Objective To analyze the rationality of hypoglycemic agents use in patients with type 2 diabetes mellitus (T2DM).Methods From May 2014 to May 2017,1 280 T2DM patients admitted to Beijing Second Hospital were inclu-ded.The rationality(including the diagnosis, writing standardization,the number,dosage of drugs, the irrationality of the combined use,etc.),the safety,and defined daily dose system(DDDS)of the clinical medication were observed and recor-ded.Results The total amount of commonly used hypoglycemic agents was 41.79 million yuan,ranked according to DDDS were:acarbose(DDDS=43 002.33), metformin hydrochloride(DDDS=21 437.50),repaglinide(DDDS=1 908.67), glimepiride(DDDS=1 348.50),gliclazide(DDDS=954.50),glipizide(DDDS=99.67).Among the prescriptions of the 1 280 patients included,1 190 cases were reasonable,the reasonable rate was 92.97%,90 cases were unreasonable, and the irrational rate was 7.03%.The number,dose,combination,irrational usage rates of drugs in the prescription were 0.47%,0.79%,0.31%,3.75%respectively;there were 22 cases of unstandardized writing(1.72%).There were 129 cases(10.08%)of adverse reactions,including gastrointestinal reaction(8.05%),hypoglycemia(4.45%),constipation (4.22%),dizziness and fatigue(2.66%), anemia(0.39%), andlactic acidosis(0.16%).Conclusion The clinical application of hypoglycemic drugs in T 2DM patients is reasonable,and metformin and acarbose are the most commonly used.The incidence of adverse drug reactions is low,but there are still problems including unstandardized prescription writing,unreasonable usage and dosage problems,calling for due attention and proper treatment.%目的 分析2型糖尿病(T2DM)患者降糖药物的用药情况.方法 选取2014年5月至2017年5月北京市第二医院收治的T2DM患者1280例,观察统计临床用药的合理性(包括诊断、书写不规范,药物数量、剂量、联用的不合理性等)及安全性、用药频度(DDDS)等.结果 纳入的1280例患者常用降糖药总金额为41.79万元,按照用药频度排序分别为阿卡波糖(DDDS=43002.33)、盐酸二甲双胍(DDDS=21437.50)、瑞格列奈(DDDS=1908.67)、格列美脲(DDDS=1348.50)、格列齐特(DDDS=954.50)、格列吡嗪(DDDS=99.67).纳入的1280例患者的用药处方中,合理1190例,合理率为92.97%,不合理90例,不合理率为7.03%.处方中药物数量、剂量、联用、用法不合理率分别为0.47%、0.79%、0.31%、3.75%,书写不规范22例(1.72%).不良反应总发生129例(10.08%),按照发生率的高低顺序依次为胃肠道反应(8.05%)、低血糖(4.45%)、便秘(4.22%)、头晕乏力(2.66%)、贫血(0.39%)、乳酸性酸中毒(0.16%).结论 我院T2DM患者降糖药物临床应用合理性好,以二甲双胍及阿卡波糖类药物最常用,药物不良反应发生率低,但药物处方仍存在一定的书写不规范、用法不合理及药物剂量问题,需要加强对以上问题的关注和妥善处理.
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