某疗养中心中成药临床不合理应用分析及改进措施  

Irrational Clinical Use of Chinese Patent Medicines in a Sanatorium

作　　者：戚虎昶 王微 倪志垚 凌静 QI Hu-chang;WANG Wei;NI Zhi-yao;LING Jing(Section One,Hangzhou Air Force Health Care Center for Special Service,Hangzhou 310007,China)

机构地区：[1]空军杭州特勤疗养中心疗养一区,浙江杭州310007

出　　处：《解放军药学学报》2022年第3期262-265,共4页Pharmaceutical Journal of Chinese People's Liberation Army

摘　　要：目的分析和改进中成药临床不合理使用问题,促进中成药的合理应用。方法调取2017-2020年某疗养中心门诊处方,每月随机抽取100张点评,选取其中的中成药处方点评数据,并分析2017-2018年(干预前,n=960)和2019-2020年(干预后,n=832)的中成药不合理处方,比较干预前后不合理处方数量和发生率。对中成药临床不合理应用情况、原因进行分析,提出加强医务人员培训、临床应用管控等改进措施。结果2017-2020年中成药处方临床不合理应用表现为临床诊断书写不全(10.2%)、适应证不适宜(32.0%)、剂型选择不适宜(10.2%)、用法用量不适宜(21.8%)、联合用药不适宜(20.4%)和其他不合理类型(5.3%)。干预前处方不合理用药发生率为22.4%,干预后为1.2%,差异有统计学意义(P<0.01);干预后临床诊断书写不全、适应证不适宜、剂型选择不适宜、用法用量不适宜、联合用药不适宜等均低于干预前,差异均有统计学意义(P<0.01),其他不合理用药类型也显著降低(P<0.05)。结论中成药临床使用不合理问题的原因有很多种,开展处方点评工作,能够降低中成药临床不合理用药的发生率,中成药合理应用需要医、药、管理部门三方共同努力持续改进。Objective To analyze and contain irrational use of Chinese patent medicines in clinical practice,and promote rational applications of Chinese patent medicines.Methods The outpatient prescriptions given by doctors in our section between 2017 and 2020 were retrieved,100 of which were randomly selected for review each month.The irrational prescriptions of Chinese patent medicines between 2017 and 2018(before intervention,n=960)and between 2019 and 2020(after intervention,n=832)were analyzed.The number,incidence and causes of irrational prescriptions before and after intervention were compared.Results Between 2017 and 2020,irrational use of Chinese patent medicines involved incomplete clinical diagnosis(10.2%),wrong indications(32.0%),inappropriate selection of dosage forms(10.2%),improper usage and dosage(21.8%),incorrect combinations of drugs(20.4%)and other types of irrational drug use(5.3%).The incidence of irrational drug use was 22.4%before intervention and 1.2%after intervention,so the difference was statistically significant(P<0.01).After intervention,the incidence of irrational use of these drugs decreased substantially,and the difference was statistically significant(P<0.01).Conclusion There are many reasons for irrational use of Chinese patent medicines in clinical practice.The incidence can be reduced by assessing prescriptions.The concerted efforts by different departments are required to promote rational applications of Chinese patent medicines.

关 键 词：中成药 合理用药 

分 类 号：R285.6[医药卫生—中药学]