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目的:评价北京市“医保”住院患者醒脑静注射液的应用状况,为合理用药和“医保”支付提供参考。方法:随机抽取2004年北京市医疗保险信息数据库中5家不同级别医院应用醒脑静的住院病例,调查其适应证、剂量、疗程、不良反应等。结果:共调查病例676例,应用醒脑静的前10种适应证中18．0％与药品说明书不符,17．5％缺乏临床研究证据支持;平均单次剂量为(27．9±9．0)mL,高于药品说明书规定的常用量和临床研究中的常用量;平均疗程14．6d,有20．9％超过20d;合并用药有抗栓药(13．3％)、活血化淤中药(12．7%)等。结论:“医保”患者醒脑静注射液应用存在与药品说明书规定的适应证、给药剂量及现有临床研究证据不符的情况。
Objective: To evaluate the application status of Xingnaojing injection in “Medicare” inpatients in Beijing, and provide references for reasonable medication and “Medicare” payment. Methods: Inpatients were randomly selected from 5 different hospitals in Beijing Medical Insurance Information Database in 2004 to investigate their indications, dosage, course of treatment and adverse reactions. Results: A total of 676 cases were investigated. 18.0% of the top 10 indications of xingnaojing were inconsistent with the drug specification and 17.5% of them lacked the evidence of clinical research. The mean single dose was (27.9 ± 9). 0) mL, which is higher than the usual amount prescribed in the drug instruction manual and commonly used in clinical studies. The average course of treatment was 14.6 days, with 20.9% for more than 20 days. The combination therapy was antithrombotic (13.3%), Chinese medicine (12.7%) and so on. Conclusion: There are some discrepancies between the application of Xingnaojing injection in “Medicare” patients and the indications prescribed in the drug specification, the dosage to be administered and the evidence of the existing clinical studies.