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中药临床应用“禁“”忌“”慎”禁忌用语的认知现状研究
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| 篇名： | 中药临床应用“禁“”忌“”慎”禁忌用语的认知现状研究 |
| TITLE： | Study on the Cognitive Status Quo of “Prohibiting“”Avoiding“”Using Caution ”in the Clinical Application of TCM |
| 摘要： | 目的：了解临床对中药应用“禁“”忌“”慎”禁忌用语的认知现状，为规范中药“禁“”忌“”慎”的内涵与合理应用提供参考。方法：基于“知识-态度-行为”理论，并结合文献调研和临床实际分别设计医师/药师版问卷和患者版问卷。通过“腾讯问卷”平台，采用线上不记名的方式分别向全国32个省（市、自治区）的近300家医疗机构发放医师/药师版问卷800份，向全国范围内使用过中药的大众患者发放患者版问卷800份。对回收问卷分别从认知度、关注度和行为力3个维度进行降维处理后，采取10分制评估临床对中药应用“禁“”忌“”慎”用语的认知、关注、行为等情况。结果：医师/药师版问卷共收回703份，其中有效问卷638份，回收率为87.9％，有效率为90.8％，Cronbachalpha系数为0.90；患者版问卷共收回644份，其中有效问卷621份，回收率为80.5％，有效率为96.4％。医师、药师对中药临床应用“禁“”忌“”慎”用语的认知度评分为（7.94±1.21）分，患者的认知度评分为（5.64±1.54）分；医生、药师对上述用语的关注度评分为（9.47±1.15）分（与认知度评分的斯皮尔曼Rho相关系数为0.077，P＞0.05），行为力评分为（7.01±1.71）分（与认知度评分的斯皮尔曼Rho相关系数为－0.021，P＞0.05）；患者的行为力评分为（7.43±1.72）分（与认知度评分的斯皮尔曼Rho相关系数为0.233，P＜0.01）。中医药教材（89.2％）、培训会议（66.5％）及本草方书（58.2％）是医师、药师学习上述禁忌用语知识的主要途径；医务人员（74.2％）和网络（52.5％）是患者了解上述禁忌用语的主要途径。结论：医师、药师和患者对中药临床应用“禁“”忌“”慎”用语的关注度均较高，而认知度与行为力较低。中药临床应用“禁“”忌“”慎”用语的认知界定较为模糊，相应的临床实践行为缺失，有待建立中医药领域的临床专家共识并积极宣传、推广，提高中药临床合理使用水平。 |
| ABSTRACT： | OBJECTIVE：To understand the current status of clinical understanding of “prohibiting”“avoiding”“using caution ” in the application of TCM ，and to provide reference for standardizing the connotation and rational application of “prohibiting” “avoiding”“using caution ”of TCM. METHODS ：Based on the theory of “knowledge-attitude-behavior”，doctor-pharmacist questionnaires and patient questionnaires were designed on the basis of literature research and clinical practice. Through the “Tencent questionnaire ”platform，800 doctor-pharmacist questionnaires were distributed to nearly 300 medical institutions from 32 provinces（cities，autonomous regions ）and 800 patient questionnaires were distributed to public patiants who had used TCM nationwide by anonymous online method. After dimensionality reduction of the questionnaire from three dimensions of cognition ， attention and behavior ，the cognition ，attention and behavior of “prohibiting”“avoiding”“using caution ”in the application of TCM were evaluated by 10 points system. RESULTS ：A total of 703 doctor-pharmacist questionnaires were collected ，including 638 valid questionnaires with recovery rate of 87.9％ and effective rate of 90.8％；Cronbach alpha coefficient was 0.90. A total of 644 patient questionnaires were collected ，including 621 valid questionnaires with recovery rate of 80.5％ and effective rate of 96.4％ . The cognition score of doctors and pharmacists to the terms of “prohibiting”“avoiding”“using caution ”in clinical application of TCM was （7.94±1.21），and that of patients was （5.64±1.54）. The score of doctors and pharmacists ’attention to the above terms was （9.47±1.15）（Spearman Rho correlation coefficient with cognition score was 0.077，P＞0.05），and the score of behavioral ability of patients was （7.01±1.71）（Spearman Rho correlation coefficient with cognition score was －0.021，P＞ 0.05）. The score of behavior ability was （7.43 ± 1.72） （Spearman Rho correlation coefficient with cognition score was 0.233，P＜0.01）. TCM textbooks （89.2％），trainingmeetings （66.5％） and herbal prescriptions （58.2％） were the main ways for doctors and pharmacists to learn the above taboos. Medical staff （74.2％）and internet （52.5％）were the main ways for patients to understand the above taboos. CONCLUSIONS ：Doctors，pharmacists and patients pay more attention to the terms of “prohibiting”“avoiding”“using caution ”in the clinical application of TCM ，but their cognition and executive power were low. Clinical cognition of “prohibiting”“avoiding”“using caution ”in the application of TCM is relatively vague，and the corresponding clinical practice behavior is lacking. It is yet to establish clinical specialist consensus in the field of TCM and publicize it actively to improve the level of clinical rational drug use. |
| 期刊： | 2021年第32卷第03期 |
| 作者： | 姜皓，张晓朦，张冰，林志健，萨日娜，张丹，吕锦涛 |
| AUTHORS： | JIANG Hao，ZHANG Xiaomeng ，ZHANG Bing，LIN Zhijian ，SA Rina，ZHANG Dan，LYU Jintao |
| 关键字： | 中药；临床应用；禁忌用语；认知；关注度；行为力 |
| KEYWORDS： | TCM；Clinical application ；Taboos；Cognition；Attention；Execution power |
| 阅读数： | 242 次 |
| 本月下载数： | 10 次 |
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