中药饮片处方宏观质量指标的设置与应用分析  

Analysis on Setting and Application of Macroscopic Quality Indicator for Prescription of Traditional Chinese Medicine Decoction Pieces

作　　者：田佳鑫[1] 李培红[1] 高善荣[1] 郭红叶[1] 苑秋菊[1] 陶丝雨 郭晓龙[1] TIAN Jiaxin;LI Peihong;GAO Shanrong;GUO Hongye;YUAN Qiuju;TAO Siyu;GUO Xiaolong(Dept.of Pharmacy,Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院药学部,北京100091

出　　处：《中国医院用药评价与分析》2020年第5期610-612,616,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：北京中医药科技发展资金项目(No.JJ2016-68)。

摘　　要：目的:探索符合中医药临床实际使用情况的中药饮片处方评价方法。方法:调取北京市处方点评平台2017年11月至2018年10月的数据(北京市51家医疗机构每月上报1周门诊全部中药饮片处方),经筛选后,纳入全部内服中药饮片处方,共1527261张。从宏观角度设置能够客观评价中药饮片处方质量的评价指标,对北京地区医疗机构饮片处方在宏观层面进行适当量化,进行大数据汇总分析。结果:北京市51家医疗机构中药饮片使用指标呈现稳定状态,使用强度平均为16.72(±4.78%),剂量偏离指数平均为1.25(±4.52%),平均每剂金额为51.66(±6.44%)元,平均药味数为13.94(±1.89%)味,平均剂数为8.53(±1.84%)剂;使用强度作为考核指标趋势稳定,而平均每剂金额每月间浮动较大;使用强度、剂量偏离指数、平均每剂金额与不同级别医院之间的相关性较小,可以统一制订监测标准;平均剂数、平均药味数需根据医院等级、类别等区别设限;使用强度与不同科室、病种等的相关性较大。中药饮片处方质量指标符合宏观层面医疗机构处方特点,可以客观反应临床用药情况,可以作为中药饮片处方宏观监测依据。结论:中药饮片处方宏观质量指标对于保障中药饮片处方质量,有效控制中药饮片处方费用不合理增长,提高医务人员临床合理用药的意识和规范性,促进中药饮片的合理使用等有积极意义。OBJECTIVE:To explore an evaluation method for prescriptions of traditional Chinese medicine(TCM)decoction pieces in accordance with the clinical practice.METHODS:Data in Beijing prescription review platform from Nov.2017 to Oct.2018(51 medical institutions in Beijing report all prescriptions of TCM decoction pieces in outpatient in 1 week every month)were acquired,1527261 prescriptions of TCM decoction pieces were involved after screening.Set an evaluation indicator that can objectively evaluate the quality of prescriptions from a macro-perspective,so as to quantify the prescriptions in medical institutions in Beijing from a macroscopic aspect,and conduct summarization and analysis of big data.RESULTS:The application indicator of TCM decoction pieces in 51 medical institutions in Beijing was in a stable condition,with the average use intensity was 16.72(±4.78%),the average dose deviation index was 1.25(±4.52%),the average medicine cost of each dose was 51.66(±6.44%)yuan,the average category of TCM was 13.94(±1.89%),the average number of doses was 8.53(±1.84%);as an evaluation indicator,the use intensity was in a stable trend,while the average medicine cost of each dose fluctuated from month to month;the correlation between use intensity,dose deviation index,average medicine cost of each dose and hospitals grades was small,so that the monitoring standards can be formulated uniformly;the average number of doses and the average category of TCM need to be restrict according to hospital grade and types;the use intensity was more relevant to different clinical departments and diseases.The quality indicator of prescriptions of TCM decoction pieces was in line with the characteristics of prescriptions in medical institutions at macroscopic aspects,which can objectively reflect the clinical drug application and can be used as the basis for macroscopic monitoring of prescriptions of TCM decoction pieces.CONCLUSIONS:The macroscopic quality indicator for prescription of TCM decoction pieces has positive significance for

关 键 词：中药饮片 处方点评 质量 大数据 

分 类 号：R932[医药卫生—生药学]