基于434221张处方数据探讨儿科常用中成药适应证审核及其规则的建立  

Indication Review and Establishment of Rules for Common Chinese Patent Medicines in Pediatrics Based on 434221 Prescriptions

作　　者：马津京[1] 王彦青[1] 张艳菊[1] 张易[1] 陈博[1] 席云鹏 吴秀君[3] MA Jinjing;WANG Yanqing;ZHANG Yanju;ZHANG Yi;CHEN Bo;XI Yunpeng;WU Xiujun(Dept.of Pharmacy,National Children’s Medical Center,Beijing Children’s Hospital,Capital Medical University,Beijing 100045,China;Dept.of Pharmacy,Shanxi Children’s Hospital,Taiyuan 030013,China;Dept.of Pharmacy,Maternal and Child Health Hospital of Guangdong,Guangzhou 511442,China)

机构地区：[1]国家儿童医学中心/首都医科大学附属北京儿童医院药学部,北京100045 [2]山西省儿童医院药剂科,太原030013 [3]广东省妇幼保健院药学部,广州511442

出　　处：《中国医院用药评价与分析》2023年第5期610-614,618,共6页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：北京市中医管理局北京中医药“薪火传承3+3工程”金世元名老中医工作室北京儿童医院分站建设项目(京中医科字〔2019〕103号)。

摘　　要：目的:通过对13家医疗机构儿科门急诊常用中成药处方进行适应证审核,了解儿科常用中成药临床使用现状,针对存在的问题提出儿科中成药处方适应证审核相关的对策及建议。方法:采用回顾性分析方法,收集整理2019年10—12月13家医疗机构儿科门急诊中成药处方数据,对适应证方面进行合理处方、争议处方和不合理处方的判定,对各判定结果以及使用问题中排序较前的具体品种进行统计分析。结果:434221张儿科常用中成药处方中,适应证方面合理处方284257张(占65.46%),争议处方130238张(占29.99%),不合理处方19726张(占4.54%)。其中,争议处方涉及解表剂最多,以小儿豉翘清热颗粒的使用最具争议;不合理处方涉及补益扶正剂居多,但以羚羊角胶囊的使用不合理现象最为突出。结论:经调研,儿科常用中成药在临床使用中存在一定的争议性问题,针对问题可制作专家调查问卷进一步开展德尔菲法研究,从而建立相应的处方审核规则。OBJECTIVE:To investigate the current status of clinical use of Chinese patent medicines in pediatrics through the indication review of Chinese patent medicines in pediatric outpatient and emergency departments in 13 medical institutions,and to put forward relevant countermeasures and suggestions for the existing problems.METHODS:Retrospective analysis method was used to collect the prescriptions of Chinese patent medicines in pediatric outpatient and emergency departments of 13 medical institutions from Oct.to Dec.2019.The rational prescription,controversial prescription and irrational prescription were judged in terms of indications,and the results of each judgment and the priority of the specific varieties in the use problem were statistically analyzed.RESULTS:Among the 434221 Chinese patent medicine prescriptions,284257(65.46%)were rational prescriptions in terms of indications,130238(29.99%)were controversial prescriptions,and 19726(4.54%)were irrational prescriptions.Among them,the most controversial prescription was the antipyretic agent,and the most controversial prescription was the use of Xiao’er Chiqiao Qingre granules.Most of the irrational prescriptions were supplement and supporting agents,yet Lingyangjiao capsule was the most irrational.CONCLUSIONS:According to the investigation,there are some controversial problems in the clinical use of commonly used Chinese patent medicines in pediatrics,which can be further studied by Delphi method by making expert questionnaire,so as to establish the corresponding prescription review rules.

关 键 词：儿科 中成药 处方审核 适应证 

分 类 号：R932[医药卫生—生药学] R969.3[医药卫生—药学]