青海省调整基本医疗保险与工伤保险乙类药品.doc

青海省基本医疗保险和工伤保险药品目录乙类药品调整品种表（西药部分）序号增删分类药品名称剂型支付范围限定中文名称英文名称1增1.1.1.3阿莫西林Amoxicillin颗粒剂2增1.1.1.3阿莫西林Amoxicillin注射剂3增1.1.1.3阿莫西林克拉维酸钾Amoxicillin and Clavulanate Potassium颗粒剂限产酶菌或怀疑产酶菌引起的重度感染4增1.1.1.3氨苄西林氯唑西林Ampicillin and Cloxacillin 注射剂5增1.1.1.3美洛西林舒巴坦Mezlocillin and Sulbactam 注射剂限产酶菌或怀疑产酶菌引起的重度感染6增1.1.2.1.2头孢拉定舒巴坦Cefradine and Sulbactam注射剂限产酶菌或怀疑产酶菌引起的重度感染7增1.1.2.1.2头孢唑林舒巴坦Cefrazolin and Sulbactam注射剂限产酶菌或怀疑产酶菌引起的重度感染8增1.1.2.1.2头孢替唑Ceftezole注射剂9增1.1.2.1.2头孢硫脒Cephathiamidine注射剂10增1.1.2.3.1头孢地尼Cefdinir颗粒剂限序贯治疗11增1.1.2.4头孢匹胺Cefpiramide注射剂限耐药菌引起的重度感染12增1.1.6胍甲环素Guamecycilne口服常释剂型13增1.1.7罗红霉素Roxithromycin颗粒剂14增1.1.7克拉霉素Clarithromycin口服常释剂型15增1.2.2吡哌酸Pipermidic Acid颗粒剂16增1.2.2诺氟沙星Norfloxacinand注射剂17增1.2.2氟罗沙星Fleroxacin口服常释剂型18增1.2.3甲硝唑磷酸二钠Metronidazole and Disodium Phosphate注射剂19增1.3.1对氨基水杨酸异烟肼IsoniazidAminosalicylate口服常释剂型20增1.3.1利福定Rifandine口服常释剂型21增1.3.1利福霉素Rifamycin注射剂22增1.4.1.2伊曲康唑Itraconazole口服液体剂23增1.5.1金刚乙胺Rimantadine口服常释剂型24增1.5.1吗啉胍Moroxydini口服常释剂型25增1.6新鱼腥草素钠Sodium New Houttuyfonate注射剂26增2.5甲硝唑Metronidazole缓释控释剂型27增3.1阿司匹林Aspirin口服散剂28增3.1醋氯芬酸Aceclofenac口服常释剂型29增3.1双氯芬酸Diclofenac软膏剂30增3.1双氯芬酸利多卡因Diclofenac and lidocaine注射剂31增3.1复方双氯芬酸CompoundDiclofenac注射剂32增3.1双氯芬酸二乙胺DiclofenacDiethylamine凝胶剂33增3.1酮洛芬Ketoprofen凝胶剂34增3.1复方川芎吲哚美辛吡罗昔康CompoundRhizomeIndometacinandPiroxicam口服常释剂型35增3.1蜂毒Apistoxin注射剂36增3.2复方别嘌醇CompoundAllopurinol口服常释剂型37增4高乌甲素Lappaconitine注射剂38增4瑞芬太尼Remifentanil注射剂39增4羟考酮Oxycodone缓释控释剂型40增5.2复方盐酸利多卡因CompoundLidocaineHydrochloride注射剂41增6.1复方维生素B2CompoundVitaminB2口服常释剂型42增6.2复合氨基酸螯合钙Compound Calcium Amino Acidacid Chelate口服常释剂型43增6.2牡蛎碳酸钙OysterShellCalcium口服常释剂型44增7.1.118种氨基酸葡萄糖Amino Acid and Glucose 18注射剂限配合肠外营养用45增7.1.1复方氨基酸18BCompound Amino Acip18B注射剂限配合肠外营养用46增7.1.1复方支链氨基酸BranchedChainAminoAcidMixture颗粒剂限重症肝病辅助治疗47增7.1.1乙酰谷酰胺Aectylglutamine注射剂限配合肠外营养用48增8.2地塞米松Dexamethasone缓释控释剂型49增8.4.1雌二醇EstradiolValerate口服常释剂型50增8.5.1甘精胰岛素Insuline Glargine注射剂51增8.5.1门冬胰岛素Insulin Aspart注射剂52增8.7骨化二醇Calcifediol口服常释剂型限肾性骨病53增8.7骨化三醇Calcitriol注射剂限肾性骨病54增8.7依降钙素Elcatonin注射剂限癌症骨转移、高钙血症、多发骨折55增9.1巴利昔单抗Basiliximab注射剂限器官移植56增9.2聚乙二醇干扰素2aPeginterferonalfa-2aSolution注射剂限白血病、淋巴瘤、黑色素瘤、肾癌、多发性骨髓瘤、丙肝57增9.2抗乙肝免疫核糖核酸ImmunlglbulinRibnucleicAcidofAntiHepatitisB注射剂限乙型肝炎58增9.2重组人干扰素RecombinantHumanInterferon注射剂限类风湿性关节炎59增9.2甘露聚糖肽Mannatide口服常释剂型限恶性肿瘤的辅助治疗60增9.2甘露聚糖肽Mannatide注射剂限恶性肿瘤的辅助治疗61增9.2胸腺肽1Thymosin注射剂限乙型肝炎62增9.2小牛脾提取物Calf Spleen Etractive注射剂限白细胞减少症和恶性肿瘤的辅助治疗63增9.2薄芝糖肽Bozhi Glycopeptide注射剂限恶性肿瘤的辅助治疗64增9.2香菇多糖Lentinan注射剂限恶性肿瘤的辅助治疗65增9.2灵杆菌多糖Hemarisin注射剂限白细胞减少症的辅助治疗66增9.2云芝胞内糖肽PolystictusGlycopeptide口服常释剂型限重症肝炎和肝癌的辅助治疗67增10.1.1雌莫司汀Estramustine口服常释剂型6810.1.1奈达铂Nedaplatin注射剂69增10.1.2卡培他滨Capecitabine颗粒剂70增10.1.2氟尿嘧啶Fluorouracil植入用缓释注射剂71增10.1.2复方氟尿嘧啶CompoundFluorouracil口服液体剂72增10.1.3博莱霉素Bleomycin注射剂73增10.1.4伊立替康Irinotecan注射剂74增1O.3甘氨双唑钠Sodium Glycididazole注射剂75增10.3唑来膦酸ZoledronicAcid注射剂76增10.3重组改构人肿瘤坏死因子RecombinantHumanTumorNecrosisFactor注射剂77增11.1氯苯那敏Chlorphenamine缓释控释剂型78增11.2酮替芬Ketotifen口服液体剂79增12.1左旋多巴Levodopa注射剂80增12.3奥卡西平Oxcarbazepine口服常释剂型81增12.4二维三七桂利嗪Divitamins，NotoginsengandCinnarizine口服常释剂型82增12.4尼莫地平Nimodipine缓释控释剂型83增12.4尼莫地平Nimodipine颗粒剂84增12.4藻酸双酯钠Alginic Sodium Diester注射剂85增12.4长春西汀Vinpocetine注射剂86增12.4桂哌齐特Cinepazide注射剂87增12.4复方氨基丁酸维ECompoundAminobutynicAcidandVitaminE口服常释剂型88增12.5卡巴拉汀Rivastigmine口服常释剂型89增12.5鼠神经生长因子Mouse Nerve Growth Factor注射剂90增12.5胞磷胆碱Citicoline口服常释剂型91增12.5复方脑蛋白水解物CompoundCerebroproteinHydrolysate口服常释剂型92增12.5脑蛋白水解物CerebroproteinHydrolysate注射剂93增12.5脑苷肌肽CattleEncephalonGlycosideandIgnotin注射剂94增12.5小牛血清去蛋白Deproteinised Calf Blood注射剂95增12.5小牛血去蛋白提取物DeproteinizedCalfBloodExtractives注射剂96增12.5依达拉奉Edaravone注射剂97增12.8复方甘露醇Compound Mannitol注射剂98增12.8细胞色素CCytochrome C口服常释剂型99增12.8乙酰天麻素Acetagastrodin口服常释剂型100增12.8长春胺Vincamine缓释控释剂型101增13.1癸酸氟哌啶醇HaloperidolDecanoate注射剂102增13.1阿立哌唑Aripiprazole口服常释剂型103增13.1米氮平mirtazapine口服常释剂型104增14.1氨溴索Ambroxol缓释控释剂型105增14.1复方甘草氯化铵CompoundLicoriceExtractumandAmmoniumChloride口服常释剂型106增14.1复方枇杷氯化铵CompoundLoguatandAmmoniumChloride口服液体剂107增14.1羧甲司坦Carbocisteine颗粒剂108增14.2复方磷酸可待因Compound Codeine Phosphate口服常释剂型109增14.2可待因桔梗Codeine Platycodon Compound口服常释剂型110增14.2右美沙芬DextromethorphanHydrobromide注射剂111增14.3班布特罗Bambuterol口服液体剂112增14.3复方氨茶碱CompoundAminophylline口服常释剂型113增14.3细辛脑Asarone注射剂114增15.1.1枸橼酸铋钾/替硝唑/克拉霉素Bismuth Potassium Citrate，Tinidazole and Clarithiomycin口服常释剂型药品注册受理号Y0401932，批件号2004B01253115增15.1.1尿囊素铝Aldioxa颗粒剂116增15.1.1曲昔匹特Troxipide口服常释剂型117增15.1.1醋氨己酸锌Acexamate Zinc口服常释剂型118增15.2多酶Multienzyme口服常释剂型119增15.2乳酸菌素Lacidophilin口服常释剂型120增15.2胃蛋白酶Pepsin口服液体剂121增15.3.2阿扎司琼Azasetron注射剂限高催吐放化疗使用122增15.5复方蛋氨酸胆碱Compound Methionine and Choline Bitartrate注射剂123增15.5促肝细胞生长素HepatocyteGrowth-promotingFactorGranules颗粒剂124增15.5苦参素Marine口服常释剂型125增15.5苦参碱Matrine注射剂126增15.5复方联苯双酯CompoundBifendate口服常释剂型127增15.5亮菌甲素Armillarisinum注射剂128增15.6柠檬烯Limonene口服常释剂型129增15.8维酶素Vitacoenayme口服常释剂型130增16.1.2去乙酰毛花苷Deslanoside注射剂131增16.4贝尼地平Benidipine口服常释剂型132增16.5美托洛尔Metoprolo缓释控释剂型133增16.9单硝酸异山梨酯Isosorbide Mononitrate缓释控释剂型 口服常释剂型134增16.9阿魏酸钠SodiumFerulate注射剂135增16.10异丙肾上腺素Isoprenaline口服常释剂型136增16.12环磷腺苷葡胺Meglumine Adenosine Cyclphosphate注射剂限心衰137增16.12二丁酰环磷酰苷钙CalciiDibutyry-ladenosiniCyclophosphas注射剂限心衰138增16.12复合辅酶CoenzymeComplex注射剂139增16.12辅酶QCoenzyme Q口服常释剂型140增18.1卡络磺钠CarbazochromeSodiumSulfonate口服常释剂型141增18.1卡络磺钠CarbazochromeSodiumSulfonate注射剂142增18.2.1舒洛地特Sulodexide口服常释剂型143增18.2.2瑞替普酶Reteplase注射剂限急性心肌梗死12小时内抢救144增18.3水解蛋白ProteinHydrolysate注射剂145增18.6双嘧达莫Dipyridamole缓释控释剂型146增19葡萄糖氯化钙GlucoseandCalciumChloride注射剂147增19木糖醇Xylitol注射剂148增20.1.1.1克林霉素甲硝唑ClindamycinandMetronideazole外用液体剂149增20.1.1.2复方酮康唑CompoundKetoconazole软膏剂150增20.1.3卤米松三氯生Halometasone and Triclosan软膏剂151增20.1.4复方氧化锌CompoundZincOxide软膏剂152增20.2.1.2重组人干扰素1bRecombinantHumanInterferon1b滴眼剂153增20.2.3氟美松龙Fluorometholone滴眼剂154增20.2.4拉坦前列素Latanoprost滴眼剂155增21.1依地酸钙钠Calcium Disodium Edetate口服常释剂型156增21.3复方氯解磷定CompoundPralidoxineChloride注射剂157删12.1司来吉兰Selegiline口服常释剂型158删12.8石杉碱甲Huperzine A口服常释剂型159删12.8乙哌立松Eperisone口服常释剂型160删15.1.1吉法酯Gefarnate口服常释剂型161删16.2阿普林定Aprindine口服常释剂型162删16.4乐卡地平Lercanidipine口服常释剂型163删16.9复方利血平氨苯蝶啶Compound Hypoensive口服常释剂型164删16.1米多君Midodrine口服常释剂型165删16.12己酮可可碱Pentoxifylline口服常释剂型 缓释控释剂型166删23精制抗蛇毒血清Refined Anti-Cobra Venom Serum注射剂青海省基本医疗保险和工伤保险药品目录乙类药品调整品种表(中成药部分)序号增删分类编号药品名称支付范围限定1增1.8.1.1芪参胶囊2增1.11.2复方丹蛭片3增1.11.7灯盏花颗粒4增1.12.1丹栀逍遥片5增1.12.2陇马陆胃药片6增1.14.4头痛宁胶囊7增1.14.4天麻胶囊（片、丸）8增1.15.5肾康注射液9增1.15.6爱活尿通10增1.3.1四季三黄软胶囊11增1.3.2板蓝解毒注射液12增1.3.2复方穿心莲片13增1.3.2莲花清瘟胶囊14增1.3.2血必净注射液15增1.3.2炎琥宁注射剂16增1.3.2土贝母皂苷注射液17增1.3.2穿心莲内酯滴丸18增1.3.2抗病毒软胶囊19增1.3.4.2云芝肝泰胶囊（颗粒、片）20增1.3.4.3乙肝健片21增1.5.2羚贝止咳糖浆22增1.5.3感咳双清胶囊23增1.5.3