某院门诊中药饮片处方合理用药分析  

Rational Use of Traditional Chinese Medicine Decoction Pieces in Outpatient Clinic of a Hospital

作　　者：李怡文 曹可鸣 兰雨泽 苏爽[4] 马洪亮 张藜莉 常晓红 李博[6] LI Yiwen;CAO Keming;LAN Yuze;SU Shuang;MA Hongliang;ZHANG Lili;CHANG Xiaohong;LI Bo(Department of Pharmacy,Emergency General Hospital,Beijing 100028,China;School of pharmacy,North China University of Science and Technology,Tangshan Hebei 063000,China;Department of Traditional Chinese Medicine,Emergency General Hospital,Beijing 100028,China;Department of Pharmacy,Wangjing Hospital of CACMS,Beijing 100102,China;Information Centre,Emergency General Hospital,Beijing 100028,China;Beijing Hospital of Traditional Chinese Medicine,Capital Medical University/Beijing Institute of Chinese Medicine/Beijing Evidence-based Chinese Medicine Center,Beijing 100010,China)

机构地区：[1]应急总医院药学部,北京100028 [2]华北理工大学药学院,河北唐山063000 [3]应急总医院中医科,北京100028 [4]中国中医科学院望京医院药学部,北京100102 [5]应急总医院信息中心,北京100028 [6]首都医科大学附属北京中医医院,北京市中医药研究所,北京中医药循证医学中心,北京100010

出　　处：《中国药物警戒》2024年第11期1293-1298,共6页Chinese Journal of Pharmacovigilance

基　　金：应急总医院院内重点课题立项(KY202406);国家自然科学基金资助项目(81774146);北京市中医管理局北京市第三批中药骨干人才培养项目(京中医科字[2022]59号);2023年全国中药特色技术传承人才培训项目(T20234832005)。

摘　　要：目的探讨PDCA循环管理方法在中药饮片处方点评中的应用,分析其对提高处方合格率和促进合理用药的作用。方法对照组选取2023年10~12月期间院内门诊的645张中药饮片处方,研究组为2024年1~3月(612张)和2024年4~6月(615张),分别为第一阶段和第二阶段PDCA循环管理的处方。通过比较开展PDCA循环管理前后的处方点评结果,评价该方法在提高中药饮片处方合格率及减少不合理处方产生的效果。结果经过2个PDCA循环管理,中药饮片的处方合格率得到了显著提升。研究第一阶段组,门诊中药饮片处方的合格率明显提高,从70.54%提高至81.69%(P<0.01),并未达到预期效果;第二轮循环后,研究第二阶段组合格率达91.87%,与对照组和研究第一阶段组相比明显改善(P<0.01)。在诊断缺失、无中医辨证、特殊煎法未标注及毒性饮片合理使用等方面,亦有明显改善(P<0.01)。结论PDCA循环管理策略显著优化了中药饮片处方的质量,可推动医院合理用药水平提升。Objective To investigate the applications of PDCA cycle management method in the review of prescriptions for traditional Chinese medicine decoction pieces and to analyze its role in improving the rate of standard prescriptions and promoting the rational use of medicines.Methods A total of 645 prescriptions for traditional Chinese medicine decoction pieces given by the outpatient clinic between October and December 2023 were selected as the control group while the prescriptions after the first and second rounds of PDCA cycle management from January to March 2024(612 prescriptions)and from April to June 2024(615 prescriptions)were selected for the intervention group.The results of review of prescriptions before and after the PDCA cycle was carried out were compared to evaluate the utility of the method in improving the qualified rate of Chinese medicine prescriptions.Results After two PDCA cycles,the qualified rate of prescriptions for traditional Chinese medicine decoction pieces was significantly improved.In the first stage study group,the qualified rate of outpatient Chinese medicine prescriptions was significantly increased from 70.54%to 81.69%(P<0.05),but it did not reach the intended goal.In the second stage study group,the qualified rate of outpatient Chinese medicine prescriptions was increased to 91.87%(P<0.05).In case of diagnostic absence,lack of Chinese medicine diagnosis,lack of labeling of special decoctions,and in terms of rational use of toxic sips,the qualified rate of the second stage study group was significantly higher than that of the control group and the first stage study group(P<0.05).Conclusion The PDCA cycle management method can effectively improve the quality and rationality of traditional Chinese medicine decoction pieces.

关 键 词：PDCA循环 中药 饮片 处方 点评 质量管理 合理用药 

分 类 号：R969.3[医药卫生—药理学] R944.4[医药卫生—药学]