关于中成药处方点评实施要点的探讨

Discussion on the main points of implementation of comment on Chinese Medicine Prescriptions

目的探讨中成药处方点评实施要点及干预措施。方法选择2020年1月~2020年12月医院门诊中成药处方1200张作为对象,分析不同处方科室来源,统计中成药处方中成药物不合理使用情况、科室分布、药物类型及患者年龄段等,并完成数据的分类,针对可能的原因采取相应的措施进行干预。结果本研究调查某院12个月中成药处方,每个月抽取处方数100张,合计处方1200张。通过对抽取的中成药处方进行点评,结果表明:不合理处方数为155份,不合格率为12.92%。不合格中成药处方类型相对较多,排在前三位的分别为:适应证不适应、用法用量不适宜和重复用药,分别占:29.68%、25.81%和20.00%;本研究罗列了处方适应证不适宜主要集中在普外科、肿瘤科、消化科,主要是未考虑患者症状及疾病类型用药;而药物用法用量不适宜主要是未考虑成人与儿童用药等特殊情况;医院不同科室出现频次相对较高的重复用药类型包括:盆腔炎、咽炎、冠心病等,患者均以中成药处方重复用药为主。结论中成药处方中不合理处方发生率较高,且主要以药物的适应证不适宜、用法用量不适宜和重复用药为主,应根据上述可能的因素,从医师、药师及医院管理系统等方面进行综合干预,提高患者用药合理性。

Objective To explore the key points and intervention measures of prescription reviews of Chinese patent medicines.Methods Select 1200prescriptions of Chinese patent medicines in hospital outpatient clinics from January 2020 to December 2020 as the object,analyze the sources of different prescription departments,and count the unreasonable use of Chinese patent medicine prescriptions,the distribution of departments,the types of medicines and the age groups of patients,etc.,complete the classification of the data,and take corresponding measures to intervene for possible reasons.Results This study investigated the prescriptions of Chinese patent medicines in our hospital for 12 months.A total of 100 prescriptions were drawn every month,for a total of 1200 prescriptions.By reviewing the selected prescriptions of Chinese patent medicines,the results showed that:the number of unreasonable prescriptions was 155,and the unqualified rate was 12.92%.There are relatively many types of unqualified proprietary Chinese medicine prescriptions,and the top three are:unsuitable indications,inappropriate usage and dosage,and repeated medication,accounting for 29.68%,25.81% and 20.00% respectively;this study lists prescription adaptations symptoms are mainly concentrated in general surgery,oncology,and gastroenterology,mainly because the patient’s symptoms and disease types are not considered;and the dosage of drugs is mainly not considering special conditions such as adult and children’s medication;63 sheets of repeated medication,gynecology 40 sheets,23 sheets of Chinese medicine department.In this study,the types of repeated medications with a relatively high frequency in different departments of the hospital are listed,including:pelvic inflammatory disease,pharyngitis,coronary heart disease,etc.The patients are mainly prescribed Chinese patent medicines for repeated medication.Conclusion The incidence of irrational prescriptions in the prescription of Chinese patent medicines is relatively high,and the main reasons are that the indications of the drug are not suitable,the usage and dosage is not suitable for repeated use,and the usage and dosage are not suitable.According to the above possible factors,the doctor,pharmacist and comprehensive interventions in the hospital management system and other aspects to improve the rationality of patients’medication.