临床不合理使用中成药医嘱分析

Analysis on irrational use of Chinese patent medicine in clinic

目的:了解某院住院病历中中成药用药状况,发现并纠正病历中开具中成药不合理用药现象,促进临床合理用药,提高医疗质量,充分发挥中成药的临床治疗作用。方法:分析2018年1—12月某院开展病历质控点评和重点监控品种专项点评抽查的病历2160份,根据药品说明书、《中成药临床应用指导原则》、《中华人民共和国药典》(2015版)、《新编药物学》(第18版)对不合理使用中成药病历进行分类统计与分析。结果:2160份病历中有30份在中成药应用方面存在用药不合理的情况,约占1.4%。中成药不合理用药具体体现为适应症不适宜、中成药联合用药不合理、重复用药、中西药联用不适宜等。结论:某院住院病历在中成药使用上仍存在不合理现象,中成药的合理使用离不开医疗质控管理部门和临床药师的密切配合,建议加大点评力度,促进临床中成药的合理使用。

Objective:To understand the status of Chinese patent medicines in the medical records of a hospital,find out and correct the irrational use of Chinese patent medicines in the medical records,promote the rational use of Chinese patent medicines in clinical practice,improve the medical quality,and give full play to the clinical therapeutic effect of Chinese patent medicines.Methods:From January 2018 to December 2018,a total of 2160 medical records of Quality Control Review and special review of key monitored varieties were analyzed,according to the manual of medicine,the 2015 edition of Pharmacopoeia of the People's Republic of China,the 18th edition of New Pharmacology,and the management standard of hospital prescription review(trial),the medical records of irrational use of Chinese patent medicines were classified and analyzed.Results:30 out of 2160 medical records(about 1.4%)showed irrational use of Chinese patent medicines.The irrational use of Chinese patent medicines is embodied in the inappropriate indications,irrational combination of Chinese patent medicines,repeated use of Chinese patent medicines and unsuitable combination of Chinese and Western medicines.Conclusion:There are still some unreasonable phenomena in the use of Chinese patent medicines in the medical records of a certain hospital.The rational use of Chinese patent medicines can not be separated from the close cooperation between the Management Department of Medical Quality Control and clinical pharmacists,promoting the rational use of clinical Chinese patent medicine.