500张附子与半夏、贝母、天花粉同方配伍门诊处方调查分析  

Investigation and analysis of 500 outpatient prescriptions ofAconiti Lateralis Radix Aconiti with Pinelliae Rhizoma, Fritillaria Bulbus and Trichosanthis Radix

作　　者：苏芬丽[1] 姚媛[1] 冯时茵 丘振文[1] SU Fenli;YAO Yuan;FENG Shiyin;QIU Zhenwen(Pharmacy of Department,First Affiliated Hospital,Guangzhou University of Traditional Chinese Medicine,Guangdong Guangzhou 510405,China)

机构地区：[1]广州中医药大学第一附属医院药学部,广东广州510405

出　　处：《中国医院药学杂志》2024年第4期451-455,461,共6页Chinese Journal of Hospital Pharmacy

摘　　要：目的:回顾性分析门诊处方中附子与半夏、贝母、天花粉同方配伍使用情况,促进临床合理用药。方法:选取某院2022年1-12月份附子与半夏、贝母、天花粉同方配伍的门诊处方500张,对其使用情况进行统计学处理。结果:开具附子反药配伍处方最多的科室为内分泌科,其次为妇科;针对的疾病归属最多的是瘿病和消渴病,证型排前3位的分别是少阳失枢、胆火内郁证,少阳证,少阴阳虚寒湿证;单张处方平均用药疗程为13.4 d;附子均采取先煎,最大用量为30 g;处方常用配伍中药饮片为干姜和炙甘草。结论:附子反药配伍并非绝对禁忌,但临床医生开具处方时需完善中医证型,辨证用药,注意用药剂量及比例,随证加用干姜(或生姜)、炙甘草等,同时药师加强审方和用药交代,提高附子反药配伍使用的安全性和有效性。OBJECTIVE To retrospectively analyze the compatibility of Aconiti Lateralis Radix Aconiti with Pinelliae Rhizoma,Fritillaria Bulbus and Trichosanthis Radix in outpatient prescriptions and promote clinical rational drug use.METHODS 500 outpatient prescriptions of Aconiti Lateralis Radix Aconiti with Pinelliae Rhizoma,Fritillaria Bulbus and Trichosanthis Radix from January to December 2022 were selected and a statistical analysis was done on the use.RESULTS The department of endocrinology with the most prescriptions was followed by the department of gynecology.The main diseases involved were thyroid disease and diabetes,and the former 3 positions of the treatment of disease were internal accumulation of gallbladder fire syndrome due to Shaoyang dysfunction,Shaoyang syndrome and Shaoyin yang-deficiency and cold-damp syndrome.The average usage period of treatment of a single prescription was 13.4 d.Aconiti Lateralis Radix Aconiti all prescriptions was decocted first,and the maximum dosage was 30 g.The commonly used compatibility of traditional Chinese medicine in the prescriptions were Zingiberis Rhizoma and Glycyrrhizae Radix Et Rhizoma Preparata Cum Melle.CONCLUSIONS The incompatibility of Radix Aconiti Lateralis Preparata is not absolute contraindication.The clinicians should improve the prescription of TCM syndrome type,drug differentiation,pay attention to the dosage and proportion of medication,and add Zingiberis Rhizoma or Zingiberis Rhizoma Recens,Glycyrrhizae Radix Et Rhizoma Preparata Cum Melle with the syndrome.In additional,pharmacists should strengthen the prescription review and drug education,in order to improve the safety and effectiveness of the incompatibility of Aconiti Lateralis Radix Preparata.

关 键 词：附子 同方配伍 十八反 安全性 合理用药 

分 类 号：R969.3[医药卫生—药理学]