北京市四家社區(qū)衛(wèi)生服務(wù)中心抗高血壓藥處方分析

馬玉潔 申學(xué)謙 熊緒臣

摘要：目的 ?對(duì)北京市大屯社區(qū)、甘棠社區(qū)、潞城社區(qū)、金盞社區(qū)四家社區(qū)衛(wèi)生服務(wù)中心抗高血壓藥物門(mén)診處方進(jìn)行分析，以促進(jìn)臨床合理和規(guī)范用藥。方法 ?從北京市四家社區(qū)醫(yī)院（大屯社區(qū)、甘棠社區(qū)、潞城社區(qū)、金盞社區(qū)）信息系統(tǒng)中選取2019年12月575張抗高血壓藥物門(mén)診處方進(jìn)行研究，分析處方涉及抗高血壓藥物的名稱(chēng)和種類(lèi)、用藥的頻度、單一及聯(lián)合用藥等情況。結(jié)果 ?共收集處方575張，其中使用頻次最高的前3位抗高血壓藥的種類(lèi)分別為鈣離子通道阻滯劑CCB、血管緊張素Ⅱ受體拮抗劑ARB、β受體阻滯劑β-RB;使用量排名前3位的藥物分別為氨氯地平、氫氯噻嗪及美托洛爾;處方中46.43%為單一用藥，53.57%為二聯(lián)及二聯(lián)以上用藥;根據(jù)《中國(guó)高血壓防治指南》，聯(lián)合用藥方案中存在4例不合理用藥現(xiàn)象。結(jié)論 ?北京市四家社區(qū)醫(yī)院的抗高血壓藥物處方基本合理，但仍有不合理現(xiàn)象，建議按照臨床高血壓聯(lián)合用藥的原則和指南開(kāi)具處方，避免不合理的用藥方案。

關(guān)鍵詞：處方分析;抗高血壓藥;合理用藥

中圖分類(lèi)號(hào)：R544.1 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻(xiàn)標(biāo)識(shí)碼：B ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?DOI：10.3969/j.issn.1006-1959.2020.17.040

文章編號(hào)：1006-1959（2020）17-0140-03

Abstract：Objective ?To analyze the outpatient prescriptions of antihypertensive drugs in four community health service centers in Datun， Gantang， Lucheng， and Jinzhan communities in Beijing， so as to promote reasonable clinical and standardized drug use.Methods ?From the information system of four community hospitals in Beijing （Datun community， Gantang community， Lucheng community， Jinzhan community）， 575 outpatient prescriptions of antihypertensive drugs in December 2019 were selected for research， and the prescriptions related to antihypertensive drugs were analyzed. Name and type， frequency of medication， single and combined medication， etc.Results ?A total of 575 prescriptions were collected. The top 3 antihypertensive drugs used most frequently were calcium channel blocker CCB， angiotensin II receptor antagonist ARB， and β-receptor blocker β-RB; The top 3 drugs used were amlodipine， hydrochlorothiazide， and metoprolol; 46.43% of prescriptions were single-drugs， 53.57% were double-dose and higher-dose drugs; according to the "Guidelines for the Prevention and Treatment of Hypertension in China"， combined there were 4 cases of irrational medication in the medication regimen.Conclusion ?The prescriptions of antihypertensive drugs in the four community hospitals in Beijing are basically reasonable， but there were still unreasonable phenomena. It was recommended that the prescriptions be prescribed in accordance with the principles and guidelines of clinical hypertension combination drugs to avoid unreasonable medication regimens.

Key words：Prescription analysis;Antihypertensive drugs;Rational drug use

高血壓（hypertension）是目前我國(guó)最常見(jiàn)的心血管疾病之一，患者需長(zhǎng)期堅(jiān)持服用降壓藥治療。我國(guó)多病共存的老年人多重用藥情況非常普遍，高血壓的治療目標(biāo)不僅是要將患者的血壓控制在一個(gè)合理適宜的范圍內(nèi)，同時(shí)還應(yīng)重點(diǎn)考慮高血壓藥物及多重用藥對(duì)患者的血糖、血脂、尿酸、凝血系統(tǒng)功能等的影響，保護(hù)心、腦、腎等重要靶器官[1]。……