【摘要】：目的本文旨在了解南寧市帕金森病患者用藥情況,分析其影響因素,與國內(nèi)外其他地區(qū)用藥情況進(jìn)行比較,擬提出促使帕金森病患者合理用藥的相關(guān)對(duì)策和建議。 方法對(duì)2013年7月至2013年11月就診于南寧市各大醫(yī)院神經(jīng)內(nèi)科的臨床確診的228例帕金森病患者進(jìn)行當(dāng)前用藥情況的調(diào)查,按照研究者所在醫(yī)院的藥品價(jià)格計(jì)算患者每月藥費(fèi)情況,進(jìn)行一般資料問卷調(diào)查,并對(duì)全部患者進(jìn)行采用改良Hoehn-Yahr分級(jí)量表(Modified Hoehn and Yahr stage, H-Y)和統(tǒng)一帕金森病評(píng)分量表(Unified Parkinson's Disease Rating Scale, UPDRS)評(píng)估病情程度,利用蒙特利爾認(rèn)知評(píng)價(jià)量表(Montreal Cognitive Assessment, CoMA)評(píng)估患者認(rèn)知程度。 結(jié)果228例患者中,南寧市地區(qū)有126例,南寧以外的縣市有102例；男性有152例(66.67%),女性有76例(33.33%)；有216例(94.73%)患者應(yīng)用了左旋多巴制劑(多巴絲肼或卡左雙多巴),有107例(46.92%)患者使用了多巴胺受體激動(dòng)劑(Dopamine agonist, DR)(吡貝地爾或普拉克索),其中多巴絲肼168例(73.68%),卡左雙多巴48例(21.05%),吡貝地爾89例(39.35%),普拉克索18例(7.89%),苯海索114例(50.00%),金剛烷胺86例(37.72%),司來吉蘭6例(2.63%),恩他卡朋2例(0.88%)。H-Y分級(jí)Ⅰ-Ⅱ級(jí)患者南寧市市區(qū)患者的月均費(fèi)用為168.20士62.10元,外地患者的月均費(fèi)用為158.20士46.72元,兩組間比較無明顯差異(P0.05),Ⅲ級(jí)者南寧市市區(qū)患者的月均費(fèi)用為288.50士262.19元,外地患者的月均費(fèi)用為240.41士239.41元,兩組間比較無明顯差異(P0.05),Ⅳ-Ⅴ級(jí)者南寧市市區(qū)患者的月均費(fèi)用為411.76士301.65元,外地患者的月均費(fèi)用為408.68士374.15元,兩組間比較無明顯差異(P0.05)。單因素分析及元Logistic多回歸分析結(jié)果顯示,患者的病程、文化程度、對(duì)疾病的認(rèn)知程度等因素對(duì)患者用藥情況的影響有統(tǒng)計(jì)學(xué)意義。 結(jié)論南寧各區(qū)與南寧各縣的PD治療治療藥物基本相似,月均費(fèi)用比較無明顯統(tǒng)計(jì)學(xué)差異,患者認(rèn)知程度是影響患者用藥的主要因素。而國內(nèi)多巴胺受體激動(dòng)劑的使用還不如國外普及程度。為了提高PD患者規(guī)范化治療的水平、減少經(jīng)濟(jì)負(fù)擔(dān)、改善患者生活質(zhì)量,需要PD患者、醫(yī)務(wù)工作者、政府部門的共同努力。
[Abstract]:Objective the purpose of this paper is to understand the situation of drug use in patients with Parkinson's disease in Nanning, analyze its influencing factors, compare it with other regions at home and abroad, and propose relevant countermeasures and suggestions to promote the rational use of drugs in patients with Parkinson's disease. Methods from July 2013 to November 2013, 228 patients with Parkinson's disease who were clinically diagnosed in the Department of Neurology, Nanning City, were investigated. The monthly drug cost of the patients was calculated according to the drug price in the hospital. General data were investigated and the patients were assessed with modified Hoehn-Yahr scale (Modified Hoehn and Yahr stage, H-Y) and Unified Parkinson's Disease scale (Unified Parkinson's Disease Rating Scale, UPDRS). The cognitive degree of patients was evaluated by Montreal Cognitive Assessment scale (Montreal Cognitive Assessment, CoMA). Results among 228 patients, 126 were in Nanning and 102 were in counties other than Nanning, 152 (66.67%) were male and 76 (33.33%) were female. 216 patients (94.73%) were treated with levodopa (dobutazid or carbozodopa) and 107 patients (46.92%) with dopamine receptor agonist (Dopamine agonist, DR) (pipedil or Praquisole. 48 cases (21.05%), 89 cases (39.35%), 89 cases (39.35%), 18 cases (7.89%), 114 cases (50.00%), 86 cases (37.72%), 86 cases (37.72%), 6 cases (2.63%), 2 cases (0.88%), respectively. The average monthly cost of non-local patients was 158.20 鹵46.72 yuan, and there was no significant difference between the two groups (P0.05). The average monthly cost of Nanning patients in grade 鈪，

本文編號(hào)：2277640