【作者】 李韵；

【导师】 许崇涛；

【作者基本信息】 汕头大学 ， 临床医学， 2011， 硕士

【摘要】 目的:了解我院门诊与住院精神分裂症患者药物治疗的合理性,从而进一步规范我院的治疗手段,提高治疗效果,减少不良反应。材料与方法:1.采取自设计的调查表对2009年初次在我院门诊就诊与首次入住我院的精神分裂症患者的病历进行调查。2.采用WHO药物统计合作中心设定的限定日剂量(DDD)计算我院抗精神病药的用药频度(DDDs)、药物利用指数(DUI)。3.统计分析:调查数据应用EXCEL2003和SPSS13.0统计学软件进行统计分析。符合正态分布的数据应用均数±标准差(x±S)表示,进行两独立样本的t检验;若数据不符合正态分布则进行两独立样本的秩和检验;两组数据为计数资料时,进行卡方分析。以P≤0.05为差别有显著性。结果:1.我院门诊精神分裂症患72.6%为单一用药,最常用的药物是奥氮平,住院患者53.4%为单一用药,最常用的药物是利培酮。单一用药疗效比较,住院组优于门诊组。2.本次调查中联合用药率为38.3%,其中门诊组为27.4%,最常用的联合用药方案为奥氮平+利培酮;住院组为46.6%,最常用的方案为氯氮平+利培酮。住院组联合用药率显著高于门诊组,也高于国内外的调查研究。3.本次调查结果显示,单一用药与联合用药的疗效比较无统计学意义。4.门诊组的药物利用指数DUI≤1,住院组除阿立哌唑、奥氮平、洛沙平DUI略大于1,其余各抗精神病药DUI≤1。5.门诊组有66.2%患者应用抗胆碱能药物,住院组有67.06%患者应用。门诊组患者有18.04%患者长期(>4周)应用苯二氮卓类药物,住院组患者有13.35%。结论:我院门诊与住院精神分裂症患者用药结构倾向合理,但也存在不合理的现象。更多还原

【Abstract】 Objective:To investigate the clinical utilization of drugs for outpatients and inpatients with schizophrenia , so as to further regulate the rationality of our treatment method and improve therapeutic effect, as well as reduce adverse reactions.Materials and methods:1. Using the self-designed questionnaire to investigate the patients who went to our hospital for the first. time.2. The outpatients and inpatients were analyzed with regard to DDDs , drug utilization index(DUI) and drug combination by using the defined daily dose (DDD) ,which were recommended by WHO Collaborating Center for Drug Statistic Methodology.3. Data analysis: Data were presented as mean±?standard deviation ( x±S), and statistically analyzed by two independent samples t test with EXCEL 2003 and SPSS13.0, when normally distributed. Otherwise,nonparametric test wsa applied when two sets of data for the measurement data,using the Chi-square analysis. A level of P≤0.05 was accepted as statistically significant.Results :1.There were 72.6% of outpatients with schizophrenia used single kind of antipsychotic drugs , the most common drug used was Olanzapine ;53.4% of inpatients with schizophrenia used single kind of antipsychotic drugs ,the most common drug used was Risperidone . Comparison of single drug effects, in-patient group was better than out-group.2.The survey was 38.3% in the combined treatment, including out-patient group was 27.4% and in-patient group was 46.6%. The most combination of out-patient group was Olanzapine with Risperidone,while of in-patient group was Clozapine whit Risperidone.3. The survey results show that a single drug and combination therapy had no statistically significant effect.4.The DUI of outpatients were all greater or equal to 1;while the DUI of most inpatients were greater or equal to 1,except Aripiprazole、Olanzapine and Loxapine.5.There were 66.2% of outpatients used anticholinergic drugs which were 67.06% of inpatients. There were 18.04% outpatients who had been taken benzodiazepine for longer than 4 weeks, which were 13.35% of inpatients.Conclusions:The psychopharmacotherapies in our hospital were almost rational, but some improper phenomenon still existed.更多还原