基于中医辨证论治理论探索中成药处方审核方法  

Prescription Review Method of Chinese Patent Medicines Based on the Theory of Traditional Chinese Medicine Syndrome Differentiation and Treatment

作　　者：郑金凤[1] 苏爽[1] 张婧[1] 张瑞丽[1] 程遥[1] 王景红[1] ZHENG Jinfeng;SU Shuang;ZHANG Jing;ZHANG Ruili;CHENG Yao;WANG Jinghong(Dept.of Pharmacy,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院药学部,北京100102

出　　处：《中国医院用药评价与分析》2024年第9期1140-1144,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：2023年全国中药特色技术传承人才培训项目(No.T20234832005);中国中医科学院软课题专项(No.ZZ15-RKX-01);北京市中医管理局北京市第三批中药骨干人才培养项目(No.京中医科字〔2022〕59号);中国中医科学院望京医院自主选题(No.WJYY-ZZXT-2023-18)。

摘　　要：目的:依据国家卫生健康委员会等3部门联合发布的《医疗机构处方审核规范》,探索符合该院中医类别医师医疗活动的中成药处方审核方法。方法:参考药品说明书及相关资料,建立有代表性的31种中成药的“应用要点”;回顾历史处方,与梳理的中成药“应用要点”对比,分为“一致诊断”“不规范诊断”“待讨论诊断”和“不适宜诊断”。采用多学科中医专家论证的方式,探索符合中医师思维模式及医疗行为的处方审核要素及审核方法。结果:建立了该院31种中成药处方审核方法,包括处方用药与诊断是否相符,处方剂量、用法是否正确,疗程是否适宜,联合用药是否适宜,是否有用药禁忌等方面。结论:以“药证相符”为核心,建立符合该院中医师临床诊疗思维的中成药处方审核要素及审核方法,规范化中成药审核,对保障患者合理使用中成药、减少中成药使用风险具有重要意义。OBJECTIVE:To probe into the prescription review method that conforms to the medical activities of traditional Chinese medicine clinicians in the hospital according to the Prescription Review Standard in Medical Institutions jointly issued by the National Health Commission of the People’s Republic of China and other three departments.METHODS:“Application points”of 31 kinds of Chinese patent medicines were established by referring to the drug instructions and relevant information.The historical prescriptions were reviewed,and the diagnosis was categorized into“consistent diagnosis”“irregular diagnosis”“diagnosis to be discussed”and“inappropriate diagnosis”by comparing with the“application points”.A multi-disciplinary traditional Chinese medicine expert validation approach was adopted to explore the elements and method of prescription review that were in line with mindset and medical behaviors of traditional Chinese medicine clinicians.RESULTS:A method for reviewing the prescriptions of 31 types of Chinese patent medicines in the hospital had been established,including whether the prescribed medication was consistent with the diagnosis,whether the prescribed dosage and usage were correct,whether the course of treatment was appropriate,whether the drug combination was appropriate,and whether there were any contraindications to the use of medicines.CONCLUSIONS:With the core of“conformity of medicine and evidence”,the establishment of prescription review elements and review methods in line with the clinical diagnosis and therapeutic thinking of traditional Chinese medicine clinicians in the hospital,and the standardization of prescription review are of great significance in ensuring the rational use and reducing the risk of Chinese patent medicine.

关 键 词：中成药 处方审核方法 辨证论治 合理用药 

分 类 号：R932[医药卫生—生药学] R969.3[医药卫生—药学]