中药饮片处方合理性评价知识库的构建与临床应用  

Construction and clinical application of knowledge base for evaluation of prescription rationality of Chinese herbal decoction pieces

作　　者：吴越[1] 邵燕飞[1] 叶裕祥 WU Yue;SHAO Yanfei;YE Yuxiang(Zhejiang Provincial People’s Hospital,Zhejiang,Hangzhou 310014,China;Hangzhou Ipharmacare Ltd.,Zhejiang,Hangzhou 310012,China)

机构地区：[1]浙江省人民医院,浙江杭州310014 [2]杭州逸曜信息技术有限公司,浙江杭州310012

出　　处：《中国医药科学》2022年第8期118-121,共4页China Medicine And Pharmacy

基　　金：浙江省中医药科技计划青年人才基金项目(2015ZQ002)。

摘　　要：目的探讨中药饮片处方合理性评价知识库的科学构建并通过中药饮片合理用药管理系统实现中药饮片临床合理使用。方法运用智能推理机技术,通过数据标准化、知识库表达、规则判断逻辑的科学建设,构建和完善中药饮片处方合理性评价知识库,实现中药饮片临床应用管理、分析、查询统计等功能,并通过中药饮片合理用药管理系统对浙江省人民医院2019年门诊中药饮片处方进行有效事前干预和事后点评与2018年门诊处方人工点评结果,针对中药饮片警示处方下降情况和中药饮片警示处方问题类型情况分别进行分析比较。结果通过中药饮片处方合理用药管理系统对2019年33186张门诊处方进行不同等级的规则预警干预后的处方合理性情况与2018年30179张门诊处方合理性情况进行比较和试运行,其中Ⅲ级警示处方的百分率下降5.43%,Ⅳ级警示处方的百分率下降83.94%,Ⅴ级警示处方的百分率下降91.38%;中药饮片处方各类不合理情况下降率为19.64%,其中7类警示处方问题类型处方分别下降幅度14.05%~100.00%不等。结论基于大数据的中药处方合理性评价和前置预警干预模式可有效规范临床中药饮片的合理使用,中药饮片处方合理用药管理系统的使用可明显降低不合理处方的百分率,有效避免药物使用不当的问题发生。Objective To explore the scientific construction of the knowledge base for the evaluation of prescription rationality of Chinese herbal decoction pieces(CHDPs)and to realize rational use of CHDPs in clinic through the CHDPs rational use management system.Methods Based on the scientific construction of data standardization,knowledge base expression,and rule judgment logic,the knowledge base for the evaluation of the prescription rationality of CHDPs was constructed and improved using the intelligent inference engine technology,thereby realizing the functions in clinical application management,analysis,and query statistics of CHDPs.The effective pre-intervention and prescription comment of outpatient prescription of CHDPs in Zhejiang Provincial People’s Hospital in 2019 by the CHDPs rational use management system and the results of man-made review of outpatient prescriptions in 2018 were analyzed and compared in terms of the decline rate of CHDPs warning prescriptions and the problem types of CHDPs warning prescriptions.Results The rationality of 33186 outpatient prescriptions with different levels of rule warning intervened by the CHDPs rational use management system in 2019 was compared and piloted with the rationality of 30179 outpatient prescriptions in 2018,and it was found that the percentage of grade Ⅲ warning prescriptions decreased by 5.43%,grade Ⅳ by 83.94%,and grade Ⅴ by 91.38%.Meanwhile,the rate of various types of irrationality of CHDPs decreased by 19.64%,among which the irrationality rate for prescriptions of 7 types of warning prescription problems decreased by 14.05%-100.00%.Conclusion The big data-based evaluation of the rationality of traditional Chinese medicine prescriptions and the pre-warning intervention model can effectively regulate the rational use of CHDPs in clinic,and the application of the CHDPs rational use management system can significantly reduce the percentage of irrational prescriptions and effectively avoid the occurrence of inappropriate drug use problems.

关 键 词：中药饮片 知识库 合理性评价 处方审核 

分 类 号：R288[医药卫生—中药学]