我院1268张门诊中药饮片处方点评与分析

李欣

[摘要]目的 对我院近期门诊中药饮片处方进行点评与分析，了解中药饮片不合理使用情况，提高临床用药合理性。方法 2019年9月～2020年2月，每月从广州市第一人民医院门诊中药房随机抽取中药饮片处方约200张，根据《处方管理办法》《中药处方格式及书写规范》《医院处方点评管理规范（试行）》对处方进行点评与分析。结果 我院门诊中药饮片处方不合理使用率为25.07%，主要问题为有毒/小毒中药超量使用、未注明特殊煎煮要求。结论 医师、药师、管理部门三方并行落实处方点评制度和监督，有助于规范中药饮片处方，保障临床合理用药。

[关键词]门诊;中药饮片;处方点评;合理用药

[中图分类号] R925          [文献标识码] A          [文章编号] 1674-4721（2020）6（b）-0184-04

[Abstract] Objective To understand the irrational use of Chinese herbal pieces and improve the rationality of clinical medication by comments and analysis of the recent prescriptions of Chinese herbal pieces in outpatient department of our hospital. Methods From September 2019 to February 2020， about 200 pieces of outpatient prescriptions of Chinese herbal pieces were randomly extracted in the traditional Chinese medicine pharmacy of Guangzhou First People′s Hospital every month. According to Prescription Administrative Method， Prescription of Traditional Chinese Medicine Format and Writing Norms， and Hospital Prescription Comments Management Norms （Trial）， the prescriptions were commented and analyzed. Results The irrational use rate of the outpatient prescription of Chinese herbal pieces of our hospital was 25.07%. Excessively using toxic/small toxic Chinese mdicine and unspecified special decoction requirements were the main problems. Conclusion Clinicians， pharmacists and management departments should implement the prescription comment system and supervision simultaneously， which is helpful to standardize the prescription of Chinese herbal pieces and ensure the rationality of clinical medication.

[Key words] Outpatient department; Chinese herbal pieces; Prescription analysis; Rational drug use

世界卫生组织（WHO）将“合理用药”定义为：患者所接受的药物治疗方案符合其临床需求，药物劑量满足其个体化需求，在足够长的时间内具有最低的成本[1]。其核心宗旨便是有效、安全、经济地防治和治愈疾病。中药饮片作为我国预防和治疗疾病的传统药物，其特色和优势越来越受国际认可和接受。中医中药步入现代化甚至国际化发展，则需要有健全的用药管理制度及标准。因此，规范中药饮片的使用，保证临床用药的有效性、安全性和经济性，将是医疗机构持续改进和提高合理用药的必要措施，也是中医中药发展的必要要求。为了解我院门诊中药饮片处方合理性及用药情况，提供合理用药数据，本研究对近期门诊中药饮片处方进行回顾性点评，为规范中药饮片处方管理，提高中药处方质量，保障临床合理用药提供依据。……