Yan Ziqi, Feng Zhanchun, Jiao Zhiming, Wang Ganyi, Chen Chaoyi, Feng Da
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Medical Products Administration & Center for ADR Monitoring of Henan, Zhengzhou, China.
Front Pharmacol. 2022 Apr 12;13:761097. doi: 10.3389/fphar.2022.761097. eCollection 2022.
Traditional Chinese medicine (TCM) injection is widely used, but its adverse drug reaction (ADR) may be a serious public health concern in primary medical institutions. This research will explore the safety of TCM injections and provide clinical recommendations at the primary medical institutions. ADR data were collected by the Henan Adverse Drug Reaction Monitoring Center from 2016 to 2020 were analized Descriptive statistics, chi-square analysis, binary logistic regression, and Mantel-haenszel hierarchical analysis were used to identify the risk factors associated with the rational use of TCM injections in primary medical institutions. A total of 30,839 cases were collected in this study, 4905 cases (15.90%) were SADRs. Patients using TCM injections in primary medical institutions were more likely to cause SADRs (OR = 1.149, 95% CI: 1.061-1.245). Aged over 60 years (OR = 1.105, 95% CI: 1.007-1.212), non-essential drugs (OR = 1.292, 95% CI: 1.173-1.424), autumn (OR = 1.194, 95% CI: 1.075-1.326) and TCM injections with safflower (OR = 1.402, 95% CI: 1.152-1.706), danshen (OR = 1.456, 95% CI: 1.068-1.984) and medication reasons with chemotherapy (OR = 2.523, 95% CI: 1.182-5.386) and hypertension (OR = 1.495, 95% CI: 1.001-2.233) were more likely to suffer SADR in primary medical institutions. In general, the number of reported cases of TCM injection was declining over time, but the proportion of SADRs in primary medical institutions increased. In the future, it is necessary to continue to restrict TCM injections at the macro policy level, and vigorously promote the varieties in the essential drug list. At the micro level, it is necessary to intervene in specific populations, specific diseases and specific drugs, first start with them, step by step, and effectively prevent SADR occurrences in primary medical institutions.
中药注射剂被广泛使用,但其药物不良反应(ADR)在基层医疗机构中可能是一个严重的公共卫生问题。本研究将探讨中药注射剂的安全性,并为基层医疗机构提供临床建议。河南药品不良反应监测中心收集了2016年至2020年的ADR数据并进行分析。采用描述性统计、卡方分析、二元逻辑回归和Mantel-Haenszel分层分析来确定与基层医疗机构合理使用中药注射剂相关的危险因素。本研究共收集30839例病例,其中严重ADR(SADR)4905例(15.90%)。基层医疗机构使用中药注射剂的患者更易发生SADR(比值比[OR]=1.149,95%置信区间[CI]:1.061-1.245)。60岁以上(OR=1.105,95%CI:1.007-1.212)、非基本药物(OR=1.292,95%CI:1.173-1.424)、秋季(OR=1.194,95%CI:1.075-1.326)以及使用红花(OR=1.402,95%CI:1.152-1.706)、丹参(OR=1.456,95%CI:1.068-1.984)的中药注射剂,以及化疗用药原因(OR=2.523,95%CI:1.182-5.386)和高血压(OR=1.495,95%CI:1.001-2.233)的患者在基层医疗机构更易发生SADR。总体而言,中药注射剂报告病例数随时间呈下降趋势,但基层医疗机构中SADR的比例有所上升。未来,有必要在宏观政策层面继续限制中药注射剂,并大力推广基本药物目录中的品种。在微观层面,有必要对特定人群、特定疾病和特定药物进行干预,首先从这些方面入手,逐步有效预防基层医疗机构中SADR的发生。