我国2014—2016年阿片类药物使用情况分析(1)
摘 要 目的：分析我国主要阿片类药物的使用现状及变化趋势，为阿片类药物合理使用提供参考。方法：利用药物经济开发信息网数据库，提取2014-2016年芬太尼、嗎啡、哌替啶、羟考酮和氢吗啡酮5种阿片类药物的采购数据。以百万人口日剂量数(单位：S-DDD )衡量药品使用量，分析比较阿片类药物整体及不同剂型(主要包括口服剂型、注射剂和其他剂型)在全国及不同地区(中部、东部、西部)的使用量。结果：5种阿片类药物药品使用量从2014年的69.62 S-DDD上升至2016年的78.64 S-DDD；其中氢吗啡酮、羟考酮的药品使用量呈现上升趋势，而吗啡的药品使用量基本不变，芬太尼与哌替啶的药品使用量呈现下降趋势；口服剂型药品使用量从2014年的39.77 S-DDD上升至2016年的45.61 S-DDD，注射剂药品使用量从2014年的20.74 S-DDD上升至2016年的24.23 S-DDD，其他剂型的药品使用量从2014年的9.11 S-DDD下降至2016年的8.81 S-DDD，口服剂型的药品使用量约为注射剂型的2倍，且差距逐年扩大。分地区而言，2014-2016年5种阿片类药物药品使用量在东部地区最高，西部地区次之，中部地区最低但增长率最高(2016年东部、西部、中部地区药品使用量分别为94.04、67.90、63.78 S-DDD，较2014年的增长率分别为8.50%、11.77%、16.17%)；在各地区各年份中，吗啡均为药品使用量最高的药物，其次为芬太尼；东、中部地区口服剂型与注射剂型的药品使用量逐年上升，西部地区口服剂型的药品使用量上升而注射剂型的药品使用量逐年下降。结论：我国阿片类药物使用总体呈现上升趋势，但地区间存在差异，且总体使用量仍然较低。在保证严格监管的前提下针对不同地区有必要多方面采取措施促进阿片类药物的合理使用。
关键词 阿片类药物；使用现状；变化趋势；不同地区；合理用药
Analysis of the Utilization of Opioids in China during 2014-2016
TIAN Ye1，XU Ziyue1，GUAN Xiaodong1，2，DENG Yanping3，SHI Luwen1，2(1.School of Pharmacy， Peking University， Beijing 100191， China；2.International Research Center of Medicinal Administration， Peking University， Beijing 100191， China；3.National Institute for Drug Dependence， Peking University， Beijing 100191， China)
ABSTRACT OBJECTIVE： To analyze the current status and trend of opioids consumption in China， and to provide reference for rational use of opioids. METHODS： Purchasing data on five opioids as fentanyl， morphine， pethidine， oxycodone and hydromorphone， were extracted from the database of the Medicine Economic Information Network from 2014 to 2016. Drug consumption was measured by the daily dose per million population (unit： S-DDD)， and the consumption amount of all opioids and different dosage forms (including oral dosage form， injection and other form) in China and different districts were analyzed and compared. RESULTS： The consumption amount of five opioids increased from 69.62 S-DDD in 2014 to 78.64 S-DDD in 2016. The consumption amount of hydromorphone and oxycodone showed an upward trend， while the consumption amount of morphine was basically unchanged， and the consumption amount of fentanyl and pethidine showed a downward trend. The consumption amount of oral dosage form increased from 39.77 S-DDD in 2014 to 45.61 S-DDD in 2016， the consumption amount of the injection increased from 20.74 S-DDD in 2014 to 24.23 S-DDD in 2016， and the consumption amount of other form decreased from 9.11 S-DDD in 2014 to 8.81 S-DDD in 2016. The consumption amount of oral dosage form was around twice that of injection， with the gap expanding yearly. Regionally， the consumption amount of five opioids in the eastern region was the highest， followed by the western region， and the lowest but the highest growth rate in the central region from 2014 to 2016 (in 2016， consumption amount of eastern， western and central regions were 94.04， 67.90， 63.78 S-DDD， with increase rate of 8.50%， 11.77%， 16.17%， compared with 2014). Morphine was the most widely used drug in all regions， followed by fentanyl； in the eastern and central regions， the use of oral and injection dosage form increased year by year； in western region， the use of oral dosage forms increased while that of injection decreased year by year. CONCLUSIONS： The opioids consumption in China is increasing overall， with regional differences. Nonetheless， the overall consumption is still low. On the premise of strict supervision， it is necessary to take measures to promote the rational use of opioids in different areas., 百拇医药(田野 徐子悦 管晓东 邓艳萍 史录文)
关键词 阿片类药物；使用现状；变化趋势；不同地区；合理用药
Analysis of the Utilization of Opioids in China during 2014-2016
TIAN Ye1，XU Ziyue1，GUAN Xiaodong1，2，DENG Yanping3，SHI Luwen1，2(1.School of Pharmacy， Peking University， Beijing 100191， China；2.International Research Center of Medicinal Administration， Peking University， Beijing 100191， China；3.National Institute for Drug Dependence， Peking University， Beijing 100191， China)
ABSTRACT OBJECTIVE： To analyze the current status and trend of opioids consumption in China， and to provide reference for rational use of opioids. METHODS： Purchasing data on five opioids as fentanyl， morphine， pethidine， oxycodone and hydromorphone， were extracted from the database of the Medicine Economic Information Network from 2014 to 2016. Drug consumption was measured by the daily dose per million population (unit： S-DDD)， and the consumption amount of all opioids and different dosage forms (including oral dosage form， injection and other form) in China and different districts were analyzed and compared. RESULTS： The consumption amount of five opioids increased from 69.62 S-DDD in 2014 to 78.64 S-DDD in 2016. The consumption amount of hydromorphone and oxycodone showed an upward trend， while the consumption amount of morphine was basically unchanged， and the consumption amount of fentanyl and pethidine showed a downward trend. The consumption amount of oral dosage form increased from 39.77 S-DDD in 2014 to 45.61 S-DDD in 2016， the consumption amount of the injection increased from 20.74 S-DDD in 2014 to 24.23 S-DDD in 2016， and the consumption amount of other form decreased from 9.11 S-DDD in 2014 to 8.81 S-DDD in 2016. The consumption amount of oral dosage form was around twice that of injection， with the gap expanding yearly. Regionally， the consumption amount of five opioids in the eastern region was the highest， followed by the western region， and the lowest but the highest growth rate in the central region from 2014 to 2016 (in 2016， consumption amount of eastern， western and central regions were 94.04， 67.90， 63.78 S-DDD， with increase rate of 8.50%， 11.77%， 16.17%， compared with 2014). Morphine was the most widely used drug in all regions， followed by fentanyl； in the eastern and central regions， the use of oral and injection dosage form increased year by year； in western region， the use of oral dosage forms increased while that of injection decreased year by year. CONCLUSIONS： The opioids consumption in China is increasing overall， with regional differences. Nonetheless， the overall consumption is still low. On the premise of strict supervision， it is necessary to take measures to promote the rational use of opioids in different areas., 百拇医药(田野 徐子悦 管晓东 邓艳萍 史录文)