摘要
目的:分析抗抑郁药的临床使用情况和用药特点,推测其用药趋势。方法:分析河北医科大学第一医院2002-01/2004-12计算机管理系统中的抗抑郁药消耗记录。包括三环类及四环类、5-羟色胺再摄取抑制剂及其他类的15个品种,以消耗金额、用药频度、日用药金额为考察指标。明确限定日剂量的含义,即采用主要适应证剂量范围的常用剂量。药典未收载的药品依据药品说明书及临床用药确定剂量。用药频度=某药品年销量/该药品限定日剂量值。用药频度值越大,反映该药的选择倾向性越大,用量越大。日用药金额=药品消耗总金额/用药频度,用来反映每日消耗情况。同时分析各类每品种的消耗构成比及排序,用药频度及排序,日用药金额及排序。结果:①抗抑郁药消耗金额及其构成比和排序:2002年及2003年单品种药物消耗金额最大的是文拉法新,2004年消耗金额最大的是帕罗西汀。金额排序前5名的分别是:2002年文拉法新、氟西汀、舍曲林、氟哌噻吨-美利曲辛、曲唑酮(进口);2003年文拉法新、氟哌噻吨-美利曲辛、帕罗西汀、舍曲林、氟西汀;2004年帕罗西汀、文拉法新、氟伏沙明、舍曲林、西酞普兰。三环类及四环类、5-羟色胺再摄取抑制剂及其他类的抗抑郁药消费金额构成比2002年分别为3.72%,34.68%,61.60%;2003年依次为7.86%,48.50%,43.64%;2004年为8.82%,59.02%,32.16%。②抗抑郁药消耗总量,用药频度值及排序:三环类及四环类抗抑郁药用药频度呈逐年下降的趋势,5-羟色胺再摄取抑制剂用药频度呈逐年上升的趋势,其中帕罗西汀2004年用药频度增长趋势明显,上升到第1位。其他类用药频度变化较大,其中文拉法新用药频度呈逐年下降的趋势,而路优泰用药频度2003年度有所下降,而2004年度有所上升。③抗抑郁药2004年度日用药金额,用药频度及排序:日用药金额最高的是曲唑酮19.78元,最低的是多塞平0.43元。日用药金额价格低于10.00元抗抑郁药有10个品种,占抗抑郁药总品种的67%。结论:本院抗抑郁药的临床用药频度中前5位是:文拉法新、氟西汀、氟哌噻吨-美利曲辛、帕罗西汀、氯丙米嗪。三环类及四环类药物的使用保持相对稳定、持续性好;5-羟色胺再摄取抑制剂和其它类新型药物有较好发展前景。
AIM： To analyze the applied condition and administration characteristics of anti-depressant drugs in clinic, and presume the development of antidepressant administration.METHODS： Consumptive records of antidepressant drugs 2002-01/2004-12 in computer manage system, the First Hospital of Hebei Medical University, were analyzed,The drugs included 15 kinds,such as tricyclic,tetracyclics, 5-serotonin re-intake inhibitor. Expenditure,frequency of administration, and daily expenditure were used as observational markers,Daily dose was limited within the routine dose of the main adaptation syndrome, Dose of drugs which were not involved in pharmacopeia was confirmed according to drug＇s introduction and clinical dose, Frequency of medication =total expenditure /daily dose. A higher frequency of medication indicated a larger dose and more tendency of selection.Amount of money related to daily medication--total expenditure/frequency of medication, reflecting the dally consumption. Consumptive constituent ratio and sorting order of the drugs was measured,as well as medication frequency, daily expenditure and their sorting order.RESULTS： ①Expenditure, constituent ratio and sorting order： The most expenditure for single drug was Venlafaxine in 2002 and 2003, and was paroxetine in 2004. The former five ones in the amount of money were Venlafaxine, fluoxetine, sertraline, flupenthixol-melitracen, and trazodone（import） in 2002; Venlafaxine,flupenthixol-melitracen,paroxetine, sertraline and fluoxetine in 2003; paroxetine, venlafaxine, fluvoxamine, sertraline and citalopram in 2004. The expenditure constituent ratios of tricyclic,tetracyelics, 5-serotonin re-intake inhibitor were 3.72%, 34.68% and 61.60%, respectively, in2002; 7.86%,48.50% and 43.64%, respectively, in 2003;8.82%, 59.02% and 32.16%, respectively,in2004. ②Total consumptive amount,frequency of medication and sorting order. Medication frequency of tricyclic and tetracyclics drugs was decreased gradually, while that of 5-serotonin re-intake inhibitor was increased gradually year after year. Use of paroxetine increased significantly,and ranked No.1 in 2004.Medication frequency of venlafaxine decreased gradually year after year,and that of John＇s Wort Extracts tended to decrease in 2003, but increased again in 2004. ③ Daily expenditure,frequency of medication and sorting order in 2004： The highest daily expenditure was 19.78 for trazedone,and the lowest one was 0.43 for doxepin. Daily expenditure 〈 10.00 yuan was in 10 kinds of drugs accounting for 67% of all the kinds of antidepressant drugs.CONCLUSION：The former five ones in frequency of medication are venlafaxine, fluoxetine, flupenthixol-melitracen, paroxetine, and hlorimipramine in our hospital. The use of tricyclic and tetracyclics drugs maintains stable and has a good persistence.5-serotonin re-intake inhibitor and other new drugs have a better future.
出处
《中国临床康复》
CSCD
北大核心
2005年第20期32-34,共3页
Chinese Journal of Clinical Rehabilitation
