摘要
目的 为含毒性饮片中成药的临床合理应用提供参考。方法 收集2019年至2021年上海中医药大学附属岳阳中西医结合医院含毒性饮片中成药,按2020年版《中国药典(一部)》将毒性饮片分为“小毒”“有毒”“大毒”三类,统计含毒性饮片中成药品种数、功效、销售金额、使用量等。抽取2020年9月销售金额排序居前5位的含毒性饮片中成药处方2 111张和住院医嘱299张,临床药师点评处方合理性。结果 2019年至2021年,含毒性饮片中成药品种数分别有60种、57种、51种,总品种数62种,按临床功效分为化痰、止咳、平喘剂,抗肿瘤药,祛瘀剂等12类,含小毒、有毒、大毒中药饮片分别有27种、42种、8种;含毒性饮片的中成药品种数占中成药总品种数的比例为27.18%,销售金额占中成药总销售金额的比例逐年下降。艾迪注射液、宣肺止嗽合剂、罗浮山风湿膏药的不合理处方/医嘱比例居前3位,分别为18.82%,16.86%,10.37%,主要表现为用法用量不当、适应证不适宜和重复用药。结论 对于含毒性饮片中成药应辨证用药,合理配伍,严格控制剂量,临床药师前置审方可提高处方合理性,保证用药安全、有效。
Objective To provide a reference for the clinical rational use of Chineses patent medicines containing toxic decoction pieces.Methods The Chinese patent medicines containing toxic decoction pieces in the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine from 2019 to 2021 were collected and classified into the low-toxic,toxic and high-toxic decoction pieces according to the Chinese Pharmacopoeia(2020 Edition,VolumeⅠ).The varieties,efficacy,sales amount and use amount of Chinese patent medicines containing toxic decoction pieces were analyzed.A total of 2111 prescriptions and 299 inpatient medical advice of the top five Chinese patent medicines containing toxic decoction pieces with higher sales amount in September 2020 were selected,and the rationality of prescriptions was commented by clinical pharmacists.Results From 2019 to 2021,there were 60,57 and 51 kinds of Chinese patent medicines containing toxic decoction pieces respectively,with a total of 62 kinds.According to the clinical efficacy,the above medicines were divided into 12 categories,such as expectorants,antitussive,antiasthmatic agents,anti-tumor medicines and blood stasis-removing agents.There were 27,42 and eight kinds of Chinese patent medicines containing low-toxic,toxic and high-toxic decoction pieces respectively.The proportion of the varieties of Chinese patent medicines containing toxic decoction pieces in the total varieties of Chinese patent medicines was 27.18%,and its proportion of sales amount in the total sales amount of Chinese patent medicines decreased year by year.The proportions of irrational prescriptions and medical advice of Aidi Injection(18.82%),Xuanfei Zhisou Mixture(16.86%)and Luofushan Rheumatism Plaster(10.37%)were the top three,and the irrational use mainly were improper usage and dosage,improper indications and repeated medication.Conclusion We should use Chinese patent medicines containing toxic decoction pieces based on the syndrome differentiati
作者
刘静
韩梦媛
徐熠
吴铁军
黄瑾
LIU Jing;HAN Mengyuan;XU Yi;WU Tiejun;HUANG Jin(The Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,China 200437;Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai,China 200032)
出处
《中国药业》
CAS
2023年第7期39-43,共5页
China Pharmaceuticals
基金
上海市卫生和计划生育委员会科研课题-青年项目[20174Y0194]
上海市进一步加快中医药传承创新发展三年行动计划(2021年-2023年)项目[ZY(2021-2023)-0203-03]
上海市“医苑新星”青年医学人才培养资助计划[沪卫人事[2020]87号]。
关键词
毒性饮片
含毒性饮片中成药
用药分析
toxic decoction pieces
Chinese patent medicines containing toxic decoction pieces
medication analysis
