突发重大传染性公共卫生事件背景下基于调查问卷的中药处方动态调整模式建立  

Establishment of a dynamic adjustment model for traditional Chinese medicine prescriptions based on questionnaires survey in the context of major infectious public health emergencies

作　　者：张静 杨宁 白云凤 赵智龙 ZHANG Jing;YANG Ning;BAI Yunfeng;ZHAO Zhilong(Department of Pharmacy,Yinchuan Traditional Chinese Medicine Hospital,Yinchuan,Ningxia 750000,China)

机构地区：[1]银川市中医医院药剂科,宁夏银川750000

出　　处：《现代医药卫生》2025年第1期162-166,171,共6页Journal of Modern Medicine & Health

基　　金：银川市科技计划项目(2023SF03)。

摘　　要：目的基于调查问卷形式,以“益气固表预防方”中药处方动态调整为例,建立突发重大传染性公共卫生事件下中药处方优化的工作模式,以期快速、科学地制定中医药救治诊疗方案。方法设计线上调查问卷,分为3个阶段,分别收集隔离人群一般资料调查信息、20个症状改善情况及药品不良反应和建议,依据以上资料对中药处方进行调整,形成最优处方,总结突发重大传染性公共卫生事件下中药处方动态调整模式。结果依据第一阶段问卷结果,将原处方中贯众替换为黄芩,黄芪剂量由20 g降为10 g,增加煅牡蛎30 g,相较处方调整前,第二阶段问卷反馈服药不适感例如腹痛和腹泻、口干及自觉发热症状消失,14个症状总缓解率升高,排名靠前的有自汗、肢体酸痛、恶风、头痛、咳嗽等;针对第二阶段缓解不明显的症状及患者服药感受,二次优化处方,将茯苓12 g调整为20 g,黄芩5 g调整为10 g,生地黄6 g调整为10 g,桔梗6 g调整为10 g,剂型调整为颗粒剂,并加入甜菊苷调味。第三阶段问卷统计分析得知,总缓解率相较第二阶段升高的症状有18个,排名靠前的有咽干灼热、肢体困重、发热、口渴少饮、恶心欲吐等,基本无服药不适感和建议。整体上,以第三阶段症状总缓解率高于80%为界,“益气固表预防方”对于喘促气短、咳声低弱、恶风、神疲、脘腹胀闷的改善最为显著。结论经过2次处方调整,第三阶段问卷调查结果显示各项症状缓解率均高于60%,服药人群反馈无不适症状,达到了处方优化的目的,同时建立了可行的突发重大传染性公共卫生事件下中药处方动态调整模式和推广应用流程。Objective To establish a working model for optimizing traditional Chinese medicine(TCM)prescriptions during major infectious public health emergencies,so as to develop TCM treatment protocols quickly and scientifically,based on a questionnaire survey and using the dynamic adjustment of the“Yiqi Gubiao preventive formula”as an example.Methods An online questionnaire was designed and conducted in three phases.The survey collected general demographic information about isolated individuals,data on improvements in 20 symptoms,adverse drug reactions,and feedback suggestions.Based on this information,adjustments were made to the TCM prescription to create an optimized formula.A dynamic adjustment model for TCM prescriptions during major public health emergencies was summarized.Results Based on the first phase questionnaire,the original prescription was modified by replacing Guanzhong with Huangqin,reducing the Huangqi dosage from 20 g to 10 g,and adding 30 g of Duan Muli.Compared with the pre-adjustment prescription,feedback from the second phase questionnaire indicated that symptoms such as abdominal pain,diarrhea,dry mouth,and subjective fever disappeared.The overall symptom relief rate increased,with significant improvement in symptoms such as spontaneous sweating,body aches,aversion to wind,headaches,and coughing.Based on the symptoms that showed less noticeable relief and patient feedback from the second phase,a second prescription optimization was conducted.Adjustments included increasing the dosage of Fuling from 12 g to 20 g,Huangqin from 5 g to 10 g,Sheng Dihuang from 6 g to 10 g,and Jiegeng from 6 g to 10 g.The preparation was changed to granules,and stevioside was added as a flavoring agent.Statistical analysis of the third phase questionnaire showed that the total symptom relief rate further increased for 18 symptoms.Notable improvements were observed in symptoms such as dry and burning throat,heavy limbs,fever,thirst with reduced fluid intake,and nausea.Almost no adverse reactions or suggestions were re

关 键 词：突发重大传染性公共卫生事件 中药处方调整 益气固表预防方 症状缓解率 数据收集 

分 类 号：R28[医药卫生—中药学]