Analysis and evaluation of the drug use of inpatients with vertebra-basilar artery insufficiency based on guideline and clinical pathway

目的：基于指南和临床路径对椎－基底动脉供血不足住院患者的用药情况进行分析与评价，以促进临床合理用药。方法用回顾性调查方法，对202例第一诊断为椎－基底动脉供血不足且合并诊断高血压、高脂血症的住院患者的长期医嘱进行用药分析，基于《2014年AHA／ASA卒中和TIA二级预防指南》《中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2010》与临床路径对用药合理性进行评价，并依据药品咨询系统的证据分级系统评价指南外使用药品的证据强度和推荐强度。结果药费占总费用的40．35％，用药排名前五位的注射剂为前列地尔注射液、舒血宁注射液、醒脑静注射液、丹红注射液及红花注射液。根据药品咨询系统的证据分级系统，五种注射剂均为证据强度B，推荐强度Ⅱb。结论目前对椎－基底动脉供血不足患者尚无统一的治疗方案，多种治疗药物联用的合理性缺少循证医学证据支持，还需开展更多高质量的临床试验进行研究。Objective To analyze and evaluate the drug use of inpatients with vertebra-basilar artery insufficiency, so as to promote the rational use of drugs.Methods By retrospective study, the drug use of inpa-tients with vertebra-basilar artery insufficiency from January to Decem-ber, 2013 and the rationality of drug use were analyzed and evaluated based on the Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack:a Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association, Guide-lines for the Prevention of Ischemic Stroke and Transient Ischemic Attack China 2010 and clinical pathway. According to DRUGDEX system of Healthcareseries, the strength of evidence and the strength of recommen-dation for these drugs were evaluated.Results The expenses for medi-cine accounted for 40.35%.Injection of the top five were Alprostadil, Shuxuening, Xingnaojing, Danhong and Honghua injections.Based on DRUGDEX system, the five drugs were of the strength of evidence for B and the strength of recommendationⅡb.Conclusion Current treatment for vertebra-basilar artery insufficiency is lack of unified standard.The treatment of drug combination is lack of evidence to support the rationality of evidence-based medicine.Therefore, more high quality clinical trials would be needed for further study.中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)121205-12083