基于说明书修订公告及药品国家不良反应监测报告的中药安全性内容管控现状与对策分析
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篇名: | 基于说明书修订公告及药品国家不良反应监测报告的中药安全性内容管控现状与对策分析 |
TITLE: | Analysis of the current status and countermeasures of safety content control of traditional Chinese medicine based on the revision announcement of the instruction and the national adverse drug reaction monitoring report |
摘要: | 目的 为完善中药说明书安全性内容的修订提供参考。方法系统分析2013-2024年中药说明书修订相关公告中的公告发布年份、药品名称、药品剂型、公告发布时间、3项安全性内容(【禁忌】【不良反应】【注意事项】)的平均修订条数等资料;根据2013-2024年国家药品不良反应监测报告数据,分析中药占全部药品不良反应的比例、不同剂型药品[中药注射剂、口服中药、其他(外用类)中药]不良反应构成比。结果2013-2024年国家药品监督管理局共发布了101条中药说明书修订公告,涉及241种中药。其中,口服中药163种,中药注射剂25种,其他(外用类)中药53种。中药注射剂、口服中药和其他(外用类)中药存在安全性内容缺失的分别有3、10、0种。中药注射剂不良反应数据的主要来源类型为上市后监测数据(占48.00%);口服中药不良反应数据的主要来源类型为监测数据(占71.17%);73.58%的其他(外用类)中药未提及不良反应数据来源。国家药品不良反应监测报告显示,中药占全部药品不良反应的比例从2013年的17.3%降至2024年的12.1%,其中中药注射剂的不良反应在3种剂型中药中的构成比从2015年的61.3%降至2024年的24.6%,而口服中药的不良反应在3种剂型中药中的构成比从2015年的34.7%升至2024年的64.0%。结论我国中药安全性内容风险管控已取得成效,但仍面临被动监测依赖性强、数据溯源不足及关键内容缺失三大挑战,亟须分剂型完善安全性内容、优化安全性数据来源并充分利用真实世界证据补充安全性内容。 |
ABSTRACT: | OBJECTIVE To provide a reference for revising the safety content of traditional Chinese medicine(TCM) instructions. METHODS A systematic analysis was conducted on the relevant announcements on the revision of TCM instruction from 2013 to 2024, including the year of publication, drug name, drug formulation, announcement release time, and the average number of revisions made to three safety contents (contraindication, adverse drug reaction, and precaution). According to the report data of national adverse drug reaction monitoring from 2013 to 2024, analyze the proportion of TCM in all adverse drug reactions, the composition ratio of adverse drug reaction of different dosage forms of drugs [TCM injection, oral TCM, other (topical) TCM]. RESULTS From 2013 to 2024, the National Medical Products Administration issued a total of 101 notices on the revision of TCM instruction, involving 241 types of TCM. Among them, there were 163 types of oral TCM, 25 types of TCM injection, and 53 types of other (topical) TCM. There were 3, 10 and 0 types of TCM injection, oral TCM, and other (topical) TCM with missing safety content, respectively. The main source of adverse drug reaction data for TCM injections was post- marketing monitoring data (accounting for 48.00%); the main source of adverse drug reaction data for oral TCM was monitoring data (accounting for 71.17%); 73.58% of other (topical) TCM did not mention the source of adverse drug reaction data. The report on national adverse drug reaction monitoring showed that the proportion of all adverse drug reactions of TCM had decreased from 17.3% in 2013 to 12.1% in 2024. Among them, the proportion of adverse drug reaction of TCM injection in the three dosage forms of TCM had decreased from 61.3% in 2015 to 24.6% in 2024, while the proportion of adverse drug reaction of oral TCM in the three dosage forms of TCM had increased from 34.7% in 2015 to 64.0% in 2024. CONCLUSIONS The risk management of TCM safety content has achieved results in China, but still faces three major challenges: strongdependence on passive monitoring, insufficient data traceability, and missing key content. It is urgent to improve safety content by dosage form, optimize data sources, and fully utilize real-world evidence to supplement safety content. |
期刊: | 2025年第36卷第17期 |
作者: | 朱健;王忠;武红莉;荆志伟 |
AUTHORS: | ZHU Jian,WANG Zhong,WU Hongli,JING Zhiwei |
关键字: | 中药说明书;说明书修订;安全性内容;不良反应 |
KEYWORDS: | traditional Chinese medicine instruction; revision of the instruction; safety content; adverse drug reaction |
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