中药注射剂处方点评思路探索及分析

Ideas Exploration and Analysis on the Prescription Comment of TCM Injections

目的:探索中药注射剂处方点评思路,为临床合理用药提供参考。方法:抽取我院静脉药物配置中心(PIVAS)2015年医嘱9 457条和出院病历400份,对含中药注射剂的医嘱和病历的适应证、用法用量、联合用药、溶剂选择及重复用药等进行回顾性点评,并对典型病例进行分析。结果:我院PIVAS 2015年医嘱及出院病历中,使用中药注射剂的分别有2 544条(26.90%)和195份(48.75%);不合理使用主要为溶剂选择不适宜(50.70%)、用法用量不适宜(27.00%)、适应证不适宜(10.33%)、联合用药不适宜(7.51%)和重复用药(4.46%)。结论:中药注射剂处方点评应结合患者病史,进行个体化分析;对不合理医嘱和病历,中医临床药师应积极主动进行床旁干预。

OBJECTIVE：To explore the ideas for the prescription comment of TCM injections,and provide reference for clinical rational use. METHODS：Totally 9 457 prescriptions in PIVAS and 400 hospitalized medical records in our hospital in 2015 were collected. The prescriptions and hospitalized medical records which contained TCM injections were retrospectively commented in aspects of indications,usage and dosage,drug combination,solvent selection and repeat medication,and analysis of typical case. RESULTS：In 2015,there were 2 544 prescriptions（26.90%）in PIVAS and 195 medical records（48.75%）that used TCM injections;the irrational use was mainly inappropriate solvent selection（50.70%）,inappropriate usage and dosage（27.00%）,inappropriate indications（10.33%）,inappropriate combination therapy（7.51%） and repeat medication（4.46%）. CONCLUSIONS：Prescription of TCM injections should be commented with the medical records and individual analyzed;in terms of unreasonable prescriptions and medical records TCM clinical pharmacists should actively intervene unreasonable prescriptions by the bed.