临床医学专业论文 某医院门诊抗高血压药处方分析

中国网络大学CHINESE NETWORK UNIVERSITY本科毕业设计(论文)某医院门诊抗高血压药处方分析院系名称：专业：学生姓名：学号：123456789指导老师：中国网络大学教务处制2018年03月01日某医院门诊抗高血压药处方分析【摘要】：目的：通过调查广东省某医院门诊2014年1月份的部分高血压药物处方情况，了解分析抗高血压药物的运用比例、不同科室的使用情况、通过调查问卷分析医师的处方原因，探索不同个体因素差异的处方药物联用规律，最终目的是为临床治疗决策提供依据。

方法：随机抽查2014年1月广东省某医院的450张降压药门诊处方(心内科221张，肾内科134张，内分泌科95张)，对处方进行统计分析，分析三个科室不同种类降压药及联用比例的原理，从而为临床治疗提供依据。

结果：进行分析的982张处方中降压药的处方比例：钙离子拮抗剂（CCB）41.4%，血管紧张素Ⅱ受体拮抗药（ARB）26.6%，血管紧张素转换酶抑制剂（ACEI）12.8%，利尿剂（D）6.2%，β受体阻断药(β-RB)11.1%，其他1.9%；其中CCB、ARB、β-RB主要用于心内科，而在肾科及内分泌科ARB和CCB的用药较大；450张处方中二联用药处方占比例最大有58.4%，主要是心内科的处方，而单一用药主要是内分泌处方，三联以上用药主要在肾科处方。

结论：不同降压药在不同科室使用情况大不相同，主要是根据其不同适应症满足临床不同患者的治疗需求而决定，各类药物使用情况也基本趋于合理,通过三个科室的处方分析，总结不同降压药的可应用疾病范围，为临床治疗提供依据。

【关键词】：高血压用药；处方分析；合理用药；适应症Analysis of Antihypertensive Drug Prescription inGuangdong Province People's Hospital[Abstract] Objective Through the investigation of the Guangdong people's hospital outpatient service in January 2014, part of the antihypertensive prescription, analyzes the proportion of the use of antihypertensive drugs, the usage of different departments, through the questionnaire analysis prescription, exploring different prescription drug combination law of individual difference factors, the final purpose is to provide the basis for clinical treatment decisions.Methods Random sampling in January 2014, the Guangdong people's hospital outpatient prescriptions of 450 antihypertensive drugs (Cardiology, 221, Renal medicine, 134, Endocrinology, 95), statistical analysis was carried out on the prescription, the analysis of three different kinds of antihypertensive drug department and the principle of proportion, which provide the basis for clinical treatment. Results the analysis of the 982 prescription of antihypertensive drug prescription ratio: 41.4% calcium channel blockers (CCB), angiotensin Ⅱreceptor antagonist medicine (ARB) 26.6%, angiotensin converting enzyme inhibitors (ACEI) 12.8%, diuretics (D) 6.2%, beta receptor blockers (beta - RB) 11.1%, other 1.9%. CCB, ARB, beta RB is mainly used in cardiology, and in renal diseases and endocrine ARB and CCB drug use; 450 duplex in the prescription drug prescription proportion is 58.4%, most main is heart medicine prescription, and single usage mainly endocrine prescription, more than triple in renal diseases the main drug prescription.Conclusion Different antihypertensive agents in different departments have different usage, mainly according to its different indications and decided to satisfy the treatment of patients with different clinical demand, all kinds of drug use is also the basic tend to be more reasonable, through the analysis of the three departments of prescription, the conclusion can be used to application scope of different blood pressure medication, provide the basis for clinical treatment.[key words] Antihypertensive Analysis of prescription Rational drug use Indications目录1.前言.............................................. - 5 -2.资料与方法 ........................................ - 6 -2.1 资料来源 ---------------------------------------- - 6 -2.2 研究方法 ---------------------------------------- - 6 -3.结果.............................................. - 7 -3.1 患者情况 ---------------------------------------- - 7 -3.1.1性别和年龄比例----------------------------------------------------- - 7 - 3.1.2患者主要病因------------------------------------------------------- - 7 - 3.2 用药情况 ---------------------------------------- - 7 -3.2.1 各种降压药的使用比例----------------------------------------------- - 7 - 3.2.2降压药处方中单一用药和各联合用药的使用比例------------------------- - 7 - 3.2.3 三个科室降压药的使用情况------------------------------------------- - 9 - 3.2.4 降压药在不同科室的联用情况----------------------------------------- - 9 -3.2.5 DDDs 分析: DDDs 排名前八位的药品----------------------------------- - 9 -4.讨论............................................. - 11 -4.1单类降压药比例---------------------------------- - 11 -4.2 联合用药情况分析 ------------------------------ - 12 -4.2.1 联合药物治疗原则-------------------------------------------------- - 12 - 4.2.2 二联用药处方分析-------------------------------------------------- - 13 - 4.2.3 三联及以上用药处方分析-------------------------------------------- - 16 -4.3 科室用药处方分析---------------------------------------------------- - 16 -5.结论与建议 ....................................... - 18 -6.参考文献......................................... - 19 -致谢............................................... - 21 -1.前言高血压是以体循环动脉压增高为主要表现的临床综合征,高血压的全球发病率已高达 31.3%, 约有 6.9 亿人的生命健康正在遭受这种疾病的威胁，而我国高血压患者已突破3.3亿，每10个成人中至少有2人是高血压，每年新增加高血压1000万人，部分北方地区成人高血压患病率高达30％以上[1]。