基层医院消化系统疾病中成药使用情况分析  

Analysis of the use of Chinese patent medicines for digestive system diseases in primary healthcare facilities

作　　者：金祥龙 郭景仙[2] JIN Xianglong;GUO Jingxian(Department of Pharmacy,Baizhifang Community Health Service Center,Xicheng District,Beijing 100053,China;Department of Pharmacy,Xuanwu Hospital of Capital Medical University,Beijing 100053,China)

机构地区：[1]北京市西城区白纸坊社区卫生服务中心药械科,北京100053 [2]首都医科大学宣武医院药剂科,北京100053

出　　处：《中国当代医药》2025年第11期135-138,共4页China Modern Medicine

基　　金：北京市西城区中医药传承工程。

摘　　要：目的分析西城区白纸坊社区卫生服务中心门诊治疗消化系统疾病时中成药的不合理用药情况。方法回顾性分析白纸坊社区卫生服务中心2022年消化系统疾病中成药使用情况并制定管理对策。结果该机构消化系统疾病中成药按临床功效分类涉及8个大类、15个亚类,32个品种;其中以理气剂、清热剂和泻下剂品种数居多,分别占比28.13%、28.13%、12.50%。用药频度(DDDs)由高到低排在前五位的分别是便通胶囊、降脂通便胶囊、当归龙荟片、黄连上清胶囊以及加味逍遥丸。限定日费用(DDDC)由高到低排名前五的是摩罗丹、牛黄上清片、保和丸、荜铃胃痛颗粒以及小建中片。销售金额与DDDs的比值(B/A值)由高到低排名前五的是便通胶囊、黄连上清胶囊、加味逍遥丸、麻仁润肠丸及一清片。在随机抽取的2400张门诊消化系统疾病中成药处方中,有53张处方存在不合理用药的情况,占比达到了2.21%。其中,适应证不适宜、用法用量不适宜以及联合用药不适宜成为主要问题,分别占据了不合理处方的26.42%、26.42%和20.75%。结论西城区白纸坊社区卫生服务中心在门诊治疗消化系统疾病时,中成药的应用总体上是合理的,但仍然存在一些亟待改进的地方。建议通过加强全科医师的中成药使用培训,实行消化系统疾病中成药的分类管理,规范处方管理制度,定期进行处方专项点评和专项培训,优化处方前置审核系统的规则等方法提高用药合理性,保障患者用药安全者。Objective To analyze the irrational use of Chinese patent medicines in the treatment of digestive system diseases at the outpatient department of Baizhifang Community Health Service Center in Xicheng District.Methods The use of Chinese patent medicines for digestive system diseases at Baizhifang Community Health Service Center in 2022 was analyzed retrospectively,and management strategies were formulated.Results The classification of Chinese patent medicines for digestive system diseases in this institution involved 8 major categories,15 subcategories,and 32 varieties based on their clinical efficacy.Among them,the number of varieties of qi-regulating agents,heat-clearing agents,and purgatives were the most,accounting for 28.13%,28.13%,and 12.50%respectively.The top five drugs ranked by DDDs(defined daily doses)from high to low were Bian Tong Capsules,Jiang Zhi Tong Bian Capsules,Dang Gui Long Hui Tablets,Huang Lian Shang Qing Capsules,and Jia Wei Xiao Yao Pills.The top five drugs ranked by DDDC(defined daily cost)from high to low were Mo Luo Dan,Niu Huang Shang Qing Tablets,Bao He Pills,Bi Ling Wei Tong Granules,and Xiao Jian Zhong Tablets.The top five drugs ranked by the B/A ratio(sales amount to DDDs ratio)were Bian Tong Capsules,Huang Lian Shang Qing Capsules,Jia Wei Xiao Yao Pills,Ma Ren Run Chang Pills,and Yi Qing Pills.Among the 2400 outpatient prescriptions for digestive system Chinese patent medicines randomly selected,53 prescriptions were found to have irrational medication issues,accounting for 2.21%.Among them,inappropriate indications,inappropriate usage and dosage,and inappropriate combination therapy were the main problems,accounting for 26.42%,26.42%,and 20.75%of the irrational prescriptions,respectively.Conclusion The use of Chinese patent medicines in the treatment of digestive system diseases at the outpatient department of Baizhifang Community Health Service Center in Xicheng District is generally reasonable,but there are still some areas that need improvement.It is recommended to improve med

关 键 词：消化系统疾病 中成药 处方点评 基层医院 

分 类 号：R287[医药卫生—中药学]