《国家基本医疗保险、工伤保险和生育保险药品目录》含十八反十九畏药对的成方制剂及临床应用分析

Analyzing Chinese Patent Medicine Containing Eighteen Incompatible Herbs and Nineteen Herbs of Mutual Antagonism in Medicine Catalogue for National Basic Medical Insurance,Injury Insurance and Maternity Insurance

目的:"十八反、十九畏"是中医临床用药配伍禁忌的重要组成部分,然历代医家对此问题争议颇多,临床报道也屡见不鲜。《医保目录》是由中国人力资源与社会保障部颁布的,指导药品临床合理用药的依据。方法:本文对2009年版《医保目录》中成药部分含十八反、十九畏药对的成方制剂进行整理,分别从这些含反药药对成方制剂的收载情况、反药药对出现频率、处方药味数、剂型用法以及现代临床的应用方面进行了归纳分析。结果:据统计,《医保目录》中成药部分共收录成方制剂987个品种,其中含反药配伍的成方制剂9个,包括含十八反药对的品种5个,含十九畏药对的品种4个。结论:2009年版《医保目录》中成药中含反药药对成方制剂的用药特点,为探讨反药配伍的临床使用规律,指导临床合理安全使用十八反、十九畏提供思路。

Objective：Eighteen incompatible herbs and Nineteen herbs of mutual antagonism,the incompatibility between the traditional Chinese medicine（TCM） has had the history of thousands of years so far.Whether Eighteen incompatible herbs and Nineteen herbs of mutual antagonism are incompatibility or not has become one of the hot spot of academia right now.Method：The medicine catalogue for the national basic medical insurance,injury insurance and maternity insurance was issued by the department of social security and Human Resource,which improving the level of clinical use of drugs.Result：According to statistics,there are 987 kinds of patent Chinese medicine products（CPMs） in medicine catalogue for the national basic medical insurance,injury insurance and maternity insurance（2009 Edition）,in which 5 CPMs contain eighteen incompatible herbs and 4 CPMs contain Nineteen herbs of mutual antagonism.Conclusion：This paper analyze CPMs containing Eighteen incompatible herbs and Nineteen herbs of mutual antagonism to offer some elicitation for promoting rational drug use in the clinic.