Page 102 - 《中国药房》2024年17期

陕西省基层医疗机构氨酚待因使用情况调查分析

杨 芳 1， 2＊ ，刘星宸 ，刘星雨 ，刘晓勇 ，项 程 ，杨才君 （1.西安交通大学药学院临床药学系，西安 710115；
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2.西安市高陵区医院药剂科，西安 710200）
中图分类号 R95；R971 文献标志码 A 文章编号 1001-0408（2024）17-2152-06
DOI 10.6039/j.issn.1001-0408.2024.17.17

摘 要 目的 调查分析陕西省基层医疗机构氨酚待因使用情况，为促进氨酚待因的规范、合理使用提供证据支持。方法 按照整
群分层随机抽样的方法，在陕西省全部10个省辖市中随机各选取1个区、1个县（或2个区）的基层医疗机构2020－2023年开具的
所有氨酚待因处方，采用国际疾病分类（ICD）编码对现有临床诊断进行归类，对搜集的处方用药信息进行描述性分析，并采用
SPSS 25.0软件对数据进行单因素分析和Logistic回归分析，找出影响用药疗程＞10 d的关键因素。结果 本研究共收集到氨酚待
因有效处方7 375张。使用氨酚待因的主要以女性（52.11%）、年龄19～64岁（66.73%）的患者为主。基于ICD编码，氨酚待因的使
用涉及最多的疾病类别为肌肉骨骼系统或结缔组织疾病或症状、体征（43.48%）；排名前3位的临床诊断为关节病（25.59%）、骨折
（9.95%）、牙痛（8.58%）。药品用法用量明确的7 175张处方中符合氨酚待因说明书推荐的处方有3 366张，有5.63%的处方对乙酰
氨基酚日使用量超2.0 g/d的极量限制。处方用药疗程超常规限制（7 d）的处方有4 051张，超使用疗程限制（10 d）的处方有1 336
张。影响用药疗程＞10 d的因素主要为医疗机构所属区域、类型以及患者性别、年龄，基层医疗机构中的陕南地区、乡镇卫生院以
及老年人、女性患者用药疗程＞10 d的现象偏多。结论 陕西省基层医疗机构氨酚待因的临床应用存在一定的不合理，主要表现
在药品用法用量、临床诊断以及用药疗程不适宜；医疗机构所属区域、类型以及患者年龄、性别均会影响该类药品的用药疗程。
关键词 氨酚待因；基层医疗机构；镇痛药；合理用药；陕西省

Investigation and analysis of the use of acetaminophen in primary medical institutions of Shaanxi province
YANG Fang ，LIU Xingchen ，LIU Xingyu ，LIU Xiaoyong ，XIANG Cheng ，YANG Caijun （1. Dept. of
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Clinical Pharmacy， School of Pharmacy， Xi’an Jiaotong University， Xi’an 710115， China；2. Dept. of
Pharmacy， Xi’an Gaoling District Hospital， Xi’an 710200， China）
ABSTRACT OBJECTIVE To investigate and analyze the use of acetaminophen in primary medical institutions of Shaanxi
province， and to provide evidence for promoting the standardized and rational use of acetaminophen. METHODS According to the
method of cluster stratified random sampling， all prescriptions of acetaminophen issued by primary medical institutions in one
district and one county （or two districts） were randomly selected from 10 provincial cities of Shaanxi province from 2020 to 2023；
the existing clinical diagnoses were classified by using the International Classification of Diseases （ICD） code， and the drug
information of collected prescriptions was analyzed descriptively. SPSS 25.0 software was used for single-factor analysis and
Logistic regression analysis to find out the key factors affecting the duration of medication ＞10 d. RESULTS A total of 7 375
valid prescriptions for acetaminophen were collected in this study. The patients who used acetaminophen were mainly female
（52.11%） and aged 19-64 （66.73%）. Based on the ICD code， the disease categories most involved in the use of acetaminophen
were musculoskeletal system， connective tissue diseases or symptoms and signs （43.48%）； the top 3 clinical diagnoses were joint
disease （25.59%）， fracture （9.95%）， and toothache （8.58%）. Among the 7 175 prescriptions with clear drug usage and dosage，
3 366 were in line with the recommendation of acetaminophen instruction， and 5.63% of the prescriptions exceeded the maximum
dose limit of acetaminophen 2.0 g/d. There were 4 051 prescriptions exceeding the conventional limit of treatment duration （7 d），
and 1 336 prescriptions exceeding the limit of treatment duration （10 d）. The main factors affecting the duration of drug
treatment ＞10 d were the region and type of medical institutions， the gender and age of patients， and the phenomenon of the
duration of drug treatment ＞10 d was common in the primary medical institutions from southern Shaanxi， township health centers，
the elderly and female patients. CONCLUSIONS There are some unreasonable clinical applications of acetaminophen in primary
medical institutions of Shaanxi province， which are mainly manifested in inappropriate usage and dosage， unsuitable clinical
diagnosis and drug duration. The region， type of medical
institution， age and gender of patients will affect the duration
＊第一作者 副主任药师，硕士研究生。研究方向：药事管理、临
床药学。E-mail：495243760@qq.com of this drug prescription.
# 通信作者 教授，博士生导师，博士。研究方向：药物政策与药品 KEYWORDS acetaminophen； primary medical institutions；
供应保障。E-mail：yangcj@xjtu.edu.cn analgesics； rational drug use； Shaanxi province

· 2152 · China Pharmacy 2024 Vol. 35 No. 17 中国药房 2024年第35卷第17期