Current Situation of Fritillaria thunbergii Miq. Production in Yinzhou District of Ningbo City

Yinzhou District of Ningbo City is the home and main production area of Fritillaria thunbergii Miq. Based on the analysis of Fritillaria thunbergii Miq. production in Yinzhou District in 2015,this paper firstly introduced current situation of Fritillaria thunbergii Miq. planting. The competition of Fritillaria thunbergii Miq. products was in disorder,the market price in 2015 dropped to half in 2014,and many Fritillaria thunbergii Miq. growers suffered losses. To keep sustainable development of traditional Fritillaria thunbergii Miq. industry in old production areas and maintain brand and name of genuine materials of " Zhejiang 8 Famous Kinds Herbal Medicines",it is required to actively reduce the inventory,make up short board,strengthen advantages,implement the reform of supply font,keep up with the times and market,and succeed through improving the quality.

药用植物平贝母(Fritillaria ussuriensis)组织培养的研究——Ⅰ.愈伤组织的诱导和器官分化及细胞学观察

本文对平贝母(Fritillaria ussuriensis Maxim)根、鳞茎、叶等器官在 MS,N_6,B_5,WS 和 H5种基本培养基上的培养进行详细观察。通过球状体及不定芽的形态发生曲线及差异显著性测定表明,不同培养基与激素及不同激素浓度与组合,对平贝母器官发生的影响,筛选出诱导高频率球状体与不定芽发生的培养基 MS+1.0 ppmIBA+1.0 ppmZT,MS+0.5 ppmIAA+2.0ppmBA,MS+2.0ppm NAA+0.5 ppmKT。培养过程中球状体与不定芽的形态发生的组织细胞学观察结果表明,球状体发生经过鳞片原基阶段,而不定芽发生不经此阶段;球状体形成后发育成不定芽,但生长情况优于直接产生的不定芽。早期球状体的染色体数目为2n=24。

Game Analysis of Regulation for Online Prescription Drugs under Customer Feedback Mechanism

Objective To study the way to better regulate the online sales of prescription drugs,and to provide reference for the adjustment of relevant policies since the online sales of prescription drugs has become an inevitable trend.Methods A game model was constructed for the strategy choice of pharmaceutical e-commerce platform,customers and government departments based on differential game theory and Nash equilibrium game model to analyze the pure strategy Nash equilibrium,Nash equilibrium dominant strategy of each subject and the mixed strategy Nash equilibrium under different conditions.Besides,Matlab was used to carry out simulation analysis.Results and Conclusion The study shows that:(1)Improving the credibility of the government and reducing the cost of government regulation can not only make the pharmaceutical e-commerce platform operate with high quality,but also give greater play to government functions;(2)The greater the influence of social evaluation on pharmaceutical e-commerce platforms,the lower the cost of high-quality operation of pharmaceutical e-commerce platform,and the greater the probability of customer choosing real evaluation strategy;(3)The greater the customers’perception of potential risk,the greater the compensation,and the lower the cost of reporting.Then,the greater the probability that government departments will choose strict regulation.Finally,the model solution and simulation analysis are combined to provide countermeasures and suggestions for the safety regulation of online sales of prescription drugs.

Compatibility Rules of Neonatal Parenteral Nutrition Prescriptions Based on Association Rules and Hierarchical Cluster Analysis

[Objectives]To explore the compatibility rules of neonatal parenteral nutrition(PN)prescriptions based on association rules and hierarchical cluster analysis,thereby providing a reference for standardizing neonatal parenteral nutrition supportive therapy.[Methods]The data about neonatal PN formulations prepared by the Pharmacy Intravenous Admixture Services(PIVAS)of the Affiliated Hospital of Chengde Medical University from July 2015 to June 2021 were collected.The general information of the prescriptions and the frequency of drug use were analyzed with Excel 2019;the boxplot of drug dosing was drawn using GraphPad 8.0 software;and SPSS Modeler 18.0 and SPSS Statistics 26.0 were used to perform association rules and hierarchical cluster analysis.[Results]A total of 11488 PN prescriptions were collected from 1421 newborns,involving 18 kinds of drugs,which were divided into 11 types of nutrients.Association rules analysis yielded 84 nutrient substance combinations.The combination of fat emulsion-water-soluble vitamins-fat-soluble vitamins-glucose-amino acids had the highest confidence(99.95%).The hierarchical cluster analysis divided nutrients into 5 types.[Conclusions]The prescriptions of PN for newborns were composed of five types of nutrients:amino acids,fat emulsion,glucose,water-soluble vitamins,and fat-soluble vitamins.According to the lack of electrolytes and trace elements,appropriate drugs can be chosen to meet nutritional demands.This study provides reference basis for reasonable selection of drugs for neonatal PN prescriptions and further standardization of PN supportive therapy in newborns.

Epidata Entry-Epidata Analysis软件联用在医院处方分析评价中的应用

目的探讨不合格处方分析评价的新技术、新方法。方法运用Epidata Entry软件进行数据录入,通过编写check文件,对录入数据和流程进行控制,联用Epidata Analysis软件对不合格处方进行分析。结果 Epidata Entry软件便于不合格处方的录入和管理,Epidata Analysis软件便于不合格处方的分析,两软件联用可实现不合格处方数字化管理,方法可靠。结论该方法应用于医院处方分析评价,具有简单、易学、方便、实用、几乎不需任何费用等优点。

Toward managing mixed-species stands： from parametrization to prescription

A better understanding and a more quantitative design of mixed-species stands will contribute to more integrative and goal-oriented research in mixed-species forests. Much recent work has indicated that the structure and growth of mixed species forests may fundamentally differ from monocultures. Here we suggest how to progress from the present accumulation of phenomenological findings to a design of mixed-species stands and advanced silvicultural prescriptions by means of modelling. First, the knowledge of mixing effects on the structure and growth at the stand, species, and individual tree level is reviewed, with a focus on those findings that are most essential for suitable modelling and silvicultural designs and the regulation of mixed stands as opposed to monocultures. Then, the key role of growth models, stand simulators, and scenario assessments for designing mixed species stands is discussed The next section illustrates that existing forest stand growth models require some fundamental modifications to become suitable for both monocultures and mixed-species stands. We then explore how silvicultural prescriptions derived from scenario runs would need to be both quantified and simplified for transfer to forest management and demonstrated in training plots. Finally, we address the main remaining knowledge gaps that could be remedied through empirical research.

Significance of three step prescription checking by pharmacists

In many hospitals,prescription checks are conducted by 2 or 3 individual pharmacists at each step of prescription checking,dispensing,and final checking to maintain the safety and efficacy of pharmaceutical therapies in Japan[1,2].In Gunma University Hospital,we also check all prescriptions by 3 pharmacists at each step of dispensing(3 step prescription check system)with the exception of night time.In this study,to assess the significance of our 3 step prescription check system for managing safety of pharmaceutical therapies,we investigated prescriptions that needed the confirmation of questionable points and prescription corrections.

The Principal Component Analysis of Element Contents in Chinese Herbs of the Caine Kidney Mixture

Objective: This research compares the nature of 11 kinds of Chinese herbs in the caine kidney mixture, and provides a theoretical way to concentrated prescriptions. Methods: Based on the principal component analysis of element contents in Chinese herbs, the effects of 25 chemical elements in the 11 kinds of Chinese herbs in the caine kidney mixture have been analyzed. Results: The traditional Chinese medicines of rehmannia, astragalus, mulberry, salvia miltiorrhiza, rhubarb in the caine kidney mixture play a major role in the treatment of chronic renal failure. Conclusion: The principal component analysis is very practical in the compatibility of medicines and concentrated prescriptions.

Comparing the mechanism of four classic Gualou-Xiebai prescriptions for cardiovascular diseases with phlegm and blood stasis syndrome based on molecular network modeling

Background:Four classical Traditional Chinese Medicine prescriptions,namely Gualou Xiebai Baijiu decoction,Gualou Xiebai Banxia decoction(GLXBBX),Zhishi Xiebai Guizhi decoction(ZSXBGZ)and Danlou prescription(DL),have been frequently used for treatment of phlegm and blood stasis syndrome(PBSS)-related cardiovascular diseases.However,its therapeutic mechanism has not been clearly elucidated.This study aimed to explore PBSS and its molecular mechanism,clarify and compare the mechanisms of four prescriptions in treating PBSS-related diseases.Method:In this study,we collected four prescriptions’compounds,predicted therapeutic targets,and enriched pathways which were based on network pharmacology.Then,we analysed the commen and different mechanisms by combing the network of components,targets and pathways.Finally,molecular docking was engaged to assess the binding potential of key compounds and hub targets.Results:We showed that four prescriptions’intersection genes(VEGFA,SRC,EGFR,etc.)were commonly enriched in PI3K-AKT signaling pathway,HIF-1 signaling pathway,etc.In addition,platelet activation and cAMP signaling pathway were singly enriched from the GLXBBX through unique compounds 12,13-epoxy-9-hydroxynonadeca-7,10-dienoic acid and Cyclo(L-tyrosyl-L-phenylalanyl).These bioactive compounds may exert GLXBBX’s unique pharmacological pathways via involving in mediating PPARA,PTGER3,etc.Sphingolipid signaling pathway was singly enriched from the ZSXBGZ through unique compounds tetramethoxyluteolin,ergosterol peroxide,etc.These bioactive compounds could mediate ADORA1,ADORA3 and TNFRSF1A to regulate ZSXBGZ’s unique pharmacological pathways.AMPK signaling pathway was singly enriched from the DL through unique compounds kaempferol,evofolinb,ethyl acid and aureusidin.These bioactive compounds were involved in mediating the main targets of AMPK signaling pathway,such as TNF,TNFRSF1A,etc.Conclusions:Our research demonstrated that GLXB-prescriptions involved in almost all pathological stages of PBSS-related cardiovascular diseases by modulating high-frequency shared pathways and targets mainly through key compounds(quercetin,mandenol,sitosteryl acetate and luteolin,etc.),for example,participate in the process of atherosclerosis,lipid metabolism,inflammation,immune response,thrombosis,inhibit inflammatory factors and platelet aggregation,regulate immune function,vascular function,oxidative stress.In addition to common pharmacological efficacies,there could also be specificities among GLXB prescriptions due to different compounds.For example,GLXBBX tends to regulate the function of vascular and endothelial barrier,prevent thrombosis.ZSXBGZ tends to regulate lipid metabolism and protect the heart from lipid accumulation.DL tends to maintain energy homeostasis and improve inflammation.

“润肺止咳方”干预新型冠状病毒感染后咳嗽的回顾性分析

目的:评价2022年冬季北京大学第三医院“润肺止咳方”治疗新型冠状病毒感染后咳嗽患者的临床疗效。方法:回顾性收集2022年12月15日至2023年1月5日北京大学第三医院中医科门诊收治的新型冠状病毒感染后咳嗽患者108例,其中包括观察组68例和对照组40例。观察组给予“润肺止咳方”治疗,对照组对为未采用中医治疗的新型冠状病毒感染后咳嗽的临床患者,但可能有西医对症治疗。收集患者的基本资料、中医证候和用药情况,比较2组患者的体温复常时间、核酸转阴时间以及临床疗效。结果:与对照组比较,观察组的体温复常时间和核酸转阴时间差异无统计学意义(P=0.892,P=0.967)。观察组的临床治愈率为52.9%(36/68)、总有效率为88.2%(60/68),显著优于对照组的临床治愈率12.5%(5/40)、总有效率47.5%(19/40)(均P<0.01)。结论:北京大学第三医院“润肺止咳方”可改善新型冠状病毒感染患者的咳嗽症状,提高了中医治疗新型冠状病毒咳嗽后遗症的有效率和治愈率。

基于网状Meta分析对8个经典名方治疗不稳定型心绞痛的临床疗效评价

目的:运用网状Meta分析方法系统评价8种经典名方联合西医常规治疗不稳定型心绞痛(UAP)的临床疗效,并分别进一步比较不同经典名方治疗实证和虚证(包括虚实夹杂)2大证型的疗效。方法:检索并筛选中文科技期刊数据库(CCD)、中国生物医学文献数据库(CBM)、中国国家知识基础设施数据库(CNKI)与中国学术期刊数据库(CSPD)等数据库中关于8个经典名方(血府逐瘀汤、补阳还五汤、四妙勇安汤、丹参饮、炙甘草汤、枳实薤白桂枝汤、瓜蒌薤白半夏汤、化痰祛瘀通脉汤)联合西医常规治疗UAP的随机对照试验(RCT),检索时限从各数据库建库至2022年1月14日,采用Stata 16.0软件进行网状Meta分析。结果:共纳入60个RCT,总计5088例UAP患者,涉及9种干预措施。其中,UAP属实证的有41个RCT,UAP患者共3432例,涉及5种干预措施;虚证或虚实夹杂共13个,共1130例患者,涉及4种干预措施。网状Meta分析结果提示,枳实薤白桂枝汤+西医常规治疗总有效率最优,UAP属实证者,四妙勇安汤+西医常规治疗最佳;虚证或虚实夹杂者,补阳还五汤+西医常规治疗最佳;心电图改善方面,四妙勇安汤疗效最佳;枳实薤白桂枝汤+西医常规在降低超敏C反应蛋白(hs-CRP)改善炎症反应方面更优。结论:与西医常规治疗UAP比较,枳实薤白桂枝汤联合西药常规治疗疗效较显著。但仍需要纳入更多高质量的RCT证实。

基于《中医方剂大辞典》的雷丸组方用药规律分析

目的 基于数据挖掘方法探究《中医方剂大辞典》中雷丸的组方用药规律。方法 以《中医方剂大辞典》为信息源,梳理含雷丸的方剂,构建雷丸方药数据库;采用文献分析和数据挖掘方法,探讨雷丸的增效减毒及其方剂主治病症类型、药物配伍情况;利用关联规则分析探寻其在常见病中的配伍特点;使用皮尔逊相关性分析发掘药-证的相关性,总结其用药规律。结果 含有雷丸方剂的剂型主要为丸剂和散剂,高频用药为槟榔、大黄、木香等,与雷丸配伍的主要为驱虫药、泻下药及理气药等,且味多为苦、辛,归胃经、脾经。其中“槟榔-雷丸”出现的药对配伍频数最高,其次是“大黄-雷丸”“木香-雷丸”;雷丸方剂的主治病症为虫积的频数最高,其次为疳证、积滞等。皮尔逊相关性分析结果表明,治疗虫积配伍槟榔、木香、使君子、芜荑、鹤虱等;治疗疳证配伍胡黄连、黄连、青皮等;治疗积滞配伍神曲、陈皮、牵牛子、三棱等。结论 雷丸与槟榔等配伍可加强杀虫消积的功效;与胡黄连、大黄等配伍可增加泻下攻积的作用,以上可能会引起轻微的胃肠道不良反应;与陈皮、神曲等配伍可保护胃黏膜,减轻胃肠不良反应。但雷丸毒性物质基础研究等未见报道,仍需深入研究,为雷丸临床应用提供更确切的基础。

7576张含丹参-当归药对的门诊中药饮片处方回顾性分析

目的:了解江苏省中西医结合医院南部院区/南京市溧水区中医院(以下简称“该院”)含丹参-当归药对的门诊中药饮片处方情况,探究该药对的临床配伍应用规律,为该药对的合理使用提供参考。方法:采用回顾性分析方法,统计2020—2022年该院使用丹参-当归药对的7576张门诊中药饮片处方,对患者的性别、年龄、处方药味数、金额、疗程、涉及科室及病症、使用剂量、常用的配伍比例及配伍饮片等相关内容进行统计分析。结果:7576张含丹参-当归药对的门诊中药饮片处方中,女性患者处方数约为男性患者处方数的3.21倍(5776张vs.1800张),>30~40岁患者居多。单张处方的中药饮片味数多集中在16~20味,开具的疗程均<30 d。丹参的使用剂量为《中华人民共和国药典》规定的10~15 g的处方有6490张,占85.67%;当归的使用剂量为《中华人民共和国药典》规定的6~12 g的处方有6608张,占87.22%。处方数排序居前3位的科室依次为国医堂、妇科及脑病科,治疗的病证以冲任失调、心脾两虚及气滞血瘀证为主。单张处方中丹参用量大于等于当归用量,丹参与当归的配伍比例以1∶1为多,高频配伍饮片为茯苓、川芎、炒白芍。结论:基于处方用药分析,该院含丹参-当归药对的门诊中药饮片处方基本合理,为丹参-当归药对的使用剂量范围及配伍规律研究提供了数据支持,有利于促进临床合理用药。

门诊处方点评与用药分析

目的通过对本院门诊处方点评与用药分析,促进本院门诊用药的规范性与合理性,提高处方质量,促进合理用药,保障医疗安全。方法对2022年1~12月门诊药房每月随机抽取3个工作日各50张门诊西药处方,共1800张进行点评与用药分析。结果1800张门诊处方中,合格处方1771张(98.39%),其中平均药品品种数为2.00,抗菌药处方占比19.00%,注射类处方占比5.61%,平均国家基本药物品种数占比33.76%,人均费用117.15元。不合格处方29张(1.61%),其中包括不规范处方13张,占44.83%;用药不适宜处方12张,占41.38%;超常处方4张,占13.79%。不合格处方的主要问题包括临床诊断缺项或临床诊断书写不全面、超剂量未注明原因、规定要求做皮试未注明过敏测试及结果判定。结论本院门诊处方用药不合理情况占比虽然不算太高,但还是一直存在,通过及时点评分析和有效干预,处方合格率得到进一步提高,不合格处方明显减少,用药合理性得到加强。

基于R软件的某中医院治疗骨折延迟愈合中药方剂数据挖掘

目的:探讨我院应用中药方剂治疗骨折延迟愈合的效果,并总结其治疗规律,为临床提供新的中医诊疗思路。方法:采用回顾性研究方法,收集我院HIS系统中符合纳入标准的骨折延迟愈合患者的临床资料。使用R软件进行数据分析,包括频次分析、关联规则、phi相关性分析和聚类分析,以探索中药方剂的组方模式及其中的诊疗思路。结果:共纳入215例病例,包括药物179种,药物类型42种,药物功效308种,药物主治病症566种,四气以温、平为主,五味以甘、苦、辛为主,归经以肝、肾、肺为主,强关联对药21个、角药262个,药物共现网络有73个节点、806条边。其中“骨碎补、杜仲、自然铜、淫羊藿、狗脊、土鳖虫、龙骨、续断、合欢皮、黄芪、红花”药物之间phi相关性最高;可能的新方剂组合4个,包括“狗脊、龙骨、自然铜、杜仲、黄芪、淫羊藿、土鳖虫”“合欢皮、骨碎补、牛膝、续断、当归、川芎、红花”“青风藤、蜈蚣、地龙、桂枝、粉葛”“麦芽、山楂、薏苡仁、北沙参、白术、远志、苍术、酸枣仁、茯苓、甘草、珍珠母”。结论:我院治疗骨折延迟愈合采用的中药方剂为补益肝肾、续筋接骨为主的药物,形成了治疗骨折延迟愈合的新方剂组合,为未来的中医药治疗策略提供了创新思路。

我国实施护士处方权的环境SWOT分析与建议

目的对我国实施护士处方权的内外环境进行分析,厘清内部优势和劣势、外部机遇和威胁,为进一步推进开展护士处方权的工作提出建议。方法搜集相关政策文件、研究文献等,运用SWOT方法对护士处方权实施环境进行分析,并提出建议。结果当前,我国实施护士处方权的优势包括:护理专科门诊发展、专科护理人才储备;劣势包括法律政策不健全、护士群体自身的局限;机遇主要有政府重视、专家共识的形成、理论和实践研究的推进;劣势包括教育准备不足、相关利益主体的抵制。结论结合实际,我国应并轨培养提高护士人才质量,加强立法为护士处方权的实施保驾护航,构建医务人员利益共同体,最后逐步扩大护士处方权试点区域,创新我国护士处方权实施机制。

8种中医经典方剂治疗慢性心力衰竭的网状Meta分析

目的:对8种治疗慢性心力衰竭(CHF)的经典中药方剂进行分析,系统评价经典中药方剂联合西医常规疗法在CHF治疗中的有效性及安全性。方法:按照循证医学要求,全面检索国内外数据库近5年发表的相关临床研究。采用RevMan 5.4及Stata17.0软件进行数据分析。结果:共纳入29篇文献,涵盖2 552例患者(观察组1 277例,对照组1 275例)。网状Meta分析结果显示,8种中药方剂干预联合西医常规治疗(WM)能有效提高慢性心力衰竭的临床有效率,同时改善相关理化指标,其中参附汤+苓桂术甘汤+WM是提高治疗有效率的最佳选择;苓桂术甘汤+WM是提高6 min步行距离(6MWD),降低脑钠肽(BNP)、左室收缩末期内径(LVESD)及左室收舒张期内径(LVEDD)的最佳选择;真武汤+葶苈大枣泻肺汤+WM是降低氨基端前脑钠素(NT-proBNP)的最佳选择;参附汤+苓桂术甘汤+WM是通过左室射血分数(LVEF)的最佳选择;茯苓四逆汤+WM是降低不良反应的最佳选择。结论:8种中药方剂干预联合西医常规治疗在治疗CHF方面各有所长,可根据实际情况选择对应方剂治疗。然而,受纳入研究的限制,其结论仍需开展更多大样本、多中心、高质量的随机对照试验予以验证。

不同产地太白贝母中11种核苷与碱基类成分分析及产地差异研究

目的对10批采自重庆、云南、陕西等5个省(市)的太白贝母样品中11种核苷和碱基类成分的含量进行测定,采用化学计量学分析法比较太白贝母中的核苷和碱基类成分的含量差异,对其质量进行综合评价,为规范化种植和产地优选提供参考。方法水超声提取太白贝母中的核苷和碱基类成分,采用高效液相色谱-二极管阵列检测器(HPLC-DAD)法测定样品中各成分含量,并采用主成分分析(Principal component analysis,PCA)、层次聚类分析(Hierarchical cluster analysis,HCA)对产地进行划分,偏最小二乘判别分析(Partial least squares discriminant analysis,PLS-DA)确定太白贝母中差异性的指标成分,比较指标性成分在不同产地样品间的含量差异。结果11种核苷和碱基类成分在不同产地太白贝母中存在显著差异;主成分分析和层次聚类分析可将样品聚为4类;PLS-DA鉴定出5个指标性成分,分别为尿嘧啶、胞嘧啶、尿苷、肌苷、腺苷,以重庆、湖北产地样品所含核苷和碱基成分相对较高,质量相对较优。结论该方法操作简单、重复性好、准确可靠,筛选出了鉴定不同产地太白贝母中的特征性核苷和碱基类成分,可用于初步阐明不同产地样品的差异性,并能够较好地反映太白贝母的品质,为太白贝母药材采购产地选择和质量控制提供参考。

针刺治疗抑郁症腧穴配伍规律及刺灸法应用特点

目的基于复杂网络技术分析针刺治疗抑郁症的腧穴配伍规律及刺灸法应用特点,为抑郁症针刺处方的制定提供依据和思路。方法检索中国知网(CNKI)、万方数据知识服务平台(万方数据)、维普资讯中文期刊服务平台(VIP)、中国生物医学文献数据库(CBM)、PubMed、Embase、Cochrane Library、Web of Science建库至2022年9月21日针刺为主治疗抑郁症的相关临床研究文献,根据纳入排除标准筛选文献,建立针刺抗抑郁临床文献数据库,使用Excel2010对腧穴进行频次分析,运用SPSS Modeler 18.0进行关联规则分析,采用Gephi0.9.5进行复杂网络分析。结果共纳入文献579篇,涉及腧穴172个,使用总频次为3222。腧穴归经以督脉、足太阳膀胱经、足厥阴肝经为主;特定穴多选用原穴、输穴、背俞穴、络穴、八脉交会穴、募穴、合穴。关联规则分析显示,相关性最高的腧穴组合为“印堂-百会”。通过复杂网络k-core层次分析和社团分析得到2个核心腧穴群。针刺角度、深度、方向以安全性和经脉循行方向为依据;补泻手法以辨证分型为依据;组方时遵循辨证选穴和对症选穴。结论针刺治疗抑郁症以循经选穴和特定穴为主,核心腧穴以治神及调节脏腑经气和功能为主,临证注重辨证选穴和对症选穴,同时注重刺灸法效应特异性。

医院门、急诊中成药处方专项点评分析

目的 通过分析并汇总射阳县人民医院门、急诊中成药处方专项点评情况,以期为中成药的合理应用提供参考。方法 抽查2023年8月1日至2023年8月31日射阳县人民医院门、急诊处方中成药处方1000份,经点评其中不合理处方69份,因同一张处方可能存在2种及2种以上不合理情况,经统计不合理情况数量为86处。点评的依据包括《处方管理办法》《中成药临床应用指导原则》《中药处方格式及书写规范》《医院处方点评管理规范(试行)》,点评的内容包括不规范处方(临床诊断书写不全、临床诊断为健康查体),用药不适宜处方(外用制剂给药剂量不适宜、门诊处方超7日用量未说明情况、给药频次不适宜、给药途径不适宜、联合用药不适宜、适应证不适宜、药物用量不适宜、重复用药不适宜),超常处方(无适应证用药)等情况。结果 射阳县人民医院2023年8月份共点评处方1000份,不合理处方69份,因同一张处方可能存在2种及2种以上不合理情况,经统计不合理情况数量为86处,其中不规范处方共4处[临床诊断书写不全3处(3.49%)、临床诊断为健康查体1处(1.16%)],用药不适宜处方共80处[外用制剂给药剂量不适宜3处(3.49%)、门诊处方超7日用量未说明理由23处(26.74%)、给药频次不适宜10处(11.63%)、给药途径不适宜1处(1.16%)、联合用药不适宜3处(3.49%)、适应证不适宜19处(22.09%)、药物用量不适宜3处(3.49%)、重复用药不适宜18处(20.93%)],超常处方2处[无适应证用药2处(2.33%)]。结论 本院当月门、急诊中成药用药存在不合理现象,主要以门诊处方超7日用量未说明理由、适应证不适宜、重复用药不适宜为主。医院应当加以重视,严格落实相关制度和措施,加强中成药处方管理,促进中成药合理应用。