中药小包装饮片调剂操作流程规范化的研究

王陶丽 刘玉芹 刘灿坤

[摘要] 目的 制定统一中药小包装饮片的调剂操作流程，使其规范化、标准化、有利于操作，省时省力，便于审核，防止差错，杜绝医疗纠纷的发生。 方法 依据中药饮片的调剂规范流程，结合小包装饮片的特点，根据实际操作工作经验，制定便捷可靠、省时省力、科学操作的工艺流程。 结果 小包装饮片完全不同于中药饮片的调剂，其操作方法、审核等具有独特的操作性能，审、摆、看、对、拿、掂、分、核、包、发是其主要操作要点。 结论 中药小包装饮片解决了中药饮片不利于保管、不利于分发、不利于养护，以及调剂过程中的抓称繁琐、大小不均、分量不准、不利复核、脏乱质差等弊端，充分发挥了一药一包、易于鉴别、计量准确、名物易对易换、患者知情等优点。

[关键词] 小包装饮片；调剂操作；规范化

[中图分类号] R952 [文献标识码] B [文章编号] 2095-0616（2014）16-135-03

A study on standardization of dispensing procedure for small packages of Chinese herbal pieces

WANG Taoli LIU Yuqin LIU Cankun

Pharmacy of Traditional Chinese Medicine， Zibo First Hospital in Shandong Province， Zibo 255200， China

[Abstract] Objective To establish a unified dispensing procedure for small packages of Chinese herbal pieces and to make it standardized so as to operate it easily， save time and energy， provide convenience for examination， avoid mistakes and eliminate medical disputes. Methods A convenient and reliable， time and energy saving and scientific dispensing procedure was established according to the standardized dispensing procedure of Chinese herbal pieces， the features of small packages， and real working and operating experience. Results The dispensing procedure for small packages of herbal pieces was different from that of Chinese herbal pieces in that its operational procedure and examination had unique functions. The main operational points included investigating， arranging， viewing， comparing， holding， weighing， allocating， examining， packaging， and dispatching. Conclusion Small packages of Chinese herbal pieces solve the problems of Chinese herbal pieces which are not easy to keep， allocate and maintain， as well as the problems during dispensing such as complicated weighing， uneven size， inaccurate weight， unfavorable condition for re-examination， messy environment and low quality； advantages such as one type of drug in one bag， easy identification， accurate weighing， easy check and exchange by name and drug， and informed consent for patients are ensured.

[Key words] Small packages of Chinese herbal pieces； Dispensing procedure； Standardization

中药饮片是中医临床辨证治病的重要手段之一，历来中药饮片的调剂是依据中医处方将散在的中药饮片用手抓戥称，按剂分发（一剂一分一称或估计分发），由于饮片规格大小不等，使其难于称量，难于分匀，尘土泥沙碎削混杂，调剂时撒一桌，漏一地，脏一身，浪费污染大，效率低，养护难[1]。为了适应社会文明、工作高效、科学管理的需要，国家中医药管理局组织6个单位起草，19个单位为试点进行小包装试点运行，并于2008年8月11日正式下发“国中医药办发[2008]34号《小包装中药饮片医疗机构应用指南》”，自2008年至今我们统计资料显示，与小包装饮片相关报道近50篇，但基本都是报道应用体会、优缺点、调配差错、建议及对策之类[2]。……