ҩѧÂÛÎÄ

Äúµ±Ç°µÄλÖãºÑ§ÊõÌà > ҽѧÂÛÎÄ > »ù´¡Ò½Ñ§ÂÛÎÄ > ҩѧÂÛÎÄ >

ѭ֤ҩѧԭÔòÔÚ³¬ËµÃ÷ÊéÓÃÒ©ºÏÀíÐÔÆÀ¼ÛÖеÄ×÷Óã¨Ò©Ñ§£©

À´Ô´£ºÑ§ÊõÌà ×÷ÕߣºÒ¦ÀÏʦ
·¢²¼ÓÚ£º2014-11-06 ¹²3939×Ö
ÂÛÎÄÕªÒª

¡¡¡¡Ñ­Ö¤Ò©Ñ§£¨Evidence-based Pharmacy£¬EBP£©ÊÇÖ¸ÁÙ´²Ò©Ê¦Í¨¹ýϵͳËѼ¯ÎÄÏ×£¬ÆÀ¼ÛÒ©ÎïÑо¿µÄÖ¤¾Ý£¨ÎÄÏ×£©£¬»ñµÃÒ©ÎïÁÆЧ¡¢°²È«ÐÔ¡¢¾­¼ÃÐԵȷ½ÃæµÄÑо¿×ÊÁÏ£¬ÆÀ¹ÀÆäÔÚÖƶ¨ºÏÀíÓÃÒ©·½°¸ÖеÄ×÷Ó㬲¢ÒÔ´Ë×ö³öÁÙ´²Ò©ÎïÖÎÁƾö²ßµÄÁÙ´²Êµ¼ùµÄ·½·¨ºÍ¹ý³Ì£¬ÊÇ 90 Äê´úҽҩѧÐÅÏ¢ÁìÓòµÄÖØ´ó½øÕ¹£¬ÊÇÁÙ´²Ò©Ñ§Êµ¼ùµÄ¾ö²ß·½·¨Ö®Ò»¡£

¡¡¡¡³¬ËµÃ÷ÊéÓÃÒ©£¨off-label uses of drugs£©ÓֳƳ¬·¶Î§ÓÃÒ©£¬ÃÀ¹úÎÀÉúϵͳҩʦЭ»á½«Æ䶨ÒåΪ£ºÁÙ´²Êµ¼ÊʹÓÃÒ©Æ·µÄÊÊÓ¦Ö¢£¬¸øÒ©·½·¨»ò¼ÁÁ¿²»ÔÚ¾ßÓз¨ÂÉЧÁ¦µÄ˵Ã÷ÊéÖ®ÄÚµÄÓ÷¨£¬°üÀ¨ÄêÁä¡¢¸øÒ©¼ÁÁ¿¡¢ÊÊÓ¦ÈËȺ¡¢ÊÊÓ¦Ö¢»ò¸øҩ;¾¶µÈÓëҩƷ˵Ã÷ÊéÖеÄÓ÷¨²»Í¬µÄÇé¿ö¡£Óб¨µÀÏÔʾ£¬³¬ËµÃ÷ÊéÓÃÒ©ÔÚÁÙ´²ÉÏÆÕ±é´æÔÚÇÒ¾²Âö¸øÒ©ÖдóÁ¿´æÔÚ¡£±¾ÎÄ×ÅÖظÅÊöÔËÓÃѭ֤ҩѧԭÔòÔÚ³¬ËµÃ÷ÊéÓÃÒ©ºÏÀíÐÔÆÀ¼ÛÖеÄ×÷Óá£

¡¡¡¡1¡¢ ѭ֤ҩѧµÄ¸ÅÄî¼°×÷ÓÃ

¡¡¡¡20 ÊÀ¼Í 90 Äê´ú³õÆÚ£¬¹úÍâѧÕßÊ×ÏÈÌá³öѭ֤ҽѧ£¨Evi£­dence-Based Medicine£¬EBM£©¸ÅÄÒÔÖ¤¾ÝΪ»ù´¡µÄѭ֤ҽѧ±»Ìá³öºó£¬ÈËÃǺܿìÒâʶµ½Ò½Ñ§Ä£Ê½Ò²´ÓÁÙ´²Ò½Ñ§Öð½¥À©´óµ½Ò½Ñ§¡¢Ò©Ñ§¸÷¸öÁìÓò¡£Ò©ÎïÖÎÁÆÊÇÁÙ´²Ò½Ñ§¸ÉÔ¤×îÖØÒªµÄÊֶΣ¬ÓÈÆäÐèҪѭ֤¡£ÀûÓÃÖ¤¾ÝÆÀ¼ÛһЩ¿ÉÄÜ´æÔÚÎÊÌâµÄÒ©ÎïÁÆ·¨µÃµ½½ÏΪÃ÷È·µÄ½áÂÛÒÔ´Ù½øºÏÀíÓÃÒ©£¬ÔÚʵ¼Ê¹¤×÷ÖÐÀûÓÃÄ¿Ç°×î¼ÑµÄÖ¤¾ÝÆÀ¼Û´¦·½£¬ÎªÁÙ´²Ìṩ¸ßÖÊÁ¿µÄҩѧ·þÎñ¡£

¡¡¡¡Ñ­Ö¤Ò©Ñ§×÷Ϊѭ֤ҽѧµÄÒ»¸ö·Ö֧ѧ¿Æ£¬Æä¸ÅÄîÔÚÉÏÊÀ¼Í90 Äê´úÄ©ÆÚ±»Ìá³ö£¬1997 ÄêÓ¢¹ú»Ê¼Òҩѧ»á£¨RPSGB£©Ìá³ö£º´Ù½øҩѧÖеÄѭ֤ʵ¼ù½«ÎªÒ©Ñ§·þÎñ¿ª±ÙмÍÔª£»1998 Äê Et£­misnan M µÈѧÕßÌá³öѭ֤ҩѧ»òÑ­Ö¤Ò©ÎïÖÎÁÆѧ£¨evidence-based pharmacotherapy£© ¾ÍÊÇÒÔÖ¤¾ÝΪ»ù´¡µÄÁÙ´²Ò©ÎïÖÎÁÆѧ£¬ÆäºËÐÄÄÚÈݺͻù±¾¾«Éñ¾ÍÊÇÑ°ÕÒÖ¤¾Ý¡¢·ÖÎöÖ¤¾ÝºÍÔËÓÃÖ¤¾Ý£¬ÒÔ×ö³ö¿ÆѧºÏÀíµÄÓÃÒ©¾ö²ß£»¹úÍâѧÕßÆձ鶨ÒåΪ£º“ѭ֤ҩѧÊÇÖ¸ÁÙ´²Ò©Ê¦Í¨¹ýϵͳÊÕ¼¯ÎÄÏ×£¬ÆÀ¼ÛÒ©ÎïÑо¿µÄÖ¤¾Ý£¨ÎÄÏ×£©£¬»ñµÃÒ©ÎïÁÆЧ¡¢°²È«ÐÔ¡¢¾­¼ÃѧµÈ·½ÃæµÄÑо¿×ÊÁÏ£¬ÆÀ¹ÀÆäÔÚÖƶ¨ºÏÀíÓÃÒ©·½°¸ÖеÄ×÷Ó㬲¢ÒÔ´Ë×ö³öÁÙ´²Ò©ÎïÖÎÁƾö²ßµÄÁÙ´²Êµ¼ùµÄ·½·¨Óë¹ý³Ì¡£”¹úÄÚѧÕ߶àÊý²ÉÓøö¨Òå¡£

¡¡¡¡Ëæ×Åѭ֤ҩѧµÄÑо¿²»¶ÏÉîÈ룬ÏÖÒѹ㷺ÔËÓÃÓÚÒ©ÎïÖÎÁÆ»·½ÚµÄ¸÷¸ö·½Ã棬°üÀ¨»ù±¾Ò©ÎïåàÑ¡¼°ÐÂÒ©×¼Èë¡¢Ò©ÎïÁÙ´²ÊÔÑé¡¢Ò©ÎïÁÆЧÆÀ¼Û¡¢Ö¸µ¼ÁÙ´²Ò©Ñ§Êµ¼ù¡¢Ö¸µ¼Ò©Îï¾­¼ÃѧÆÀ¼Û¡¢Ò©Ñ§ÐÅÏ¢ÊÕ¼¯ÓëÆÀ¼ÛµÈ·½Ãæ¡£

¡¡¡¡2¡¢ ³¬ËµÃ÷ÊéÓÃÒ©ÏÖ×´¼°ºÏÀíÐÔÆÀ¼ÛµÄÖØÒªÐÔ

¡¡¡¡Ò©Æ·ËµÃ÷ÊéÊÇÒ©Æ·ÐÅÏ¢×î»ù±¾¡¢×îÖ÷ÒªµÄÀ´Ô´£¬Ö¸µ¼ÁÙ´²Ò½ÉúÕýÈ·ÓÃÒ©ºÍ»¼Õß×ÔÎÒÒ©ÁƵÄÖ÷ÒªÒÀ¾Ý£¬Êǹú¼ÒʳƷҩƷ¼à¶½¹ÜÀí×ܾÖÉóºËÅú×¼µÄ¾ßÓз¨ÂÉЧÁ¦µÄÎļþ¡£ÓÉÓÚҩƷ˵Ã÷Êé¸üнÏÂý£¬ÌØÊâÈËȺÓÃÒ©Ñо¿½ÏÉÙ£¬ÒÔ¼°Ò½Ê¦»òҩʦÖ÷¹ÛÔ­ÒòµÈÒòËØ£¬µ¼ÖÂÔ¼ 20%µÄÒ½ÁÆ»ú¹¹´¦·½´æÔÚ³¬ËµÃ÷ÊéʹÓÃÇé¿ö£¬ÆäÖÐÕ¼±È×î¸ßµÄÊÇ¿¹¾ªØÊÒ©Îï £¨74%£©£¬Æä´ÎÊÇ¿¹¾«Éñ²¡Ò©Î60%£©ºÍ¿¹ÉúËØ£¨41%£©ÇÒÔÚÌØÊâÈËȺÖиü¸ß¡£Ó¢¹úÀûÎïÆÖ¸¾Å®Ò½ÔºµÄÑо¿ÏÔʾ£¬¸ÃÔºÔи¾ÓÃÒ©ÖÐ 58%µÄÒ©Æ·Æ·ÖÖºÍ 55%µÄÓÃÒ©Ò½ÖöÊôÓÚÔи¾É÷Óûò½ûÓ㻶ù¿Æ»¼Õß³¬ËµÃ÷ÊéºÍ³¬×¢²áÓÃÒ©µÄ±ÈÀýԼΪ 50%£»ÀÏÄ껼Õ߸ߴï 84%¡£Ìáʾ³¬Ò©Æ·ËµÃ÷ÊéÓÃÒ©ÔÚÁÙ´²ÉÏÆÕ±é´æÔÚ¡£

¡¡¡¡Ëæ×Åҩѧ·þÎñµÄ²»¶Ï·¢Õ¹£¬Ò©Ê¦Í¨¹ýÉóºËÆÀ¼Ûҽʦ´¦·½ÓÃÒ©ºÏÀíÐÔ£¬²ÎÓëÁÙ´²ÖÎÁƾö²ßµÄÖƶ¨±£ÕÏ»¼Õß°²È«ºÏÀíÓÃÒ©¡£

¡¡¡¡µ«ÊÇ´«Í³Ò©Ê¦É󷽶àÒÀ¿¿ÈÕ³£¹¤×÷ÖÐÈÕ»ýÔÂÀ۵ľ­Ñé¼°×ñѭҩƷ˵Ã÷ÊéµÄÓйØÐÅÏ¢¶ÔÒ½Éú´¦·½½øÐкÏÀíÐÔÆÀ¼Û£¬¶ÔÓÚ³¬ËµÃ÷ÊéÓÃÒ©´«Í³Éó·½ÆÀ¼ÛÖ±½Ó¹éΪ²»ºÏÀíÓÃÒ©·¶³ë£¬½ø¶øÒýÆðÒ½ÉúºÍҩʦ֮¼äµÄì¶Ü£¬Ò²¼Ó¾ç»¼Õ߶ÔÒ½ÉúµÄ²»ÐÅÈΡ£Ïֽ׶ζÔÓÚ³¬ËµÃ÷ÊéÓÃÒ©ÎÒ¹ú»¹Ã»ÓÐͳһ¹æ·¶µÄ¹ÜÀíÌõÀý£¬Ò½ÁƾÀ·×µ¼ÖÂÔðÈηÖÅä²»Ã÷È·£¬´Ó¶øÔö¼Ó»¼Õß¡¢Ò½ÎñÈËÔ±¼°¹«¹²Ò½ÁÆ°²È«µÄ·çÏÕ¡£Ò»Ïî¶ÔÓ¢¹úÀûÎïÆÖ¸¾²ú¿ÆÒ½Ôº 17000 ÕŲúÇ°´¦·½µÄÁ¬Ðø³éÑùµ÷²éÏÔʾ£¬75%µÄ´¦·½´æÔړ˵Ã÷ÊéÖ®ÍâµÄÓ÷¨”£¬µ«¾ø´ó¶àÊý±»ÈÏΪÊÇ°²È«µÄ£¬²¢ÇÒÓÐʱ³¬ËµÃ÷ÊéÓÃÒ©´ú±íÁË×îºÏÀíµÄѭ֤ҽѧÖÎÁÆ¡£ÈçͯÈÙÉúµÈ±¨µÀÃÀÂÞÅàÄÏÔÚÓÃÓÚÄÑÖÎÐÔÄÍÒ©¾ú¸ÐȾʱӦ²ÉÓÃÃÀÂÞÅàÄÏ 3h Á¬Ðø¾²ÂöµÎ×¢£¬ÓëҩƷ˵Ã÷ÊéÉÏÿ 8h Ò»´ÎµÄÓ÷¨²»Í¬¡£Òò´Ë¶ÔÓÚ³¬ËµÃ÷ÊéÓÃÒ©ºÏÀíÐÔµÄÕýÈ·ÆÀ¼Û¶ÔÓÚ»º½âÒ½»¼¹Øϵ£¬¼õÉÙ»¼Õß¡¢Ò½ÎñÈËÔ±·çÏÕ£¬Ìá¸ßÒ½ÁÆ»ú¹¹Ò½ÁÆ·þÎñˮƽ£¬´Ù½øÒ½Ò©ÊÂÒµµÄ·¢Õ¹¾ßÓÐÖØÒªÒâÒå¡£

¡¡¡¡3¡¢ ѭ֤ҩѧÓ볬˵Ã÷ÊéÓÃÒ©ÆÀ¼Û

¡¡¡¡3.1 ÊÕ¼¯³¬ËµÃ÷ÊéÓÃÒ©ÐÅÏ¢£ºÀûÓÃѭ֤ҩѧԭÔò¶Ô³¬ËµÃ÷ÊéÓÃÒ©½øÐкÏÀíÐÔÆÀ¼Û£¬Ê×ÏÈÐèÒªÊÕ¼¯³¬ËµÃ÷ÊéÓÃÒ©×ÊÁÏÐÅÏ¢¡£Ëæ×ÅҽѧÊÂÒµµÄ·¢Õ¹¸üУ¬ÁÙ´²ÖÎÁÆÒѾ­°´ÕÕ¼²²¡µÄ·¢Éú·¢Õ¹¹æÂɽøÐÐר¿ÆÐÔÖÎÁÆ£¬ÁÙ´²Ò½Ê¦Ö÷Òª´ÓÊÂÒ»À༲²¡µÄÕïÖι¤×÷¡£

¡¡¡¡ÁÙ´²Ò©Ñ§·þÎñ²ÎÓëÁÙ´²ÖÎÁÆ·½°¸µÄÖƶ¨»¹´¦ÓÚ̽Ë÷·¢Õ¹½×¶Î£¬Îª¸üºÃÓëÁÙ´²ÖÎÁÆÏà½áºÏ£¬¹²Í¬ÎªÌá¸ßÒ½ÁÆ·þÎñˮƽŬÁ¦£¬ÁÙ´²Ò©Ñ§·þÎñÒ²ÐèÒª½øÐÐר¿Æ»¯·¢Õ¹£¬Òò´Ë¶ÔÓÚ³¬ËµÃ÷ÊéÓÃÒ©ÐÅÏ¢µÄÊÕ¼¯ÐèÒª¶Ô²»Í¬×¨¿ÆµÄÓÃÒ©Çé¿ö½øÐв»Í¬µÄ·ÖÀàÕûÀí£¬ÒÔÀûÓÚÕë¶ÔÐÔµØÑ°ÕÒÁÙ´²ÓÃÒ©Ö¤¾Ý£¬È«Ãæ׼ȷÊÕ¼¯ÓÃÒ©ÐÅÏ¢¡£

¡¡¡¡3.2 ÊÕ¼¯ÁÙ´²ÓÃÒ©ÐÅÏ¢¼°ÖÎÁƾ­Ñ飺ѭ֤ҩѧµÄºËÐÄ֮һΪÊÕ¼¯Ò©ÎïʹÓÃÏà¹ØÖ¤¾Ý¼°Ò©ÎïʹÓÃÐÅÏ¢£¬ÓÉÓÚҩƷʹÓþßÓÐר¿ÆÐÔ£¬²¢ÇÒÓÉÓÚµØÇø²îÒì¡¢¸÷Ò½ÁÆ»ú¹¹Ò½ÁÆˮƽ²îÒ죬³¬ËµÃ÷ÊéÓÃҩʹÓÃÇé¿öÓëµ±µØÒ½ÁÆˮƽ»òÒ½ÁÆ»ú¹¹Ò½ÁÆˮƽ¼°´¦·½Ò½Éú¶ÔÓÚÒ©ÎïµÄÀí½â²»Í¬¶øÓÐÒ»¶¨²îÒì¡£ÎÄÏ×±¨µÀµÄ´óÑù±¾£¬Ë«Ã¤·¨Öƶ¨µÄʵÑéͳ¼ÆÊý¾ÝÒ²ÊÇÔÚÒ»¶¨µÄµØÓò»·¾³Ìõ¼þ¡¢²»Í¬µÄר¿Æ»¼Õß¡¢²»Í¬µÄÒ½ÁÆˮƽÌõ¼þϽøÐеģ¬ÄÇô°´ÕÕ´«Í³Ñ­Ö¤Ò©Ñ§Ô­Ôòͨ¹ý¼ìË÷Ò©ÎïÖÎÁÆÐÅÏ¢ÓйصĹؼü´ÊÔò½ÏÄÑÊÕ¼¯µ½Êʺϵ±µØÒ½ÁÆˮƽ¼°Ò½ÁÆ×´¿öµÄÓÃÒ©ÐÅÏ¢¡£Òò´ËÔÚÊÕ¼¯³¬ËµÃ÷ÊéÓÃÒ©ÐÅϢʱ£¬Ò»·½ÃæÐèҪͨ¹ý¼ìË÷¹úÄÚÍâȨÍþÊý¾Ý¿âÑ°ÕÒ³¬ËµÃ÷ÊéÓÃÒ©µÄÖ¤¾Ý²ÄÁÏ£¬ÁíÒ»·½ÃæÐèÒªÓÐÒâʶµØ¼ìË÷Óëµ±µØÒ½ÁÆˮƽ¼°µØÓò»·¾³½ÏΪÀàËƵÄʵÑéÑо¿½áÂÛ¡£Ò²¿ÉÒÔ½áºÏµ±µØÒ½ÁÆ×ÊÔ´¿ªÕ¹Ò»¶¨µÄËæ»ú¶ÔÕÕʵÑ飬¶Ô³¬ËµÃ÷ÊéÓÃÒ©Çé¿ö½øÐÐҩѧÀí»¯ÐÔÖʲⶨ¼°ÁÙ´²Ê¹ÓÃÇé¿ö¼à²â£¬Îª³¬ËµÃ÷ÊéÓÃÒ©ºÏÀíÐÔÆÀ¼ÛÌṩ²Î¿¼Ö¤¾Ý¡£

¡¡¡¡3.3 ÆÀ¼ÛÐÅÏ¢µÄÕæʵ¿É¿¿³Ì¶È£º¶ÔÓÚÊý¾Ý¿â¼ìË÷µ½µÄÎÄÏ×½øÐÐÕæʵÐÔ¡¢ÖØÒªÐÔºÍʵÓÃÐÔÆÀ¼Û£¬Ö÷ÒªÖ¸±ê°üÀ¨ÊµÑéÊÇ·ñ½øÐÐÁËËæ»ú·ÖÅäÒþ²Ø£¬ÊÇ·ñ²ÉÓÃ˫ä·¨ºÍ»ùÏßÊÇ·ñ¿É±È¡£¶ÔÓÚÉè¼ÆʵÑéÑо¿µÃµ½µÄÖ¤¾ÝÖ÷ÒªÊÇÆÀ¼ÛʵÑé¹ý³ÌÉè¼ÆÊÇ·ñºÏÀí£¬ÊÇ·ñ½øÐÐËæ»ú¶ÔÕÕʵÑ飬ʵÑéÊý¾ÝÊÇ·ñ¾ßÓдú±íÐÔ£¬²îÒìÊÇ·ñ¾ßÓÐͳ¼ÆѧÒâÒ壬ʵÑé½á¹ûÓëÎÄÏ×¼ìË÷½á¹ûµÄ²îÒìÐԱȽϵȷ½ÃæÆÀ¼Û²âµÃµÄʵÑéÊý¾ÝµÄ¿É¿¿ÐÔ¡£Ñ¡Ôñ³ö½ÏΪ¿É¿¿µÄÖ¤¾Ý²ÄÁ϶Գ¬ËµÃ÷ÊéÓÃÒ©½øÐкÏÀíÐÔÆÀ¼Û¡£

¡¡¡¡3.4 ³¬ËµÃ÷ÊéÓÃÒ©ºÏÀíÐÔÆÀ¼Û£º½áºÏÁÙ´²ÓÃÒ©¾­Ñé¼°ÊÕ¼¯µ½µÄ¿É¿¿¡¢×î¼ÑÖ¤¾Ý¶Ô³¬ËµÃ÷ÊéÓÃÒ©µÄºÏÀíÐÔ½øÐÐÆÀ¼Û£¬²¢½«ÆÀ¼ÛΪºÏÀíÓÃÒ©µÄÓÃÒ©·½°¸Ó¦ÓÃÓÚÒ½ÁÆʵ¼ù£¬¿¼²ìÆäÓ¦ÓÃÊÇ·ñ´æÔÚ·çÏÕ»òЧÒæÒÔ¼°ÖÎÁÆÈ¡µÃÒ»¶¨µÄЧ¹ûÊÇ·ñ»áÒò»¼ÕßÌåÖʲ»Í¬´æÔÚÒ»¶¨µÄ²îÒ죬×îÖÕÆÀ¼Û³öºÏÀíµÄ³¬ËµÃ÷ÊéÓÃÒ©·½°¸¡£¶ÔÆÀ¼ÛΪ²»ÊÊÒ˵ij¬ËµÃ÷ÊéÓÃÒ©·½°¸£¬¸ù¾ÝÆÀ¼Û¹ý³ÌÖмìË÷µÄÎÄÏ×±¨µÀ¼°Éè¼ÆµÄ»ù´¡ÊµÑéÑо¿½á¹û£¬½áºÏÁÙ´²ÖÎÁÆÇé¿öÍêÉÆÐÞ¸ÄÒ©ÎïÖÎÁÆ·½°¸£¬Ñ°Çó½ÏΪºÏÀíµÄÓÃÒ©·½°¸¡£

¡¡¡¡3.5 ÆÀ¼ÛЧ¹û£º³¬ËµÃ÷ÊéÓÃÒ©ÔÚÁÙ´²Êµ¼Ê¹¤×÷ÖдóÁ¿´æÔÚ£¬Êµ¼Ê¹¤×÷ÖгöÏֵij¬ËµÃ÷ÊéÓÃÒ©Çé¿ö²»ÄÜÁýͳ¹é½áΪ²»ºÏÀíÓÃÒ©£¬³¬ËµÃ÷ÊéÓÃÒ©µÄºÏÀíÐÔÆÀ¼ÛÊÇÁÙ´²Ò©Ñ§¹¤×÷µÄÖØÒª×é³É²¿·Ö¡£

¡¡¡¡ÒÑÓб¨µÀÏÔʾ£¬ÔËÓÃѭ֤ҩѧԭÀí¶Ô³¬ËµÃ÷ÊéÓÃÒ©Çé¿ö½øÐкÏÀíÐÔÆÀ¼Û¾ßÓÐʵ¼ÊÒâÒå¡£ºúÖҽܵȱ¨µÀÔËÓÃѭ֤ҩѧԭÀí¶Ô¿¹¾úÒ©ÎïºÏÀíʹÓýøÐÐÆÀ¼Û£¬½á¹ûÏÔʾÈç β-ÄÚõ£°·À࿹ÉúËØ°´ËµÃ÷ÊéÒªÇó¶àÊýÐèҪÿÌì 2 ´Î»òÿÌì 3 ´Î¸øÒ©£¬Í¨¹ýѭ֤ҩѧÆÀ¼Û֤ʵÁË β-ÄÚõ£°·À࿹ÉúËØÿÌì 1 ´Î¸øÒ©µÄÓÅÔ½ÐÔ£¬°±»ùÌÇÜÕÀ࿹ÉúËØÿÌì 1 ´Î¸øÒ©·½°¸ÔÚһЩ¹ú¼Ò»òµØÇø×÷Ϊ³£¹æ¸øÒ©·½·¨£¬Óë˵Ã÷ÊéÉϹ涨µÄÿÌì 2 ´Î»ò 3 ´Î¸øÒ©·½°¸ÓÐËù²»Í¬¡£

¡¡¡¡Áõ½¨Æ½µÈÒ²½«Ñ­Ö¤Ò©Ñ§ÔËÓÃÓÚÒ©Æ·²»Á¼·´Ó¦ÆÀ¼Û£¬ÔöÇ¿Ò©Îï²»Á¼·´Ó¦ÆÀ¼ÛµÄ·½·¨¼°Òò¹ûÍƶϵÄÔ­Ôò¡¢·½·¨ºÍÈ·¶¨ÐÔÇ¿¶È¡£

¡¡¡¡4¡¢ ½áÊøÓï

¡¡¡¡Ñ­Ö¤Ò½Ñ§±»Ìá³öºó¹ã·ºÔËÓÃÓÚҽѧ¸÷ÁìÓò£¬Ñ­Ö¤Ò©Ñ§Ó¦Ô˶øÉú£¬²¢¹ã·ºÔËÓÃÓÚÒ©ÎïÖÎÁƵĸ÷¸ö»·½Ú¡£³¬ËµÃ÷ÊéÓÃÒ©ÊÇÁÙ´²Ò©Ñ§¹¤×÷ÖÐÓöµ½µÄ³£¼ûÎÊÌ⣬Ïֽ׶ÎÎÒ¹úÄËÖÁÊÀ½ç¶¼Ã»ÓÐÐγÉÒ»¸ö³¬ËµÃ÷ÊéÓÃҩͳһ¹æ·¶µÄ¹ÜÀíÆÀ¼ÛÒâ¼û£¬²»Í¬Ò½ÁÆˮƽÌõ¼þ»á³öÏÖ²»Í¬ÀàÐ͵ij¬ËµÃ÷ÊéÓÃÒ©Çé¿ö£¬²¢ÇÒÓÉÓÚҩƷ˵Ã÷Êé×ÔÉí¾ßÓоÖÏÞÐÔ¡¢ÖͺóÐÔÒÔ¼°Ò½Ê¦¶ÔÓÚÒ©Îï֪ʶµÄ¸üг̶Ȳ»Í¬£¬Éç»áÆäËûÒòËصÄÓ°Ïìµ¼Ö³¬ËµÃ÷ÊéÓÃÒ©Çé¿öÆÕ±é´æÔÚ¡£

¡¡¡¡Ìá¸ßҩʦÉ󷽵Ť×÷ÄÜÁ¦£¬ÌáÉýҩʦÔÚҩѧ·þÎñÖеĻ°ÓïȨ£¬´Ù½øÁÙ´²ºÏÀíÓÃÒ©£¬±£ÕÏ»¼ÕßÓÃÒ©°²È«£¬ÔËÓÃѭ֤ҩѧµÄ˼ÏëÀíÄîºÍÑо¿·½·¨ÊÇÆÀ¼Û³¬ËµÃ÷ÊéÓÃÒ©ºÏÀíÐÔµÄÓÐЧ;¾¶¡£

¡¡¡¡²Î¿¼ÎÄÏ×£º
¡¡¡¡[1]Furberg CD£¬Psaty BM£¬Meyer JV. Nifedipine£ºDose -relatedincrease in mortality in patients with coronary heart disease [J].Circulation£¬1995£¬92£¨5£©£º1326-1331.
¡¡¡¡[2]Chen J£¬Jiang X H.Evidence-based pharmacy in clinical phar£­maceutical practice[J]. J China Pharm£¬2001£¬12£¨2£©£º75-77.
¡¡¡¡[3]»ÆÁÁ£¬ÉêÏòÀ裬³ÂÁ¦£¬µÈ£®ÕýÈ·ÈÏʶ²¢ÓÐЧ¹æ·¶³¬ËµÃ÷ÊéÓÃÒ©ÐÐΪ[J].ÖйúҽԺҩѧÔÓÖ¾£¬2009£¬29£¨11£©£º949-951£®
¡¡¡¡[4]Stafford RS. Regulating off-label drug use-rethinking the role ofthe FDA[J].N Engl J Med£¬2008£¬358£¨14£©£º1427.
¡¡¡¡[5]Fairman KA£¬Curtiss FR. Regulatory actions on the off-label useof prescription drugs£ºongoing controversy and contradiction in2009 and 2010[J].J Manag Care Pharm£¬2010£¬16£¨8£©£º629.
¡¡¡¡[6]ÕÔ³£¾ü£¬¼Ö¶«¸Ú£¬À×Õᦓ.³¬ËµÃ÷ÊéÓÃÒ©”µÄÏÖ×´¡¢Î£º¦ÐÔ¼°¶Ô²ß[J].ҽѧÀíÂÛÓëʵ¼ù£¬2012£¬25£¨8£©£º984-986.
¡¡¡¡[7]RPSGB£®A new age for pharmacy Practice research£ºPromotingevidence—based practice in pharmacy£®London£ºRPSGB£¬1997.
¡¡¡¡[8]Etminan M£¬Wright JM£¬Carleton BC·Evidence -based pharma£­cotherapy£¬review of basic concepts and applications in clinicalpractice[J].The Annals of Pharmacotherapy£¬1998£¬32£¨11£©£º1193.
¡¡¡¡[9]Íõ¼Òΰ£®ÊÔÎöҩƷ˵Ã÷ÊéÓëºÏÀíÓÃÒ©[J].ÁÙ´²Ò©ÎïÖÎÁÆÔÓÖ¾£¬2006£¬4£¨5£©£º40.
¡¡¡¡[10]ÎâΡ£¬ÐÏ»¨.ҩƷ˵Ã÷ÊéÖ®ÍâµÄÓ÷¨³õ̽[J].ÖйúÒ©Îᆵ½ä£¬2012£¬9£¨6£©£º344-346.

Ïà¹ØÄÚÈÝÍƼö
Ïà¹Ø±êÇ©£ºÒ©Ñ§±ÏÒµÂÛÎÄ
·µ»Ø£ºÒ©Ñ§ÂÛÎÄ