質子泵抑制劑審方規則專家共識

中圖分類號 R952;R975 文獻標志碼 A 文章編號 1001-0408（2022）08-0897-14

DOI 10.6039/j.issn.1001-0408.2022.08.01

摘 要 為進一步規范質子泵抑制劑的臨床應用，為處方適宜性審核提供參考，重慶市醫院協會藥事管理專業委員根據國家衛生健康委辦公廳頒布的《質子泵抑制劑臨床使用指導原則》，發起“質子泵抑制劑審方規則制訂項目”。該項目由陸軍軍醫大學第一附屬醫院牽頭，聯合國內多家醫療機構的臨床專家、藥學專家和循證專家等，針對質子泵抑制劑的適應證、用法用量、特殊人群用藥及藥物相互作用等重點審核內容進行了研討，最終形成了本共識。共識的主要內容包括奧美拉唑、艾司奧美拉唑、泮托拉唑、雷貝拉唑、蘭索拉唑和艾普拉唑（均包括注射劑和口服制劑，按通用名計）的基礎審方規則，并在此基礎上針對基礎審方規則未涵蓋的部分臨床應用情形形成了12條審方推薦意見，以期為各級醫療機構提供參考。

關鍵詞 質子泵抑制劑;處方適宜性;審方規則;臨床應用;專家共識

Expert consensus on prescription review rules of proton pump inhibitors

Pharmaceutical Administration Committee of Chongqing Hospital Association

ABSTRACT ? In order to further standardize the clinical application of proton pump inhibitors and provide reference for prescription suitability review， under the guidance of Guiding Principles for Clinical Use of Proton Pump Inhibitor which was promulgated by the General Office of National Health Commission of the Peoples Republic of China， Pharmaceutical Admini- stration Committee of Chongqing Hospital Association initiates “the formulation Project on Prescription Review Rules for Proton Pump Inhibitors”. The First Affiliated Hospital of the Army Medical University takes the lead and cooperates with clinical experts， pharmaceutical experts and evidence-based experts from many domestic medical institutions to discuss the indications， usage and dosage， medication for special groups and drug interactions of proton pump inhibitors， and finally forms this consensus. The main contents of the consensus include the basic prescription review rules of omeprazole， esmeprazole， pantoprazole， rabeprazole， lansoprazole and iprazole （including injection and oral preparations， calculated by common name）， and 12 prescription review recommendations for some clinical applications not covered on the basic prescription review rules， in order to provide reference for medical institutions at all levels.

KEYWORDS ? proton pump inhibitor; prescription suitability; prescription review rules; clinical application; expert consensus

質子泵抑制劑（proton pump inhibitors，PPIs），又稱胃氫-鉀泵（氫-鉀腺苷三磷酸酶）抑制劑，可通過抑制胃壁細胞上的氫-鉀腺苷三磷酸酶來阻斷由各種原因所致胃壁細胞泌酸的共同及最終環節，進而強效而持久地抑制胃酸分泌。PPIs是目前抑酸作用最強的藥物之一，被廣泛用于消化性潰瘍、胃食管反流病、上消化道出血和卓-艾綜合征（又稱“胃泌素瘤”）等酸相關性疾病及應激性潰瘍的臨床治療和預防[1]。

近年來，PPIs的全球使用量不斷增長，超適應證、超劑量、超療程以及不當聯合使用的情況越來越多，大大增加了患者的用藥風險和經濟負擔[2-4]。……