中成药处方分析与合理性应用的探讨  

Discussion on Prescription Analysis and Rational Application of Proprietary Chinese Medicine

作　　者：温敏 张义才 李铭华 吕书雷 WEN Min;ZHANG Yicai;LI Minghua;LV Shulei(Fengqiu County Hospital of Traditional Chinese Medicine,Fengqiu 453300,Henan,China)

机构地区：[1]封丘县中医院,河南封丘453300

出　　处：《中国药物滥用防治杂志》2024年第8期1423-1427,共5页Chinese Journal of Drug Abuse Prevention and Treatment

基　　金：河南省医学教育研究项目(编号:Wjlx20210411)。

摘　　要：目的:分析中成药处方,并探讨合理性应用的情况。方法:回顾性分析我院2022年1月—2023年12月开具的2000张中成药处方,依据《处方管理办法》《中成药临床应用指导原则》和药品说明书,同时参考医院内部的处方点评标准与实施细则,对所选处方进行合理性评估后,将处方分为合理处方和不合理处方,并对不合理处方进一步分类,包括不规范处方、用药不适宜处方和超常处方,分析不合理处方情况。结果:2000张中成药处方中,不合理处方251张(12.55%),包括不规范处方115张(5.75%)、用药不适宜处方73张(3.65%)、超常处方63张(3.15%);合理处方1749张(87.45%),中成药处方合理率显著高于不合理率(P<0.05)。对251张不合理处方进行分析,发现信息填写不完整占23.12%(58/251),书写内容不规范占11.95%(30/251),修改后未签字占10.76%(27/251),药品剂型不适宜占15.54%(39/251),超说明书用药占17.13%(43/251),其他问题占21.51%(54/251)。结论:中成药处方整体而言较为合理,但仍存在部分不合理情况,如在处方书写过程中,仍存在不符合规范的情况,影响患者用药安全与治疗效果;在药物选择、剂量调整等方面,部分处方未能充分考虑患者具体情况,存在用药不当风险;且存在药物滥用或过度用药问题。通过加强医生培训、规范处方书写、加强患者教育和完善医院管理等措施,可以有效提高中成药处方的合理性,保障患者的用药安全和治疗效果。Objective:To analyze the prescription of proprietary Chinese medicines and discuss the rationality application.Methods:The 2000 prescriptions of proprietary Chinese medicines issued by our hospital from January 2022 to December 2023 were retrospectively analyzed.Based on the Measures for the Administration of Prescription,Guiding Principles for the Clinical Application of Proprietary Chinese Medicines,and the drug instructions,and also referring to the hospital’s internal prescription review standards and implementation rules,the selected prescriptions were classified into reasonable and unreasonable prescriptions,and further classified unreasonable prescriptions,including irregular prescriptions,prescriptions with inappropriate medication,and overthe-counter prescriptions,and analyzed the unreasonable prescriptions.Results:Among 2000 prescriptions of proprietary Chinese medicines,251(12.55%)were unreasonable prescriptions,including 115(5.75%)irregular prescriptions,73(3.65%)prescriptions with inappropriate medication,and 63(3.15%)over-the-counter prescriptions;and 1749(87.45%)were reasonable prescriptions,and the rate of reasonable proprietary Chinese medicines prescriptions was significantly higher than the rate of unreasonable prescriptions(P<0.05).The 251 unreasonable prescriptions were analyzed and found that incomplete information accounted for 23.12%(58/251),irregular writing content accounted for 11.95%(30/251),modification without signature accounted for 10.76%(27/251),inappropriate drug dosage form accounted for 15.54%(39/251),and use of medicines with overdescription accounted for 17.13%(43/251),other problems accounted for 21.51%(54/251).Conclusion:The prescription of proprietary Chinese medicines is reasonable on the whole,but there are still some unreasonable situations,such as in the process of prescription writing,there are still cases that do not comply with the norms,affecting the safety of patients’medication and therapeutic effect;in the selection of drugs,dosage adjustment,etc.,some presc

关 键 词：中成药处方 不合理处方 用药合理性 安全性 

分 类 号：R288[医药卫生—中药学]