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中药注射剂的安全性概况:中国自发报告系统的分析

Safety profile of traditional Chinese herbal injection: An analysis of a spontaneous reporting system in China.

作者信息

Li Haona, Deng Jianxiong, Deng Lewen, Ren Xuequn, Xia Jielai

机构信息

Department of Health Statistics, Fourth Military Medical University, Xi'an, China.

Huaihe School of Clinical Medicine, Henan University, Kaifeng, China.

出版信息

Pharmacoepidemiol Drug Saf. 2019 Jul;28(7):1002-1013. doi: 10.1002/pds.4805. Epub 2019 May 27.

Abstract

PURPOSE

Although a series of serious adverse events have continually raised concerns about the potential toxicity of traditional Chinese medicine injections (TCM injections), studies on this subject are still sparse. We conducted a descriptive analysis of a spontaneous reporting system in China to describe the safety profile of TCM injections.

METHODS

The safety profile of TCM injections is described by descriptive analysis of 559 066 adverse reports collected from Guangdong Provincial Center for adverse drug reaction (ADR) Monitoring in China during 2003 to 2017.

RESULTS

The percentage of new or serious ADRs of TCM injections is much higher than average percentage of China's spontaneous reporting system (SRS) as a whole (48.70% vs <25%). Compared with conventional injections, TCM injections have a slightly lower percentage of serious ADRs (6.02% vs 6.72%) and much higher percentage of unknown (new) ADRs (46.74% vs 24.13%). The gender and age distribution for TCM injections are similar to conventional injections. The reporting rates of ADRs increased with age. Anaphylactic shock and anaphylactoid reaction are high-risk ADRs for TCM injections and, anaphylactic shock is ranked number 1 in causing deaths (50.00%).

CONCLUSIONS

There are some differences and similarities on the safety profile between TCM injections and conventional injections. TCM injections have higher risk of adverse effects than any other dosage forms of TCM medications and higher percentage of new or serious adverse effects than conventional injections. A lot of work need to be done to clarify the huge amount of potential unknown adverse effects related to TCM injections.

摘要

目的

尽管一系列严重不良事件不断引发对中药注射剂潜在毒性的担忧,但关于这一主题的研究仍然很少。我们对中国的一个自发报告系统进行了描述性分析,以描述中药注射剂的安全性概况。

方法

通过对2003年至2017年期间从中国广东省药品不良反应监测中心收集的559066份不良反应报告进行描述性分析,来描述中药注射剂的安全性概况。

结果

中药注射剂新的或严重不良反应的百分比远高于中国自发报告系统(SRS)的总体平均百分比(48.70%对<25%)。与传统注射剂相比,中药注射剂严重不良反应的百分比略低(6.02%对6.72%),未知(新)不良反应的百分比则高得多(46.74%对24.13%)。中药注射剂的性别和年龄分布与传统注射剂相似。不良反应报告率随年龄增长而增加。过敏性休克和类过敏反应是中药注射剂的高风险不良反应,过敏性休克在导致死亡方面排名第一(50.00%)。

结论

中药注射剂与传统注射剂在安全性概况上存在一些异同。中药注射剂比其他任何中药剂型都有更高的不良反应风险,且新的或严重不良反应的百分比高于传统注射剂。需要做大量工作来阐明与中药注射剂相关的大量潜在未知不良反应。

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