某院门诊中成药临床应用分析  

Clinical Application of Chinese Patent Medicines in Outpatient Department of a Hospital

作　　者：徐坤勇 付玉杰 杜茂波[2] XU Kunyong;FU Yujie;DU Maobo(The First Hospital of Zhangjiakou,Zhangjiakou,Hebei,China 075000;Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing,China 100700)

机构地区：[1]河北省张家口市第一医院,河北张家口075000 [2]中国中医科学院中药研究所,北京100700

出　　处：《中国药业》2024年第22期52-55,共4页China Pharmaceuticals

基　　金：河北省中医药管理局科研计划项目[2023194]。

摘　　要：目的分析某院门诊中成药合理使用情况。方法按分层随机化抽样原则,从张家口市第一医院医院信息系统2022年20136张门诊中成药处方中每月随机抽取200张,共计2400张,根据中医药基础理论,药品说明书,相应法规、规范,以及该院实际进行点评。采用帕累托图分析不合理处方类型。统计强化不合理处方干预力度后中成药不合理处方占比。结果共发现不合理中成药处方318张(13.25%),其中不规范处方192张,不适宜处方126张,临床诊断书写不全和适应证不适宜为主要不合理类型;延长处方用药时长未注明理由和用法用量不适宜为次要不合理类型;其余为一般不合理类型。中成药不合理处方占比由干预前(2022年6月)的18.50%逐月降至干预后(2022年12月)的4.50%。结论通过帕累托图分析医院中成药不合理用药类型并干预,形成中成药专项点评模式,可提高中成药的合理使用率。该院门诊中成药使用趋于合理,但仍存在不合理用药情况,仍需持续改进和完善。Objective To analyze the use rationality of Chinese patent medicines in outpatient department of a hospital.Methods Based on the principle of stratified randomized sampling,2400 prescriptions were randomly selected from 20136 outpatient prescriptions of Chinese patent medicines in the hospital information system of the First Hospital of Zhangjiakou in 2022,with 200 prescriptions per month.According to the basic theory of traditional Chinese medicine,drug instructions,relevant regulations,standards,and the actual status of the hospital,the selected prescriptions of Chinese patent medicines were commented.The Pareto chart was used to analyze the irrational ptypes of rescriptions.The proportion of irrational prescriptions of Chinese patent medicines after strengthening the intervention measures was calculated.Results A total of 318 irrational Chinese patent medicines prescriptions(13.25%)were found,including 192 non-standard prescriptions and 126 inappropriate prescriptions.The incomplete clinical diagnosis writing and inappropriate indications were the major irrational types;the extended prescription medication duration without unspecified reasons and inappropriate usage and dosage were the minor irrational types;the rest were the general irrational types.The proportion of irrational prescriptions of Chinese patent medicines decreased from 18.50%before intervention(June 2022)to 4.50%after intervetion(December 2022).Conclusion Through the analysis of irrational use types of Chinese patent medicines in the hospital by the Pareto chart and the implementation of interventions,a special prescription comment mode for Chinese patent medicines is formed,which can improve the rational use rate of these drugs.The use of Chinese patent medicines in the outpatient department of the hospital tends to be rational,but there are still some irrational medication problems,which needs to be improved and perfected.

关 键 词：门诊 中成药 处方点评 帕累托图 合理用药 

分 类 号：R95[医药卫生—药学]