社区卫生服务中心心脑血管疾病患者活血化瘀中成药应用现状分析

Analysis of application status of traditional Chinese medicines for promoting blood circulation and removing blood stasis in patients with cardiovascular and cerebrovascular diseases in a community health service center

目的分析社区卫生服务中心心脑血管疾病患者活血化瘀中成药使用现状,为临床合理应用提供依据。方法从上海市家庭医生门诊系统中调取上海市嘉定区真新社区卫生服务中心有缺血性心脑血管疾病的患者的临床资料,查询2018年1月份开具的活血化瘀中成药,进行整理、归纳、总结。结果该中心常用活血化瘀、通络平肝的药物26种,其中使用频率居前十位的分别是麝香保心丸、银杏叶片、培元通脑胶囊、复方丹参滴丸、银杏酮酯片、脑心通胶囊、丹参片、血塞通胶囊、银丹心脑通胶囊、强力天麻杜仲胶囊;药物联合使用较为普遍,最多使用8种相关药物。结论该中心活血化瘀类药物种类较多,存在缺少辨证论治、药物配伍不当、缺少疗程管理及监管不力等混乱现象,应加强全科医师相关知识培训,加强医患沟通,建立有效的监督管理和投诉机制。

Objective To analyze the current status of the use of traditional Chinese medicines for promoting blood circulation and removing blood stasis in patients with cardiovascular and cerebrovascular diseases in a community health service center and provides a basis for rational clinical application.Methods Selected the patients with ischemic cardio-cerebrovascular disease in Shanghai Jiading District Zhenxin Community Health Service Center from the family doctors outpatient system,and query the Chinese patent medicine for promoting blood circulation to remove blood stasis prescribed in January 2018,and then sorted and summarized these data.Results Twenty-six drugs were commonly used in the center to promote blood circulation,remove stasis,and clear the liver,among which the top ten most frequently used drugs were Shexiangbaoxin pill,Ginkgo biloba,Peiyuantongnao capsule,compound Danshen dropping pills,Ginkgo biloba ester tablets,Naoxintong capsule,Danshen tablet,Xuesaitong capsule,Yindanxinnaotong capsule,Qianglitianmaduzhong capsule;the combination of drugs was more common,and up to 8 related drugs were used.Conclusion There were many types of blood-activating drugs for removing blood stasis in this center.But there are some confusion phenomenon such as lacking of syndrome differentiation and treatment,improper drug compatibility,lacking of treatment management and poor supervision.It is necessary to strengthen the training of general practitioners,strengthen the communication between doctors and patients,and establish effective supervision and complaints mechanism.