目的：为制订相关政策及具体措施促进合理用药提供依据。方法：对云南省A、B、C地区（分别代表经济发达地区、中等

经济发展地区、经济欠发达地区）的14 个乡镇卫生院和18 个村卫生室的191 名乡村医生进行抗菌药物、糖皮质激素认知问卷调查

及处方抽查，并就调查结果进行统计分析。结果：共发放调查问卷382 份（抗菌药物和糖皮质激素问卷各191 份），回收有效问卷

382 份，有效回收率为100％；共计抽查处方2 300 张。问卷调查结果显示，受访乡村医生对抗菌药物和糖皮质激素的认知及使用

情况仍存在一些误区和盲目性，如β-内酰胺类抗菌药物的用法大多没有完全掌握，对抗菌药物的经验性选用和用药疗程部分仍不

完全清楚，对于激素的分类、禁忌证超过40％的受访者不清楚，超过半数不知道《糖皮质激素类药物临床应用指导原则》；门诊处

方抽查结果显示，抗菌药物和糖皮质激素处方比例存在地区差异，A地区抗菌药物和糖皮质激素处方比例是3 个地区中最高的，分

别为60.9％和18.9％；不合理处方比例最高的是C地区，为22.5％。结论：乡村医生对于抗菌药物和糖皮质激素的认知及合理使用

仍需加强。应采取有效措施，制订相应的监管制度并加以落实，加强乡村医生抗菌药物和糖皮质激素的知识培训，全面落实合理

用药原则，以提升其合理用药水平。

OBJECTIVE：To provide reference for implementing relevant policies and measures，and promote rational drug use.

METHODS：The cognition（questionnaire）and application（prescription spot checks）about antibiotics and glucocorticoids by 191

rural doctors from 14 township hospitals and 18 health room in area A，B and C（representing the economically developed areas，

moderately developed areas and undeveloped areas）were investigated，and the results were statistically analyzed. RESULTS：Totally

382 questionnaires were sent out（191 for antibiotics and 191 for glucocorticoids），and 382 were effectively received with effective

recovery of 100％；and 2 300 prescriptions were checked. Results of questionnaire showed，there were still some misunderstandings

and blindness among the rural doctors’cognition and application about antibiotics and glucocorticoids，the usage of β-lactam

was not fully grasped，part of the empirical use of antibiotics and drug treatment was still not entirely clear，more than 40％

had no clear ideas about the classification and contraindications of hormones，and more than half of them didn't know the Glucocorticoids

Clinical Practice Guidelines；results of prescription spot checks showed，there were regional differences about the proportion

of antibiotics and glucocorticoids，area A had the highest proportion among 3 areas，accounting for 60.9％ and 18.9％，respectively.

And area C showed highest proportion about unreasonable prescriptions，accounting for 22.5％. CONCLUSIONS：The cognition

and reasonable use of rural doctors for antibiotics and glucocorticoids still needs to be strengthened. It is suggested to take effective

measures，formulate and implement the corresponding supervision system，strengthen antibiotics and glucocorticoids knowledge

training for rural doctors and fully implement the the principles of rational drug use to improve the rational drug use.