抗结核药品使用核查理论消耗量计算公式的探讨

摘要

统计活动性肺结核患者各体质量组的构成比、涂阳患者2个月末痰检阳性率及肺结核并发结核性胸膜炎患者占肺结核患者的比率等,采用由丹东市防痨协会专家组共同研讨的新药品使用核查理论消耗量的公式,计算出2014年丹东市全市免费抗结核药品的理论消耗量为:乙胺吡嗪利福异烟片(Ⅱ) (H:75 mg;R:150 mg;Z..400 mg;E:275 mg,商品名“怡诺尼康片”)为331 976.6片,异福片(H:150 mg;R:300 mg)为421 953.3片,异福胶囊(H:100 mg;R:150mg)为66 415.5粒.通过直接累加每例患者完全按照标准化疗方案治疗所消耗的药品数量统计出绝对理论消耗量分别为:怡诺尼康片331 770片,异福片424 080片,异福胶囊63 720粒;新公式计算出的药品理论消耗量的准确率分别为怡诺尼康片100.06％(331 976.6/331 770),异福片99.50％(421 953.3/424 080),异福胶囊104.23％(66 415.5/63 720).根据原公式及改进后的原公式计算出的怡诺尼康片的理论消耗量分别为289 813.5片和334 061.6片,准确率分别为87.35％(289 813.5/331 770)和100.69％(334 061.6/331 770).使用新理论消耗量公式计算出的FDC药品使用差异度中,丹东市市辖区的怡诺尼康片使用的核查差异度(-29.40％)和宽甸满族自治县异福胶囊使用的核查差异度(-72.33％)均超过参考区间范围.通过改进理论消耗量的计算方法,解决了巩固期FDC药品理论消耗量的计算问题,并提高了强化期药品理论消耗量计算的准确性.%We calculatedthe theoretical consumptions of each anti-tuberculosis (TB) drug by using a new formula that was recommended by the expert group of Dandong anti-TB association.The following information were collected andanalyzed,including the proportions of the body-weight groups of the patients with active TB,the spu turn conversion rate of smear-positive TB patients at the end of 2 months treatment,the proportion of the pulmonary TB patients with compliance of tuberculosis pleurisy,and then the theoretical consumptions of each anti-TB drug in Dandong City in 2014 were worked out as follows:fixed-dose combination (FDC) tablet with INH (75 mg),RFP (150 rng),PZA (400 mg),EMB (275 rng) (brand name Yinuonikang Tablet) was 331 976.6 tablets;FDC tablet with INH (150 mg) and RFP (300 mg) (named Yifu Tablet) was 421 953.3 tablets;FDC capsule with INH (100 mg) and RFP (150 mg)(named Yifu Capsule) was 66 415.5 capsules.By summing up the actual consumptions of the anti-TB drugs in all patients,the absolute theoretical consumptions of each anti-TB drugin Dandong City in 2014 were worked out as follows:Yinuonikang Tablet was 331 770 tablets;Yifu Tablet was 424 080 tablets;Yifu Capsule was 63 720 capsules.The accuracy rates of the new formula for Yinuonikang Tablet was 100.06％ (331 976.6/331 770),for Yifu Tablet was 99.50％ (421 953.3/424 080) and for Yifu Capsule was 104.23％ (66 415.5/63 720).By using the original formula and the modified formula based on the original formula,the theoretical consumptions of Yinuonikang Tablet were calculated respectively and the results were 289 813.5 tablets and 334 061.6 tablets;the accuracy rates were 87.35％ (289 813.5/331 770) and 100.69％ (334 061.6/331 770) respectively.Using the new formula,the degree of the difference between theoretical and actual consumptions for FDC was calculated during the usage verification of anti-TB drug and the results showed that the degree of the difference for Yinuonikang Tablet in the downtown of Dandong City was-29.40 ％ and it was-72.33 ％ for Yifu Capsule in Kuandian County;those all exceeded the referencerange.By modifying the calculation method of the theo retical consumptions,the issues on calculation of the anti-TB FDC theoretical consumptions which are used during the continuous phase of anti-TB treatment can be solved and the accuracy of the anti-TB FDC theoretical consump tions which are used in the intensive phase of anti-TB treatment is also improved.