189-03

[Abstract] Objective To comment on the rationality of the clinical application of auxiliary drugs in the Third Affiliated Hospital of Guangdong Medical University （Longjiang Hospital， Shunde District， Foshan City）， and to provide for strengthening the management and control of auxiliary drugs and standardizing clinical rational drug use in accordance with. Methods Randomly check the top 10 auxiliary medications used in the hospital from January to September 2019， select the top 3 departments for each drug， and randomly check 50 doctor orders from each department to make special comments on auxiliary medications， and analyze their medication rationality. Results There are unreasonable phenomena in the application of adjuvant medications in the hospital. Inappropriate indications account for a large proportion， followed by inappropriate usage and dosage， repeated medication， contraindications to medication， contraindications to compatibility， and improper course of treatment. Conclusion In response to the unreasonable use of adjuvant medications， the hospital has launched comprehensive interventions on adjuvant medications， including strengthening the management and control of full coverage of clinical departments and educating clinicians and patients， so as to reduce drug costs， reduce the economic burden of patients， and promote rationality medication.

[Key words] Adjuvant medication; Rational medication; Special comments; Comprehensive intervention

輔助用药是指有助于增加治疗药物的作用或通过影响治疗药物的作用机制、吸收或代谢来增加其疗效的药物以及有助于功能紊乱或疾病的预防和辅助治疗的药物[1]。合理应用辅助药物，可以促进患者生命体征或症状的改善或稳定，提高常规药物治疗的效果，使得患者可以更好的康复。但是随着其临床使用越来越广，不合理情况也越来越多。辅助用药的不合理使用，不仅阻碍医疗质量的提高，同时也会造成医疗资源的浪费。为加强该院辅助用药临床应用管理，提高合理用药水平，控制医疗费用不合理增长，该院于2019年1—9月抽查使用金额排名前10位的辅助用药进行研究，开展对辅助用药的专项点评并进行综合干预。……