73588张门诊中药饮片处方点评与分析

Analysis and Review on 73 588 Outpatient Prescriptions of Chinese Herbal Medicine Decoction Pieces

目的:了解上海市杨浦区中医医院(以下简称"我院")门诊中药饮片处方合理性,探讨不合理原因,以提高处方质量,促进临床合理用药。方法:抽取2016年3—11月我院门诊中药饮片处方73 588张,依据国家相关法律法规、《中华人民共和国药典》(2015年版)及中医药理论相关知识与文献,对处方进行点评与分析。结果:73 588张处方中,不合理处方69张(占0.094%);其中,适应证不适宜处方27张,诊断不全处方14张,未注明特殊用法处方12张,医师未签章处方11张,存在"十八反"处方4张、超常规剂量处方1张。结论:我院门诊中药饮片处方基本合理,但仍存在一些问题。药师应不断提高审方能力,将不合理处方杜绝在"事前";同时,医院应采取有效措施,促进医师合理用药,确保患者用药安全、有效。

OBJECTIVE： To investigate the rationality of outpatient prescriptions of Chinese herbal medicine decoction pieces in Shanghai Yangpu District Hospital of Traditional Chinese Medicine（ hereinafter referred to as ＂our hospital＂）,and probe into the irrational causes,so as to improve the quality of prescriptions and promote the rational drug application in clinic. METHODS： 73 588 outpatient prescriptions of Chinese herbal medicine decoction pieces were extracted from our hospital during Mar. to Nov. 2016,review and analysis were conducted by reference to the national laws and regulations,Pharmacopoeia of the People＇s Republic（ 2015 edition） and related knowledge and literature of traditional Chinese medicine theory. RESULTS： Of the 73 588 outpatient prescriptions,69 cases（ 0. 094%） were irrational prescriptions,among which,27 cases had improper indications,14 cases had incomplete diagnosis,12 cases had no indications for special application,11 cases had no signature of clinicians,4 cases had eighteen incompatible medicaments and 1 case had abnormal dosage. CONCLUSIONS： The outpatient prescriptions of Chinese herbal medicine decoction pieces are basically rational in our hospital,yet there are still some irrational problems. The pharmacists should continuously improve the ability of examining and eliminate unqualified prescriptions in advance; in the meantime,the hospital should take effective measures to promote the rational application of drugs and ensure the safe and effective medication.