中药饮片配方质量强化干预对中药处方合理性的影响

The Impact of Quality Enhancement Intervention on the Rationality of Traditional Chinese Medicine Prescriptions in Chinese Herbal Medicine Decoction Pieces

目的讨论并分析中药饮片配方质量对中药处方的合理性的影响。方法我中心自2022年9月1日起施行中药饮片配方质量强化干预。以开具时间前后为依据,抽取2021年8月至2022年8月使用并保存的中药处方共77份,定义为对照组(监管方式为常规质量监管),并以同样方式抽取2022年9月至2023年9月使用并保存的中药处方共77份,定义为强化组(监管方式为强化常规质量监管)。对比两组中药处方的疗效、不良反应发生情况、用药不合理性及患者治疗总满意度。结果①对照组处方治疗有效率为84.42%,而强化组处方有效率为97.40%,两组处方治疗有效率对比差异较大,有统计学意义(P<0.05)。②对照组恶心6例、发热4例、皮疹2例、其他3例,而强化组恶心2例、发热1例、皮疹0例、其他2例。两组处方不良反应发生率对比差异显著,有统计学意义(P<0.05)。③对照组饮片数量不合理4例、单味饮片剂量不合理5例、毒性饮片剂量较大3例、不同毒性饮片使用不合理4例,而强化组单味饮片剂量不合理、毒性饮片剂量较大例数均为0例,且其他用药不合理情况发生例数均低于对照组,组间数据对比差异较大,有统计学意义(P<0.05)。④强化干预前,患者的治疗总满意度仅为81.82%,而强化干预后的治疗总满意度上升至97.40%,二者相比差异较大,有统计学意义(P<0.05)。结论中药饮片配方质量强化干预可进一步提高中药处方疗效,减少不良反应,提高用药合理性。

Objective To discuss and analyze the influence of the quality of the formula of traditional Chinese medicine decoction pieces on the rationality of traditional Chinese medicine prescription.Methods Our center implemented the intensive intervention on the quality of the formula of traditional Chinese medicine decoction pieces from September 1,2022.Based on the time of issuance,a total of 77 TCM prescriptions used and preserved from August 2021 to August 2022 were sampled and defined as the control group(the supervision method was routine quality supervision),and a total of 77 TCM prescriptions used and preserved from September 2022 to September 2023 were selected in the same way,which was defined as the strengthen group(strengthen routine quality supervision).The efficacy,adverse reactions,irrationality of medication and treatment total satisfaction between the two groups were compared.Results(1)The effective rate of prescription treatment in the control group was 84.42%,while that in the strengthen group was 97.40%,and there was a significant difference in the effective rate of prescription treatment between the two groups(P<0.05).(2)There were 6 cases of nausea,4 cases of fever,2 cases of rash and 3 cases in the control group,while 2 cases of nausea,1 case of fever,0 cases of rash and 2 cases of others in the strengthen group.There was a significant difference in the incidence of prescription adverse reactions between the two groups(P<0.05).(3)There were 4 cases of unreasonable number of decoction pieces,5 cases of unreasonable dose of single decoction pieces,3 cases of large dose of toxic decoction pieces,and 4 cases of unreasonable use of different toxic decoction pieces in the control group,while the number of cases of unreasonable dose of single decoction pieces and large dose of toxic decoction pieces in the strengthen group were 0 cases,and the number of cases of unreasonable use of other drugs was lower than that of the control group,and the data comparison between the groups was statistically significant(P<0.05).(4)Before the strengthen intervention,the patients'total satisfaction with the treatment was only 81.82%,but after the strengthen intervention,the total satisfaction with the treatment increased to 97.40%.There was a significant difference in two groups(P<0.05).Conclusions The strengthen intervention of TCM decoction formula quality can further improve the efficacy of TCM prescription,reduce adverse reactions,and improve the rationality of medication.