北京部分医疗机构开展中药临方加工调研及分析

Research and analysis of personalized traditional Chinese medicine preparations in some medical institutions in Beijing

目的:了解北京地区医疗机构开展临方加工(临方制剂)的现状,普及“一人一方”相关知识,拓展传统中药剂型的服务空间,促进传统工艺在医疗机构的发展。方法:调研北京地区63家医疗机构,对其所开展的临方加工(临方制剂)现状及了解程度进行问卷调查。结果:此次调研共发放问卷70家医疗机构,收回有效问卷63份。其中中医院20家,占比31.75%(20/63);中西医结合医院15家,占比23.81%(15/63);综合性医院13家,占比20.63%(13/63);社区卫生服务中心及其他15家,占比23.81%(15/63)。三级医院41家,占比65.08%(41/63);二级医院7家,占比11.11%(7/63);一级医院及社区15家,占比23.81%(15/63)。对临方加工(制剂)概念的了解情况方面,其中45家了解,占比65.08%(45/63);基本了解21家,占比33.33%(21/63);不了解1家,占比1.59%(1/63)。45家医疗机构认为开展此项目非常重要,占比71.43%(45/63);一般重要16家,占比25.4%(16/63);可有可无或不清楚2家,占比3.18%(2/63)。了解临方制剂与中药制剂区别的28家,占比44.44%(28/63);基本了解29家,占比46.03%(29/63);不了解6家,占比9.52%(6/63)。了解传统工艺概念的35家,占比55.56%(35/63);基本了解25家,占比36.68%(25/63);不了解3家,占比4.76%(3/63)。其中已经开展临方加工(临方制剂)项目的41家,占比65.08%(41/63);未开展的占比22家,占比34.92%(22/63)。已经开展中药临方加工(制剂)项目的医疗机构可委托加工的剂型主要集中在中药汤剂的35家,占比85.37%(35/63);膏剂20家,占比48.78%(20/63);散剂19家,占比46.34%(19/63);丸剂11家,占比26.83%(11/63)。设有独立区域开展的23家,占比56.1%(23/63);与其他区域合并的13家,占比31.71%(13/63);在制剂室完成的3家,占比7.32%(3/63)。有收费标准的32家,占比78.05%(32/63);免费的9家,占比21.95%(9/63)。按公斤收费的12家,占比29.27%(12/63);按人次收费7家,占比17.07%(7/63);其他收费标准的22家,占比53.66%(22/63)。负责此项目工作的人员获得相关资质证书的26家,占比63.41%(26/63);药师兼职的14家,占比34.15%(14/63)。接受患者委托开展临方加工(临方制剂)前,与患者签订临方加工委托协议书的11家,占比26.83%(11/63);未签订的28家,占比68.29%(28/63);其他2家,占比4.88%(2/63)。结论:本研究包含了北京地区63家医疗机构,可大致反映北京部分医疗机构中药临方加工(临方制剂)的现状。临方加工(临方制剂)的开展需要统一的管理规定、技术及质量标准,使此项目高速发展,为患者提供个体化的中药服务。

Objective:To understand the current situation of clinical prescription processing(clinical prescription preparation)in medical institutions in Beijing,to popularize the knowledge of one person,one prescription,to expand the service space of traditional Chinese medicine dosage forms,and to promote the development of traditional crafts in medical institutions.Methods:Sixty-three medical institutions in Beijing were investigated,and a questionnaire survey was conducted on the current status and knowledge of the clinical prescription processing(clinical preparations)carried out by them.Results:A total of 70 medical institutions were issued questionnaires,and 63 valid questionnaires were returned.Among them,twenty TCM hospitals,accounting for 31.75%(20/63),fifteen the integrative medicine hospitals,accounting for 23.81%(15/63),thirteen general hospitals,accounting for 20.63%(13/63),15 community health service centers and other medical institutions,accounting for 23.81%(15/63).Forty-one tertiary hospitals,accounting for 65.08%(41/63),seven secondary hospitals,accounting for 11.11%(7/63),fifteen primary and community medical institutions,accounting for 23.81%(15/63).There are 45 medical institutions that know about clinical processing(preparation),accounting for 65.08%(45/63),21 of basic understanding,accounting for 33.33%(21/63),1 of do not understand,accounting for 1.59%(1/63).Forty-five medical institutions think it is very important to carry out this project,accounting for 71.43%(45/63),generally important 16,accounting for 25.4%(16/63),optional or unclear 2,accounting for 3.18%(2/63).There are 28 medical institutions understand the difference between clinical preparation and TCM medicine preparation,accounting for 44.44%(28/63),basically understand 29,accounting for 46.03%(29/63),do not understand 6,accounting for 9.52%(6/63).Understanding of the concept of traditional craft 35,accounting for 55.56%(35/63),basic understanding of 25,accounting for 36.68%(25/63),do not understand 3,accounting for 4.76%(3/63).Among them,forty-one have carried out clinical formula processing(clinical formula preparation)project,accounting for 65.08%(41/63),twenty-two have not carried out,accounting for 34.92%(22/63).There are 35 medical institutions that have carried out TCM medicine clinical prescription processing(preparation)project commissioned the dosage form of TCM decoction mainly,accounting for 85.37%(35/63),twenty cream,accounting for 48.78%(20/63),nineteen bulk,accounting for 46.34%(19/63),eleven Wan(丸),accounting for 26.83%(11/63).There are 23 independent areas to carry out,accounting for 56.1%(23/63),and 13 combined with other areas,accounting for 31.71%(13/63),and 3 done in the preparation room,accounting for 7.32%(3/63).Thirty-two with charges,accounting for 78.05%(32/63),and nine free,accounting for 21.95%(9/63).Twelve with charges by kilogram,accounting for 29.27%(12/63),seven with charges by attendance,accounting for 17.07%(7/63),and 22 with other charges,accounting for 53.66%(22/63).The personnel responsible for this project received relevant qualification certificates in 26 cases,accounting for 63.41%(26/63),and pharmacists worked part-time in 14 cases,accounting for 34.15%(14/63).Before accepting patients’commission to carry out clinical prescription processing(clinical prescription preparation),26.83%(11/63)signed a clinical prescription processing commission agreement with patients,68.29%(28/63)did not sign it,and 4.88%(2/63)was of others.Conclusion:This study includes 63 medical institutions in Beijing,which can roughly reflect the current situation of TCM medicine clinical prescription processing(clinical prescription preparation)in some medical institutions in Beijing.The development of clinical prescription processing(clinical prescription preparation)needs unified management regulations,technology and quality standards,so as to promote the development of this project,to provide individual traditional Chinese medicine services for patients.