摘要
目的:探讨临床药师参与中西医结合治疗脑卒中相关性肺炎(SAP)患者用药的会诊情况及药学监护效果,并总结该类疾病用药特点,促进临床合理用药。方法:采用回顾性调查方法,对2020年10月至2022年10月该院神经内科中西医结合临床药师会诊的87例SAP患者的抗感染相关用药情况进行分析。结果:会诊后,临床药师对65例患者建议调整抗感染治疗方案,对21例患者建议给予通腑泄热治疗,对42例患者建议进行化痰药物方案的调整,对24例患者建议进行改善肾功能方案的调整。在调整抗感染治疗方案的基础上,会诊药师从中西医结合角度建议加强化痰、改善便秘、改善肾功能等措施,临床医师采纳了建议,患者的感染指标(体温、白细胞计数、中性粒细胞百分比和C反应蛋白)较会诊前好转,差异有统计学意义(P<0.05)。结论:临床药师提供临床药学服务,开展药学监护,除了建议选择适宜的抗菌药物外,还从中西医结合角度分析,通腑泄热、清热化痰、利湿降浊可协助抗感染治疗,加强控制肺部感染,提高疗效,进而减少抗感染药物的滥用,提高抗感染药物的合理应用水平。
OBJECTIVE:To probe into the effects of medication consultation and pharmaceutical care for the treatment of stroke-associated pneumonia(SAP)with integrated traditional Chinese and western medicine by the clinical pharmacists,and summarize the characteristics of medication of the disease,so as to promote the clinical rational drug use.METHODS:Retrospective survey method was used to analyze the anti-infective-related medication of 87 SAP patients who were consulted by clinical pharmacists of integrated traditional Chinese and western medicine in the department of neurology of the hospital from Oct.2020 to Oct.2022.RESULTS:After consultation,the clinical pharmacists adjusted the anti-infective treatment regimen for 65 patients,Tongfu Xiere treatment for 21 patients,phlegm drug regimen for 42 patients,and renal function improvement regimen for 24 patients.On the basis of adjusting the anti-infective treatment regimen,the consultation pharmacist suggested strengthening the elimination of sputum,improvement of constipation and improvement of renal function from the perspective of integrated traditional Chinese and western medicine.The clinicians adopted the suggestions,and the infection indicators of the patient(body temperature,white blood cell count,neutrophil percentage and C-reactive protein)were improved compared with those before consultation,with statistically significant difference(P<0.05).CONCLUSIONS:Clinical pharmacists provide clinical pharmaceutical services and carry out pharmaceutical care.In addition to suggesting the selection of appropriate antibiotics,clinical pharmacists also analyzed the medication from the perspective of integrated traditional Chinese and western medicine.Tongfu Xiere treatment,phlegm elimination treatment and reducing turbidity can assist the anti-infective treatment,strengthen the control of pulmonary infection,improve the efficacy,reduce the abuse of anti-infective drugs and improve the rational application level of anti-infective drugs.
作者
冯英楠
庄伟
董宪喆
王之舟
齐晓涟
FENG Yingnan;ZHUANG Wei;DONG Xianzhe;WANG Zhizhou;QI Xiaolian(Dept.of Pharmacy,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)
出处
《中国医院用药评价与分析》
2023年第10期1254-1258,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
全国中医药创新骨干人才培训项目(No.国中医药办人教函[2019]91号)
北京市中医药管理局第六批北京市级中医药专家学术经验传承项目。
关键词
临床药师
会诊
脑卒中相关性肺炎
抗感染
中西医结合
Clinical pharmacists
Consultation
Stroke-associated pneumonia
Anti-infection
Integrated tradi-tional Chinese and Western medicine
