1175张处方有毒中药饮片超剂量使用分析

Analysis of overdose toxic Chinese herbal pieces from 1175 prescriptions

目的分析北京市丰台区妇幼保健院(以下简称“我院”)1175张处方中有毒中药饮片超剂量使用情况,规范有毒中药饮片的合理应用。方法随机抽取我院2018年1~12月门诊和住院中药饮片处方4200张,以2015年版《中华人民共和国药典》一部和2011年版《北京市中药饮片调剂规程》中规定的中药饮片使用剂量范围为标准进行统计和分析。结果开具含有毒和小毒中药饮片处方共1175张(水煎口服和外用),占抽取处方总量的27.98%。其中共有21种毒性中药饮片涉及超剂量使用,21种超剂量使用有毒中药饮片中,超剂量使用频率最高的为法半夏,占17.19%,超剂量毒性饮片的处方统计中,法半夏超量处方比例48.51%,苦杏仁、制川乌、生艾叶、蛇床子处方比例超出40%。使用科室以妇科最多,占处方比例39.71%。结论中药饮片有毒药物超量应用的情况比较普遍,在临床中,应严格控制其使用剂量,科学合理地使用有毒中药饮片,避免不良反应事件的发生。

Objective To analyze the overdose use of poisonous Chinese herbal pieces in 1175 prescriptions of Pharmacy Department of Beijing Fengtai District Maternity&Baby Care Hospital(hereinafter referred to as“our hospital”),and to standardize the rational use of poisonous Chinese herbal pieces.Methods The 4200 prescriptions from January to December in 2018 in our hospital were counted and analyzed randomly based on the dose regulation by the Pharmacopoeia of the People′s Republic of China(2015 Edition)and Beijing Municipal Regulation Dispensing of Herbal Tablets(2011 Edition).Results The results showed that there were 1175 prescriptions(including oral and external use)containing toxic and mild toxic herbs covering 27.98%of the total prescriptions of which 21 kinds of toxic herbs were overdosed,and among the top frequency herbs were Rhizoma Pinelliae Preparata covering 17.19%of all the herbs.It covers 48.51%of the toxic herbs in the prescriptions containing toxic herbs,and Bitter Apricot Kernel,Radix Aconiti Preparata,Raw Mugwort,Fructus Cnidii were over 40%of the total prescriptions.The prescriptions of toxic herbs were mainly prescribed by Maternity Department,covering 39.71%.Conclusion It is very common that the prescription of overdose toxic Chinese herbal pieces are prescribed in clinic.It is concluded that proper and scientific application of toxic herbs should be practiced and toxic herbs should be strictly controlled to avoid adverse event.