中药处方分析方法应用于中药调剂中对临床安全用药的影响

Influence of traditional Chinese medicine prescription analysis method applied to traditional Chinese medicine dispensing on clinical safe medication

目的探讨中药调剂中应用处方分析方法对临床安全用药的影响。方法查阅整理我队2018年1月至2019年1月门诊部使用的7 000张中药处方,2018年1月至2018年6月中药调剂中未经处方分析的3 500张处方被设为对照组,2018年7月至2019年1月中药调剂中采用处方分析的3 500张处方设为观察组。比较两组的中药调剂差错率、单张中药处方味数及不合理处方占比。结果观察组的组方结构不明、处方书写不规范、药物剂量过大、未标明脚注、配伍禁忌、配药错误、发药错误的调剂差错率及总差错率均低于对照组(P<0.05)。两组单张中药处方的味数主要为10~20味,且观察组1~5味、6~10味占比高于对照组,11~15味及16~20味占比低于对照组(P<0.05)。观察组不合理处方占比低于对照组(P<0.05)。不合理处方主要包括诊断不符合规定、药物用量不合理、药物搭配不合理、脚注及煎煮用法不当及重复用药。结论在中药调剂中应用处方分析方法能降低差错率,减少处方不合理现象发生,避免用药过多过杂。

Objective To explore the influence of prescription analysis method applied to traditional Chinese medicine dispensing on clinical safe medication. Methods A total of 7 000 traditional Chinese medicine prescriptions used in the outpatient department of our team from January 2018 to January 2019 were checked and sorted out, 3 500 prescriptions in traditional Chinese medicine dispensing without prescription analysis from January to June 2018 were seted as control group, while 3 500 prescriptions in traditional Chinese medicine dispensing of prescription analysis from July 2018 to January 2019 were seted as observation group. The error rate of traditional Chinese medicine dispensing, the traditional Chinese medicine number of single prescriptions and the proportion of unreasonable prescription were compared between the two groups. Results Dispensing error rates of unknown formula structure, nonstandard prescription writing, excessive drug dosage, unmarked footnote, incompatibility contraindications, dispensing error and giveout drug error and the total error rate in the observation group were lower than those in the control group(P<0.05). The traditional Chinese medicine number of single prescription in the two groups was mainly 10-20, and the proportion of 1-5 and 6-10 in the observation group were higher than those in the control group, while the proportion of 11-15 and 16-20 were lower than those in the control group(P<0.05). The proportion of unreasonable prescription in the observation group was lower than that in the control group(P<0.05). Unreasonable prescription mainly included non-compliance of diagnosis, unreasonable dosage of drugs, unreasonable combination of drugs, improper footnote and decoction usage and repeated use of drugs. Conclusion The application of prescription analysis method in traditional Chinese medicine dispensing can reduce the error rate and the unreasonable phenomena of prescription, avoid excessive and miscellaneous use of drugs.