中成药处方点评的标准与尺度探索(十):儿童用药  

The exploration on criteria and compromise in the prescription review of Chinese patent medicines X:medication for children

作　　者：金锐[1] 王宇光[2] 薛春苗[3] 孙路路[1] 鄢丹[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院药剂科,北京100038 [2]北京中医药大学第三附属医院药学部,北京100029 [3]北京中医药大学附属东直门医院药学部,北京100700

出　　处：《中国医院药学杂志》2017年第11期1003-1008,共6页Chinese Journal of Hospital Pharmacy

基　　金：首都卫生发展科研专项重点攻关项目(首发2011-2008-01);北京市中医管理局中西医结合项目(2014-ZYJ14);北京药学会临床药学研究项目(2013-03;2016-14);首都医科大学附属北京世纪坛医院中青年学科骨干培养专项(院国青2015-QB04)

摘　　要：由于特殊的生长发育特点,儿童安全合理使用中成药一直是各方的关切点,本文尝试梳理目前儿童使用中成药的主要问题,并从安全性角度提出解决方法,形成处方点评标准和尺度。从目前现状看,儿科使用中成药较为普遍,且处方不合理比例较高,还存在很多超说明书用药情况,亟需严格规范和深入研究。首先,从传统中医儿科用药经验上看,轻粉、朱砂等金石药,巴豆、麝香等毒烈药,牛黄、犀角等苦寒药均为历代医家所警惕,对于小儿用法用量也有特殊说明;从现代儿童特殊人群用药角度看,治疗儿童疾病的药物选择、给药途径选择、用法用量计算等均有更为详细的用药指导,这些内容均可以为儿童使用中成药所借鉴。未来趋势上,应综合以上内容,形成专门针对儿童的中药安全用药体系,并加强中药的发育毒理学研究。最后,提出中成药儿童用药点评的理念和方法,并阐述选药是否适宜、用法用量是否准确、疗程是否合理三个重要关注点的点评标准与尺度。Rational drug use for children is the focus of physicians, pharmacists and researchers because of characteristics of growth and development of children. This paper tried to analyze the current problems in padiatric use of Chinese patent medicines and proposed a primary solution from the safety aspect, then the criteria and compromise of this issue were given. Currently, the pediatric use of Chinese patent medicines was relatively common, with much unreasonable uses and off-label uses recorded in some literatures. However, it is believed in the traditional Chinese medicine that some mineral medicines like calomel and cinnabar, some toxic medicines like croton and musk and some cold bitter medicines like bezoar and rhinoceros horn, should be strictly limited when they were used for children. The dosage and administration route were also elucidated from the tradi- tional aspect. Besides, modern medicine had more specific guidelines for how to choose and use medicines for children, which gave references for the administration of Chinese patent medicine. Furthermore, we need to construct a comprehensive safety medication system for children and strengthen the scientific research of developmental toxicology. At last, the principles of prescription review for children were proposed and three important items including medicine choice, usage adjustment and treatment course were elucidated.

关 键 词：中成药 中药 处方点评 临床药学 儿童用药 儿科 

分 类 号：R952[医药卫生—药学]