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目的:分析我院治疗肾病综合征超说明书用药的合理性,为临床合理用药提供科学依据,并进一步规范我院超说明书用药行为。方法:选取本院2014年11月~2015年4月诊断为肾病综合征的门诊处方1 908张,列出所有超说明书药品;通过查阅相关指南、文献等对其用药合理性进行分析评价。结果:超说明书用药中他克莫司胶囊、吗替麦考酚酯胶囊、注射用环磷酰胺、环孢素软胶囊、双嘧达莫片、硫酸羟氯喹片、华法林钠片等均有国内外指南推荐,有较高循证医学证据级别;雷公藤多苷片、来氟米特片有大量临床文献支持;以上9种药符合用药合理性。蚓激酶肠溶胶囊、丹参川芎嗪注射液、匹多莫德分散片仅有少数期刊报道;细菌溶解产物胶囊、硼酸粉无相关资料支持,属医师经验用药;以上5种药属于不合理用药。结论:肾病综合征超说明书用药现象普遍存在,用药情况大部分合理,临床医师应当谨慎用药。我院需对有较高循证医学证据的超说明书用药行为进一步规范化管理,以提高临床合理用药水平以及处方的合理率。
OBJECTIVE: To analyze the rationality of the treatment of nephrotic syndrome in our hospital and to provide a scientific basis for clinical rational drug use, and to further regulate the use of ultra-instructions in our hospital. Methods: A total of 1 908 outpatient prescriptions diagnosed as nephrotic syndrome were selected from November 2014 to April 2015 in our hospital, and all the super-description medicines were listed. The related prescriptions and literature were used to analyze the rationality of drug use. Results: Super manual drug tacrolimus capsules, mycophenolate mofetil capsules, cyclophosphamide for injection, cyclosporine soft capsules, dipyridamole tablets, hydroxychloroquine sulfate tablets, warfarin sodium tablets Dengjun There are guidelines recommended at home and abroad, a higher level of evidence-based medical evidence; Tripterygium glycosides tablets, leflunomide tablets have a large number of clinical literature support; more than nine kinds of drugs in line with the rationality of medication. There are only a few periodicals in which lumbrokinase enteric-coated capsules, ligustrazine and ligustrazine injection, and Pidotimod dispersible tablets are only reported in a few journals. Bacterial lysate capsules and boric acid powder are not supported by relevant data, which is a physician’s experience. The above five kinds of drugs are irrational drugs. CONCLUSIONS: The overuse of nephrotic syndrome is widespread and the medication is largely rational, and clinicians should be cautious about medication. Our hospital need to have a higher evidence-based evidence of ultra-instructions to further standardize the use of drugs to improve the clinical rational use of drugs and the rational rate of prescriptions.