摘要
目的探讨严重精神障碍患者出院信息单上出院用药指导的临床特点及性别差异。方法以湖北省武汉市优抚医院(以下简称“我院”)2018年全年精神科执业医师填写的严重精神障碍出院信息单上的用药指导为研究对象。共399份出院信息单,其中男性患者出院信息单257份,女性患者出院信息单142份。根据医师填写的出院用药指导,以使用的抗精神病药为主线,对精神科药物进行包含性别差异的临床研究进行分析。结果2018年我院严重精神障碍患者出院用药使用率最高的抗精神病药为利培酮,其次依次为奥氮平、氯氮平、阿立哌唑、喹硫平、氨磺必利,典型抗精神病药使用率较小(占总人数4.91%)。口服利培酮、氯氮平抗精神病治疗的比例,男性患者明显高于女性患者,差异有统计学意义(P<0.01或者P<0.05),口服利培酮进行抗精神病治疗的患者中,男、女性患者药量比较,差异无统计学意义(0.05<P<0.10)。口服奥氮平、阿立哌唑、氨磺必利、齐拉西酮的比例,女性患者高于男性患者,差异有统计学意义(P<0.01或者P<0.05)。在使用阿立哌唑抗精神病治疗的比例以及治疗时的平均剂量,女性患者均高于男性患者(P<0.05)。在服氨磺必利抗精神病治疗时,氨磺必利在治疗中起主要作用的比例,女性患者高于男性患者(P<0.01),氨磺必利的使用剂量女性患者高于男性患者(P<0.05)。男女患者在服喹硫平片、帕利哌酮、典型抗精神病药,以及情感稳定剂、镇静催眠药、抗抑郁药方面差异无统计学意义(P>0.05)。结论非典型抗精神病药目前是严重精神障碍患者的一线精神治疗药物。严重精神障碍患者出院用药在选择新型抗精神病药治疗的种类上有性别差异,个别抗精神病药治疗剂量上有性别差异,而在情感稳定剂、镇静催眠药、抗抑郁药等治疗上无性别差异。
Objective To explore the clinical characteristics and gender differences of discharge medication guidance in discharge information sheet of patients with severe mental disorders.Methods The medication guidance on the discharge information sheet of patients with severe mental disorders filled out by psychiatric practitioners in Wuhan Excellent Hospital(“our hospital”for short)in 2018 was taken as the research object.There were a total of 399 discharge information sheets,including 257 male patient discharge information sheets and 142 female patient discharge information sheets.According to the discharge medication guidance filled in by psychiatrists,we conducted a clinical study analysis including gender differences with the antipsychotic drugs used as the main line in this research.Results In 2018,risperidone was the antipsychotic drug with the highest usage rate among patients with severe mental disorders in our hospital,followed by Olanzapine,Clozapine,Aripiprazole,Quetiapine and Sulfamethylate successively.The usage rate of typical antipsychotic drugs was relatively low(accounting for 4.91%of the total number).The proportion of male patients with severe mental disorders receiving antipsychotic treatments with Risperidone and Clozapine was significantly higher than that of female patients(P<0.01 or P<0.05).Among the patients receiving oral Risperidone for antipsychotic treatment,there was no statistically significant difference in the dose between male and female patients(0.05<P<0.10).The proportion of female patients taking Olanzapine,Aripiprazole,Amisulpiride and Ziprasidone was higher than that of male patients,the differences were statistically significant(P<0.01 or P<0.05).The proportion of female patients with severe mental disorders using Aripiprazole for antipsychotic treatment and the mean dose at treatment were higher than those of male patients(all P<0.05).The proportion of female patients who received Amsulpiride as a major antipsychotic drug was higher than that of male patients(P<0.01),and the
作者
潘利
程军
盛慧
PAN Li;CHENG Jun;SHENG Hui(Department of Psychiatry,Wuhan Excellent Hospital,Hubei Province,Wuhan430023,China;Department of Gynecology,Wuhan Fourth Hospital,Hubei Province,Wuhan430023,China)
出处
《中国医药导报》
CAS
2019年第32期169-172,共4页
China Medical Herald
基金
湖北省武汉市卫生计生委医疗卫生科研项目（WX15D56）
关键词
严重精神障碍
出院用药指导
性别差异
Severe mental disorders
Discharge medication guidance
Gender differences
