综合医疗卫生机构临床医师中成药使用的调查分析

Investigation and Analysis on Clinical Application of Proprietary Chinese Medicine by Clinicians in Integrated Medical Institutions

目的:为促进中成药的临床合理应用提供参考。方法:设计问卷调查表,内容包括中成药临床应用相关问题(如中成药用药依据及习惯、联合用药、临床疗效及其影响因素、特殊群体用药安全性等)及建议。通过发放调查问卷的形式对四川省西南地区及成都市部分二、三级综合医疗卫生机构的临床医师进行无记名问卷调查,对回收问卷相关数据进行统计,分析临床医师使用中成药现状及存在问题,并提出建议。结果:共发放调查问卷300份,回收有效问卷264份,有效回收率为88.0%。受访临床医师以本科为主,技术职称以住院医师与主治医师为主;入职后接受过中医药基础理论培训的仅6.8%;经常应用中成药的占36.4%,且用药依据以药品说明书(64.0%)和临床经验(55.3%)为主;51.1%认为适应证不明确影响中成药的应用,64.0%认为中成药药品说明书不能满足临床工作需要。在简述题的回答中,受访临床医师普遍认为中成药药品说明书过于简单,需进一步完善。结论:中成药临床应用中存在的问题不容忽视。国家相关部门应加强中成药临床应用的监管,加强中成药上市后的再评价工作,为不断完善中成药药品说明书提供数据支撑。医疗卫生机构应适时对使用中成药的临床医师进行相关培训,药师应依据《中成药临床应用指导原则》《处方管理办法》等规范加大中成药处方的审核和专项处方点评力度,切实发挥其在促进合理用药中的作用。

OBJECTIVE：To understand the application of proprietary Chinese medicine by clinicians in integrated medical insti-tutions,and provide reference for its rational use. METHODS：The questionnaire was designed,including related issues of proprie-tary Chinese medicine clinical application（such as medication basis of proprietary Chinese medicine,combined medication,clini-cal efficacy and its influencing factors,medication for special groups and so on）and suggestions;the questionnaires were delivered to the clinicians who worked in some second and third grade of integrated medical institutions located in southwestern regions and Chengdu,and the questionnaires was in the form of an anonymous;relevant data of available questionnaire were collected statisti-cally;the application situation of proprietary Chinese medicines and the existence question were analyzed,and suggestions were put forward. RESULTS：Totally 300 questionnaires were sent out,264 were effectively received,with effective rate of 88.0%. The clinicians involved in investigation were mainly in undergraduate,mostly the resident physicians and attending physician;only 6.8%of the physicians received the training of basic theory of traditional Chinese medicine after work;36.4%physicians often pre-scribe proprietary Chinese medicines,and the medication basis was mainly in package insert （64.0%） and clinical experience （55.3%）;51.1% thought unclear indications affected the application of proprietary Chinese medicines,64.0% thought package in-sert can not meet clinical needs. In terms of answers in brief questions,the surveyed clinicians generally considered the package in-sert was too simple,which needed further perfected. CONCLUSIONS：The problems in clinical application of proprietary Chinese medicines should not be ignored. The relevant departments should strengthen the supervision of clinical application of proprietary Chinese medicines,and strengthen the re-evaluation of proprietary Chinese medicines market,as to provide data support for the continuous improvement of package insert. Medical institutions should carry out training timely for the physicians who prescribe pro-prietary Chinese medicines,the pharmacists should strengthen checking of proprietary Chinese medicines prescription and special prescription comment,and ensure prescription checking and comment play a active role in promoting rational drug use based on“proprietary Chinese medicines clinical application guiding principle”“prescription management method”.