我院儿科门诊0~12周岁儿童毒性中药处方的回顾性分析

Retrospective analysis of toxic traditional Chinese medicine prescriptions for children aged 0-12 years in pediatric outpatient department of our hospital

目的 分析我院儿科门诊2022年0~12周岁儿童毒性中药处方的使用情况及特点。方法 回顾性分析2022年我院儿科门诊0~12周岁儿童毒性中药处方的临床资料,并对患儿的年龄、性别、疾病、中药处方、剂量等数据进行统计分析。结果 调查获得处方共计816张,包含12种毒性中药成分。依照《中国药典(2020年版)》中对于毒性中药的描述,有毒中药为炒苍耳子、制草乌以及制川乌,小毒中药为燀苦杏仁、川楝子、蛇床子、艾叶、胆南星、法半夏、细辛、重楼以及蒺藜。这12味毒性药物中大部分为辛、苦药,主要归肺、肝、肾经。在我院儿科门诊816例0~12周岁患儿中,男518例,占比63.48%;女298例,占比36.52%。其中学龄前期(3~6岁)患儿使用含毒性中药处方占比最高,婴儿期患儿占比最低,4岁儿童毒性中药使用率居于第一位。含有毒性中药的处方大部分主治呼吸系统疾病,排名第1位的主要证型为风邪外袭证。在开具的含毒性中药处方中,排名前4位的中药分别是燀苦杏仁、法半夏、炒苍耳子以及细辛。部分药物(总计89例)存在超剂量使用情况,占比10.91%,其中法半夏占比最高。结论 目前,儿科门诊开具的中药处方中含有毒性中药属于普遍现象,但仍需要严格监督其合理使用,应尽量避免在用药过程中出现超药典剂量用药的情况。

Objective To analyze the use and characteristics of toxic traditional Chinese medicine prescriptions for children aged 0-12 years in the pediatric outpatient department of our hospital in 2022.Methods The clinical data of toxic traditional Chinese medicine prescriptions for children aged 0-12 years in the pediatric outpatient department of our hospital in 2022 were retrospectively analyzed,and the data of age,gender,disease,traditional Chinese medicine prescription and dosage were statistically analyzed.Results A total of 816 prescriptions were obtained,including 12 toxic traditional Chinese medicine components.According to the description of toxic traditional Chinese medicine in the Chinese Pharmacopoeia(2020 Edition),the toxic traditional Chinese medicine were stir-fried Xanthii Fructus,Aconiti Kusnezoffii Radix Cocta and Aconiti Radix Cocta,and the small toxic Chinese medicines were blazing Armeniacae Semen Amarum,Toosendan Fructus,Cnidii Fructus,Artemisiae Argyi Folium,Arisaema Cum Bile,Pinelliae Rhizoma Praeparatum,Asari Radix Et Rhizoma,Paridis Rhizoma and Tribuli Fructus.Most of these 12 toxic drugs were pungent and bitter drugs,mainly belonged to the lung,liver and kidney meridians.Among the 816 children aged 0-12 years in the pediatric outpatient department of our hospital,518 were male,accounting for 63.48%;there were 298 females,accounting for 36.52%.Among them,the use of toxic Chinese medicine prescriptions in preschool children(3-6 years old)accounted for the highest proportion,while the proportion of infants was the lowest,and the use rate of toxic Chinese medicine in 4-year-old children ranked the first.Most of the prescriptions containing toxic traditional Chinese medicine were mainly used for respiratory diseases,and the main syndrome type ranked first was the external attack of wind evil.In the prescription of toxic traditional Chinese medicine,the top four traditional Chinese medicine were blazing Armeniacae Semen Amarum,Pinelliae Rhizoma Praeparatum,stir-fried Xanthii Fructus and Asari Radix Et Rhizoma.Some drugs(89 cases in total)were overdosed,accounting for 10.91%of all drugs,of which Pinelliae Rhizoma Praeparatum accounted for the highest proportion.Conclusion At present,it is a common phenomenon that the prescriptions of traditional Chinese medicine issued by pediatric outpatient department contain toxic traditional Chinese medicine,but it still needs to strictly supervise its rational use,and should try to avoid the situation of overdose in the process of medication.