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[100249例儿童病例中热毒宁注射液临床安全性的前瞻性、多中心、大样本医院集中监测]

[Prospective,multi-center,and large-scale hospital centralized monitoring of clinical safety of Reduning Injection in 100249 children cases].

作者信息

Wang Lian-Xin, Yang Shuo, Wang Meng-Meng, Liu Fu-Mei, Li Jun, Lin Ai-Wei, Xiang Long, Wang Meng-Qing, Lei Jie, Zhong Rou, Zhang Hong-Yan, Zhang Ai-Hua, Xie Yan-Ming

机构信息

Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences Beijing 100700,China.

Children's Hospital of Nanjing Medical University Nanjing 210008,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2024 Jun;49(12):3396-3403. doi: 10.19540/j.cnki.cjcmm.20240306.501.

Abstract

This study utilized a prospective, large-sample, multi-center, and registered key specialty approach of hospitals to monitor the application of Reduning Injection. A total of 100 249 adolescent patients aged 14 years and below who received Reduning Injection were monitored, resulting in 83 cases of adverse events, with 76 of them being classified as adverse drug reaction(ADR). The calculated incidence rate of ADR for Reduning Injection was 0.076%, indicating a very rare ADR. The main symptoms of ADR were pruritus, diarrhea, abdominal pain, vomiting, high fever, dyspnea, convulsion, and chills. All ADR cases were reported for the first time, including three new ADR cases and 73 known ADR cases. The categories of ADR was general ADR. All ADR was mild in severity. There were more males than females in ADR patients. One patient had a history of ADR, and the drug causing ADR was buprofen. The largest number of ADR cases occurred when the dosage of Reduning injection was 5-10 mL. The dropping speed was 30 drops or less per min, and the solvent type was 5% glucose injection. The most common manifestation of ADR patients was pruritus, followed by diarrhea, abdominal pain, vomiting, high fever, dyspnea, convulsions, and chills. 72 patients(94.74% of ADR patients) discontinued the drug, and three patients(3.95% of ADR patients) were given oxygen inhalation. 47 cases(61.84% of ADR patients) were treated with medication, of which dexamethasone was the most used(24 cases, 46.15% of ADR patients). 76 ADR patients were cured or improved. ADRs are more likely to occur when diagnosed with acute bronchitis by western medicine and cough by traditional Chinese medicine(TCM), TCM syndrome type is wind heat syndrome, and the combination medicine is ambroxol hydrochloride and bromhexine hydrochloride injection, ascorbic acid/vitamin C injection. This result provides an evidence-based safety basis for active pharmacovigilance of Reduning Injection in adolescents aged 14 years and below.

摘要

本研究采用前瞻性、大样本、多中心、医院重点专科登记的方法,对热毒宁注射液的使用情况进行监测。共监测100249例14岁及以下使用热毒宁注射液的青少年患者,出现不良事件83例,其中76例被判定为药品不良反应(ADR)。热毒宁注射液ADR发生率为0.076%,提示ADR发生情况极为罕见。ADR主要临床表现为瘙痒、腹泻、腹痛、呕吐、高热、呼吸困难、抽搐、寒战。所有ADR病例均为首次报告,其中新的ADR病例3例,已知ADR病例73例。ADR类型为一般不良反应,严重程度均为轻度。ADR患者中男性多于女性。1例患者有ADR史,引发ADR的药物为布洛芬。ADR发生最多的剂量为热毒宁注射液5~10mL,滴速为每分钟30滴及以下,溶媒种类为5%葡萄糖注射液。ADR患者最常见的表现为瘙痒,其次为腹泻、腹痛、呕吐、高热、呼吸困难、抽搐、寒战。72例患者(占ADR患者的94.74%)停药,3例患者(占ADR患者的3.95%)给予吸氧。47例患者(占ADR患者的61.84%)进行了药物治疗,其中使用最多的药物为地塞米松(24例,占ADR患者的46.15%)。76例ADR患者治愈或好转。西医诊断为急性支气管炎、中医诊断为咳嗽,中医证型为风热证,联合用药为盐酸氨溴索与盐酸溴己新注射液、维生素C注射液时,ADR发生可能性较大。本研究结果为14岁及以下青少年热毒宁注射液的主动药物警戒提供了循证安全依据。

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