中医医院中药处方比例和中医非药物治疗人次比例的分析与思考

Analysis and consideration on the proportion of prescriptions and the number of people using non-drug therapy of traditional Chinese medicine

目的:研究不同级别、类别和地区中医医院中药处方比例和中医非药物治疗人次比例情况,为相关决策提供参考。方法:收集2012年度全国各级各类中医医院的中药饮片处方数、中成药处方数、中医非药物治疗人次数、门诊处方总数、门诊总诊疗人次数、使用中药饮片的出院人次数和出院总人次等数据,进行分类和统计。结果:三级中医医院中药处方比例为66.38%,明显高于二级和一级医院;中医专科医院的中药处方比例达73.59%,明显高于其他类别医院;中部地区中医医院的中药处方比例明显高于东、西部;监测医院的一周门诊中医非药物治疗人次比例均值均大于10%;一周使用中药饮片的出院人次比例除中西医结合医院为42.70%外,其他类别医院均大于50%;小包装中药饮片在东部地区、在三级大医院中处方比例与散装中药饮片相近,明显高于中、西部和一、二级医院。结论:中医特有的治疗方式和特色疗法在中医临床被广泛使用;一、二级中医医院的中医药服务能力有待提高;小包装中药饮片在中、西部和一、二级中医医院的推广使用力度有待加强;应关注中医特色疗法在临床使用后的疗效和优势所在,以更好地优化中医医疗资源的配置。

OBJECTIVE To investigate the proportion of prescriptions and the number of people using non-drug therapy of traditional Chinese medicine （TCM） in different TCM hospitals, and provide reference for decision-making. METHODS The number of Chinese herbal prescription, the number of TCM prescription, the number of non-drug therapy, the total number of prescription in outpatients, the number of people using Chinese herbal pieces in discharged patients and the total number of dis- charged patients, etc. , were collected and analyzed respectively. RESULTS The proportions of prescriptions of TCM in first- class hospitals were 66. 38%, apparently higher than in second class or third-class hospitals; and the proportions in special hos pitals were 73.59~/oo, apparently higher than other categories of hospitals. The proportions of prescriptions of TCM in middle area were higher than that in eastern or western areas. The proportions of the people using non-drug therapy in TCM were all more than 10%. The proportions of the people using Chinese herbal pieces in discharged patients were more than 50% exclu- ding hospitals combining traditional Chinese and Western medicine. The proportions of small package of Chinese herbal pieces and the bulk of traditional Chinese herbal pieces in third - class and eastern region were nearly the same, and apparently higher than in middle or western region and first or second class hospital. CONCLUSION The treatment mode with TCM characteris- tic and distinctive therapy was widely used in the TCM hospitals. The TCM services ability in the first-grade and second-grade hospitals were needed to improve. The promotion of small package of Chinese herbal pieces in middle or western region should be strengthened. The curative effect and advantages of TCM characteristics therapeutics in clinic should be pay more attention to so as to optimize the allocation of the TCM medical resources.