基于中药处方用药特点分析的社区医院中医药建设探讨

Analysis on Traditional Chinese Medicine Construction in Community Hospitals Based on the Characteristics of Prescription of Traditional Chinese Medicine

目的:为社区医院中医药系统建设提供参考。方法:采用Excel 2010和R语言对成都市双流区某社区医院2020年1-12月的中药饮片和配方颗粒处方进行回顾性分析。结果:该社区医院中医科室在2020年共诊疗患者3045人次,以0~18岁的婴幼儿和青少年为主(47.31%);16.67%的中医医生接诊处方量占总中医处方量的83.54%,少数医生接诊量占比高,头部效应明显。处方中中药配方颗粒总体使用率为43.51%,给婴幼儿开具的处方中使用率高达94.19%。配方颗粒组成的处方因药味和药量少,并未对患者造成经济负担。66.32%的毒性中药使用超过了2020年版《中华人民共和国药典》规定最大用量;不合理处方中66.03%未写特殊煎法,应引起重视。结论:中医药社区诊疗可通过加大中药配方颗粒的推广和普及,并建立有毒饮片使用规范等制度,同时提高软硬件条件,从而提升社区医院中医药服务水平。

Objective:To provide some references for the construction of traditional Chinese medicine(TCM)system in community hospitals.Methods:The prescriptions of TCM decoction pieces and TCM formula granules from January to December in 2020 in the community hospital of Shuangliu district,Chengdu were retrospectively analyzed by Excel 2010 and R language.Results:In 2020,the TCM department of the community hospital treated a total of 3045 patients.Among them,most patients were infants and adolescents aged 0-18 years old,accounting for 47.31%.16.67% of TCM doctors in the community received 83.54% of the total TCM prescriptions,which indicated that a few doctors received a high proportion and the head aggregation effect was obvious.The overall utilization rate of TCM formula granules in prescriptions account for 43.51%.The utilization rate rate of prescription for infants reached up to 94.19%.The prescription of formula granules brought no economic burden to patients,for these medicines have fewer medicinal materials and smaller dosages.66.32% of toxic Chinese medicines used in the community hospital exceeded the maximum dosage prescribed by Chinese Pharmacopoeia(2020 Edition).66.03% of unreasonable prescriptions didn’t show special decocting methods,which should be paid more attention to.Conclusion:TCM services in community hospitals can improve their software and hardware conditions by increasing the promotion and popularization of TCM formula granules,establishing a reasonable system for the use of toxic TCM slices,thus the service of TCM in community hospitals would be improved eventually.