1200张中医皮肤门诊处方合理性分析与临床用药方案探讨  

Rationality analysis of 1200 traditional Chinese medicine dermatology outpatient prescriptions and exploration of clinical medication regimens

作　　者：张弩 刘荣丰[1] 杨春燕[1] 王鹏 李琼 付寒[1] ZHANG Nu;LIU Rong-feng;YANG Chun-yan(Pharmacy Department,Shenzhen Chronic Disease Prevention and Control Center,Shenzhen 518020,China)

机构地区：[1]深圳市慢性病防治中心药剂科,518020

出　　处：《中国现代药物应用》2025年第6期153-156,共4页Chinese Journal of Modern Drug Application

摘　　要：目的评价中医皮肤门诊处方合理性,促进临床合理用药。方法采用回顾性调查方法抽取中医皮肤门诊处方1200张,采用帕累托图分析出现不合理处方的主要因素,评价处方合理性,统计临床常见疾病证型的种类,分析用药方案中经典名方的用法,收集临床人用经验信息。结果1200张中医皮肤门诊处方中,不合理处方有90张,占总处方数量的7.5%,其中不规范处方57张、占比63.3%,为出现不合理处方的A类因素(主要因素),用药不适宜处方26张、占比28.9%,特殊人群用药不适宜处方6张、占比6.7%,超长处方1张、占比1.1%。1200张中医皮肤门诊处方中最常见的8种疾病证型分别为肺经风热证、肝胆湿热证、营卫不和证、气滞血瘀证、肝郁不舒证、肝郁脾虚证、肝肾不足证、脾肾阳虚证。临床治疗方案中常用的经典名方包括消风散、龙胆泻肝汤、桂枝汤、当归四逆汤、小柴胡汤、逍遥散、六味地黄丸、五味消毒饮、黄连解毒汤。结论通过处方合理性评价和药物人用经验信息的收集与分析,既能促进临床合理用药管理,又能助力医院皮肤科中药制剂的研究,一举多得。Objective To evaluate the rationality of traditional Chinese medicine dermatology outpatient prescriptions and promote rational use of drugs in clinical practice.Methods A retrospective survey method was used to extract 1200 prescriptions from traditional Chinese medicine dermatology outpatient,and a Pareto chart was used to analyze the main factors causing rational prescriptions and evaluate their rationality.The types of common clinical disease syndromes were counted,the usage of classical prescriptions in medication regimen was analyzed,and the information of human use experience was collected.Results Among the 1200 prescriptions from traditional Chinese medicine dermatology outpatient,there were 90 irrational prescriptions,accounting for 7.5%of the total number of prescriptions,including 57 irregular prescriptions,accounting for 63.3%of the total number of prescriptions,which was the class A factor(main factor)for the occurrence of irrational prescriptions,26 prescriptions for inappropriate use of medication,accounting for 28.9%of the total number of prescriptions,6 prescriptions for inappropriate use of medication by special populations,accounting for 6.7%of the total number of prescriptions,and 1 extraordinary prescription,accounting for 1.1%of the total number of prescriptions.The most common 8 disease patterns in 1200 prescriptions from traditional Chinese medicine dermatology outpatient were lung meridian wind-heat syndrome,liver and gallbladder damp-heat syndrome,Yingwei disharmony syndrome,qi stagnation and blood stasis syndrome,liver depression and non relaxation syndrome,liver depression and spleen deficiency syndrome,liver and kidney deficiency syndrome,and spleen and kidney yang deficiency syndrome.Classical prescriptions commonly used in clinical treatment protocols included Xiaofeng San,Longdan Xiegan Decoction,Guizhi Decoction,Danggui Sini Decoction,Xiao Chaihu Decoction,Xiaoyao San,Liuwei Dihuang Pill,Wuwei Xiaodu Drink,and Huanglian Jiedu Decoction.Conclusion Through the rational evaluation of

关 键 词：中医皮肤门诊 处方合理性评价 中药人用经验 疾病证型 经典名方 皮肤科中药制剂 

分 类 号：R288[医药卫生—中药学]