贾燕宁 王瑞 卞元清 张春香

中圖分类号 R969.3 文献标志码 A 文章编号 1001-0408（2021）16-2035-05

DOI 10.6039/j.issn.1001-0408.2021.16.19

摘 要 目的：探讨临床药师参与良性前列腺增生（BPH）治疗的效果，为临床药师参与慢性病的管理提供参考。方法：选取2018年1月-2019年11月在南京市江宁医院泌尿外科门诊就诊的195例BPH患者，按就诊顺序依次分为干预组（98例）和对照组（97例）。对照组患者接受泌尿外科门诊常规诊疗服务;干预组患者在常规诊疗服务的基础上，由临床药师主动提供包括BPH疾病宣教、健康生活方式指导、合理用药指导等个体化药学服务。比较两组患者干预前和随访2、4、6、9个月时的国际前列腺症状评分（IPSS）、生活质量评分（QOL）、用药依从性以及疾病进展情况。结果：因干预组有15例患者失访，故最终分别纳入干预组83例、对照组97例。干预前，两组患者的一般资料特征、IPSS评分、QOL评分以及用药依从性比较，差异均无统计学意义（P>0.05）。与对照组比较，干预组患者随访2、4、6、9个月时的IPSS评分、QOL评分均显著降低（P<0.001），干预组用药依从性好的患者比例显著升高（P<0.001），但两组患者尿路感染等疾病进展情况比较差异均无统计学意义（P>0.05）。结论：临床药师参与BPH的治疗能够显著降低患者的IPSS评分和QOL评分，提高其用药依从性和治疗效果。

关键词 良性前列腺增生;临床药师;药学服务;用药依从性;疾病进展;生活质量;治疗效果

Effect Evaluation of Clinical Pharmacists Participating in the Therapy of Benign Prostatic Hyperplasia

JIA Yanning，WANG Rui，BIAN Yuanqing，ZHANG Chunxiang（Dept. of Pharmacy， Nanjing Jiangning Hospital， Nanjing 211100， China）

ABSTRACT   OBJECTIVE： To explore the effect of clinical pharmacists participating in the therapy of benign prostatic hyperplasia （BPH）， and to provide reference for clinical pharmacists participating in the management of chronic diseases. METHODS： Totally 195 BPH patients， admitted to urology outpatient department of Nanjing Jiangning Hospital during Jan. 2018 to Nov. 2019， were collected and divided into intervention group （98 cases） and control group （97 cases） according to visiting order. Patients in the control group received routine outpatient service of urology surgery. Clinical pharmacists took the initiative to provide individualized pharmaceutical care for intervention group on the basis of routine service， which mainly included BPH disease education， healthy lifestyle guidance， and guidance on rational drug use. International prostate symptom score （IPSS）， quality of life score （QOL）， medication adherence and disease progression were compared between 2 groups before intervention and at 2， 4， 6 and 9 months of follow-up. RESULTS： Because 15 patients in intervention group lost follow-up， 83 cases were included in the intervention group and 97 cases were included in the control group. Before the intervention， there was no statistical significance in general information， IPSS， QOL scores and medication adherence between 2 groups （P>0.05）. Compared with control group， IPSS score and QOL score of intervention group were significantly decreased at 2， 4， 6 and 9 months of follow-up （P<0.001）; the proportion of patients with high medication adherence in the intervention group increased significantly （P<0.001）; there was no significant difference in disease progression as urinary tract infection between 2 groups （P>0.05）. CONCLUSIONS： The participation of clinical pharmacists in the treatment of BPH can significantly decrease IPSS score and QOL score， and improve medication adherence and therapeutic effect.

KEYWORDS   Benign prostatic hyperplasia; Clinical pharmacist; Pharmaceutical care; Medication adherence; Disease progression; Quality of life; Theraputic effect

良性前列腺增生（benign prostatic hyperplasia，BPH）是引起中老年男性排尿障碍的常见疾病，通常发生在40岁以后[1]。我国BPH流行病学研究显示，该病在41～50岁人群中的发病率为13.2%，51～60岁为20.0%，61～70岁为50.0%，71～80岁为57.1%，80岁以上高达83.3%[2]。吴楠等[3]对我国11个城市60岁及以上老年BPH患者的调查结果表明，BPH的发病率随年龄的增长而升高。可见，随着我国人口老龄化的日益加剧，将会有更多的老年群体受到该疾病的困扰，BPH的治疗和管理应成为医疗卫生服务领域重点关注的问题[4]。