2014年8月-2017年7月厦门大学附属中山医院中药配方颗粒和传统中药饮片应用分析

Analysis on Application of Chinese Medicinal Granules and Traditional Chinese Medicine Decoction Pieces in Zhongshan Hospital Affiliated to Xiamen University from Aug. 2014 to Jul. 2017

目的:了解中药配方颗粒、传统中药饮片的临床应用情况和医师、患者对中药配方颗粒的态度,探讨中药配方颗粒给传统中药饮片带来的冲击及其应用前景。方法:调取厦门大学附属中山医院2014年8月—2017年7月中药配方颗粒和传统中药饮片使用数据,对两者的使用量、使用金额、处方量及处方金额等进行统计分析;通过问卷调查,了解医师和患者对中药配方颗粒的看法。结果:2014年8月—2015年7月,中药配方颗粒的使用金额稳步上升,传统中药饮片的使用金额快速下降;2015年8月后,传统中药饮片的使用金额相对稳定;2016年8月后,中药配方颗粒的使用金额持续下降,2017年5—7月降至23.12万元,仅为传统中药饮片的28.37%。中药配方颗粒的平均价格指数为(146.38±4.71)元/kg,平均处方金额为(206.15±35.95)元;传统中药饮片的平均价格指数为(117.71±11.81)元/kg,平均处方金额为(151.91±24.47)元。医师和患者对中药配方颗粒看法的问卷调查结果显示,"完全接受"和"不能接受"者占比较小,"可以考虑"者占比最大。结论:作为传统中药饮片的补充,中药配方颗粒的应用有临床基础和社会基础。临床疗效和价格因素是其临床应用的困扰焦点,等效性临床研究和药物经济学评价是解决问题的办法。

OBJECTIVE： To investigate the clinical application of Chinese medicinal granules and traditional Chinese medicine decoction pieces,to investigate the attitudes of clinicians and patients towards Chinese medicinal granules,to probe into the impact of Chinese medicinal granules on traditional Chinese medicine decoction pieces and its application prospects. METHODS： Data of the application of Chinese medicinal granules and traditional Chinese medicine decoction piece in Zhongshan Hospital Affiliated to Xiamen University from Aug. 2014 to Jul. 2017 was collected and analyzed in terms of usage amount,consumption sum,number and amount of prescription; to investigate the opinions of clinicians and patients towards Chinese medicinal granules through questionnaire survey. RESULTS：During Aug. 2014 to Jul. 2015,the consumption sum of Chinese medicinal granules was in a stable increasing,the consumption sum of traditional Chinese medicine decoction pieces was in a rapid decreasing and remained stable after Aug. 2015; after Aug. 2016,the consumption sum of Chinese medicinal granules was in continuous declination,which reduced to 231. 2 thousand yuan from May to Jul. 2017,accounted for 28. 37% of that of the traditional Chinese medicine decoction piece. The average price of Chinese medicinal granules was（ 146. 38 ± 4. 71） yuan/kg,the average amount of prescription was（ 206. 15 ± 35. 95） yuan; the average price of Chinese medicinal granules was（ 117. 71 ± 11. 81） yuan/kg,the average amount of prescription was（ 151. 91 ± 24. 47） yuan. The results of questionnaire survey on the opinions of clinicians and patients towards Chinese medicinal granules indicated that people who chose ＂totally acceptable ＂ and ＂unacceptable ＂ accounted less,people who chose ＂may consider ＂accounted the most. CONCLUSIONS： As for the supplement of traditional Chinese medicine decoction pieces,theapplication of Chinese medicinal granules is under clinical and social bases. Clinical efficacy and price are the main troubles for its application,which can be solved by equivalence research and pharmacoeconomic evaluation.