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目的对北京市医疗保险神经科住院患者醒脑静注射液(下简称“醒脑静”)的用药情况进行调查和分析,为神经科醒脑静合理用药提供依据。方法从北京市医疗保险用药信息数据库中,抽取5家不同级别医院神经科住院患者使用醒脑静的数据,并对醒脑静的适应证、用法用量进行评价。结果共抽取440例应用醒脑静的神经科患者。在适应证方面,22.0%不符合说明书,14.7%缺乏临床研究证据的支持。醒脑静平均单次剂量为28.9mL,263(59.8%)例次患者应用醒脑静的剂量高于说明书中规定的常用量(10￣20mL)。醒脑静的疗程平均15.7d,有25.5%的患者应用时间超过20d。443例次患者合并应用活血化淤的中药。结论神经科医疗保险患者醒脑静的用药中存在与说明书规定的适应证、给药剂量及现有临床研究证据不符的情况。
Objective To investigate and analyze the medication of Xingnaojing injection (“Xingnaojing”) in the inpatients of medical insurance neurology in Beijing, and provide the basis for rational use of drugs in the department of neurology. Methods Data from 5 medical insurance inpatients of neurology department in Beijing were collected from Beijing Medical Insurance Information Database. The data of Xingnaojing used in inpatients in neurology department of different levels were also evaluated. Results A total of 440 neurosurgical patients were recruited. In terms of indications, 22.0% did not meet the instructions, 14.7% lack of clinical research evidence support. The average single dose of Xingnaojing was 28.9mL, and the dosage of Xingnaojing was higher than the common dosage (10 ~ 20mL) prescribed in the manual in 263 cases (59.8%). Medication Jingjing treatment average 15.7d, 25.5% of patients with application time more than 20d. 443 cases of patients combined application of traditional Chinese medicine promoting blood circulation. Conclusion There is a discrepancy between the indications prescribed in the manual, the dose administered and the existing evidence from clinical studies in patients receiving neurotropological medical insurance.