基层医院5695张中药饮片处方点评结果分析

Analysis on 5 695 prescriptions of TCM decoction pieces in a fundamental hospital

目的通过对我院中药饮片处方点评分析,了解其临床合理用药情况,促进临床合理用药水平提高。方法选取我院2015年7月份和8月份2个月的全部成人(年龄>18岁)中药饮片门诊处方共5 695张,结合《医院处方点评管理规范》、《处方管理办法》和《中药处方格式及书写规范》等法律法规对抽取的处方进行点评,将不合理处方区分为不规范处方、不适宜处方和超常处方。结果 5 695张处方中不合理处方634张(11.12%),不合理处方主要表现为不规范处方583张(91.96%)和不适宜处方51张(8.04%)。不规范处方主要为脚注问题306张(48.26%)、诊断问题240张(37.85%)和疗程(处方超7 d量)问题37张(5.84%);不适宜处方主要表现为有毒中药饮片超过药典规定剂量(50张,7.89%),另有重复用药1张(0.16%)。结论我院中药饮片处方不合格率较高,临床医师、药师应重视中药饮片处方的规范性,确保临床用药安全、有效。

Objective To understand the irrational drug use in a Fundamental hospital by analysis of the prescription of traditional Chinese medicine（TCM）decoction pieces so as to decrease the irrational drug use rate and improve the level of clinical rational drug use. Methods All of adult prescriptions over 18 years of age were extracted from July 1 st to August 31 st in 2015 and evaluated in accordance with prescription administrative method hospital prescription comments management norms and prescription of traditional Chinese medicine Format and Writing Norms. Unqualified prescriptions were classified into three types,such as non-standard prescription,inappropriate prescriptions and supernormal prescription. Results A total of 5695 adult prescriptions of Chinese herbal medicine were collected in two months of July and August in 2015,of which 634 prescriptions were unqualified,indicating unqualification rates of 11.12%. The irrational prescriptions included 583 irregular prescriptions（91.96%）and 51 inappropriate prescriptions（8.04%）.Non-standard prescriptions included 306 prescriptions（48.26%）which had footnote problems,240 prescriptions（37.85%）which had diagnostic issues,and 37 prescriptions（5.84%）which prescription time was out of 7 days. There were 50 inappropriate prescriptions（7.89%）which problems were toxic Chinese herbal tablet exceeding the prescribed dosage of Pharmacopoeia,and 1 inappropriate prescription（0.16%）which was repeated prescription. Conclusion The unqualification rate of Chinese herbal medicine prescriptions in our hospital is relatively high. Attention should be paid to the normalization of Chinese herbal medicine prescriptions so as to ensure the safe and effective use of drugs.