中医馆与中医坐堂医诊所中药饮片管理现状分析——以深圳市福田区为例

Investigation and Analysis of the Management of Decoction Pieces in Traditional Chinese Medicine Hospitals and Clinics:Taking Futian District in Shenzhen as an Example

目的调查分析深圳市福田区中医馆和中医坐堂医诊所中药饮片管理和使用现状及存在问题,为相关部门提供参考。方法根据《广东省医疗机构中药饮片管理专项检查评估细则》制定调查问卷,对福田区44家中医馆和中医坐堂医诊所的中药学人员资质,中药饮片采购、储藏、养护、调剂以及煎煮等方面进行调查,对结果进行统计分析。结果共发放问卷88份,回收有效问卷86份,有效回收率为97.73%。受访机构当天在岗中药师共55名(占70.51%),存在缺岗现象。13.63%的受访机构无法提供供货方的合法资质,56.82%的机构无法提供饮片检验报告及入库验收记录。11.36%的机构设置阴凉药库,81.82%的机构每月或每季度进行饮片养护。27.27%的机构尚未按要求印制处方,40.91%的机构审方、调剂签名不符合要求,77.27%的机构未定期对称量工具进行校对。84.10%的机构开展了饮片煎煮服务。结论福田区中医馆和中医坐堂医诊所目前存在专业人员缺乏、采购验收不严格、储藏养护不规范、审方调剂不严谨、中药煎煮服务不规范等共性问题,需完善管理制度、提高专业人员素质、加强行业自律自助、加大监管力度,以保障人民用药安全。

Objectives Through investigation and analysis of the management, utilization and existing problems of decoction pieces in traditional chinese medicine（TCM） hospitals and clinics in Futian District in Shenznen, this arucle intends to provide references for relating governmental sectors. Methods The questionnaire was designed based on the Regulations for Inspection and Assessment of the Management of TCM decoction pieces for Medical Institutes Guangdong Province. A survey was conducted among 44 TCM hospitals and clinics in Futian District to collect data about the qualification of pharmacists, and purchase, storage, maintenance, adjustment and tisane of the decoction pieces. The data was then analyzed statistically. Results 86 questionnaires were retrieved out of the 88 copies sent out, with a response rate of 97.73 %. 55 pharmacists（70.51% ）in these institutes were on duty with some staff skipping the work. 13.63% of the institutes could not provide proof for the legal qualification of the suppliers. 56.82 of the institutes could not provide the test report and inbound records. Storage rooms placed in a shady and cool place were found in 11.36 of these institutes. 81.82% carried out a monthly or seasonal maintenance of the pieces. 27.27% did not print the prescription according to standards. Unqualified review of the prescription and signature of adjustment existed in 40.91% of the institutes. Regular calibration for the measurement tools was not implemented in 77.27 of the institutes. 84.10% of the institutes provided tisane services. Conclusions Things like lace of professional personnel, lax purchase and inbound, unstandardized storage and maintenance, imprecise review and adjustment of the prescription, disqualified tisane services are all common problems existing in the TCM hospitals and clinics of Futian Distric. Measures should be taken to improve management system, elevate the qualification of the personnel,enhance self-regulation and cooperation within TCM profession, and strengthen regulation to guaran- tee the safety of medicine used by the patients.