2022年—2023年某院药剂科中药饮片处方用药现状及质量管理建议

Current Situation and Quality Management Suggestions of TCM Decoction Piece Prescription in Pharmacy Department of a Hospital from 2022 to 2023

目的 分析2022年—2023年西安市阎良区人民医院药剂科中药饮片处方用药现状,并提出中药饮片质量管理建议。方法 随机抽样选取2022年2月—2023年2月500张西安市阎良区人民医院门诊中药饮片处方。分析中药饮片的使用量、频率、超剂量使用情况,同时分析不合理用药处方发生原因,统计用药后不良反应发生情况。结果 经分析,500张处方中,7至13副为369张,占比最高(73.80%),药物总剂量为201g至400g合计占比最高(73.80%)。500张处方中出现频次前三味的中药饮片分别为甘草(44.20%)、黄芩(43.60%)、黄芪(40.00%),超剂量使用频率前三味分别为黄连(46.67%)、枸杞(44.44%)、连翘(32.80%)。500张处方中发现不合理处方29张,总占比为5.80%。500例患者用药后不良反应发生率为5.20%(26/500)。结论 500张处方中清热、补虚类方剂中药物超量使用情况较多;中药饮片处方不合理类型主要为用量不适宜、处方未按“君臣佐使”排列、诊断书写不规范,药剂科在后续工作中应当强化用药合理性审查,积极推动相关制度及标准的建设与完善,以全面提高药物服务质量,保障用药安全性。

Objective This paper analyzed the current situation of TCM decoction piece prescriptions in the Pharmacy Department of Yanliang District People's Hospital of Xi'an City from 2022 to 2023 and put forward suggestions on the quality management of TCM decoction pieces.Methods A total of 500 prescriptions of TCM decoction pieces from the outpatient department of Yanliang District People's Hospital of Xi'an City in February 2022 and February 2023 were randomly selected.The usage,frequency,and excessive use of TCM decoction pieces were analyzed,and the causes of irrational drug prescriptions were analyzed.The adverse reactions after drug use were counted.Results After analysis,among the 500 prescriptions,369 prescriptions included 7–13 pairs of TCM decoction pieces,accounting for the highest proportion(73.80%),and the total dose of the drug was 201–400 g,accounting for the highest proportion(73.80%).Among the 500 prescriptions,the top three TCM decoction pieces were Radix et Rhizoma Glycyrrhizae(44.20%),Radix Scutellariae(43.60%),and Radix Astragali(40.00%).The top three TCM decoction pieces with excessive use were Rhizoma Coptidis(46.67%),Fructus Lycii(44.44%),and Fructus Forsythiae(32.80%).Among the 500 prescriptions,29 were found to be unreasonable prescriptions,accounting for 5.80%.The incidence of adverse reactions in 500 patients was 5.20%(26/500).Conclusion It can be seen from the study that the excessive use of heat-clearing and deficiency-tonifying drugs is more in 500 prescriptions.The irrational types of TCM decoction pieces prescriptions are mainly inappropriate dosage;monarch drugs and adjuvant drugs in prescriptions are not rationally arranged,and the diagnosis is not standardized.The pharmacy department should strengthen the examination of the rationality of drug use in the follow-up work and actively promote the construction and improvement of relevant systems and standards,so as to comprehensively improve the quality of drug service and ensure the safety of drug use.