目的：为提升县级公立医院合理用药水平提供参考。方法：分析我院合理用药相关指标数据，并对周边的县级公立医院

相关指标数据进行调查和分析，结合相关法律法规和政策，建立了包括行政管理指标、门诊管理指标、住院管理指标、药品采购管

理指标等四部分共36 项的合理用药管理指标体系，并在应用中不断完善和优化；同时，通过统计和分析我院2010－2014 年合理用

药相关指标数据评价该体系应用的成效。结果：5 年间，我院药品收入占业务收入的比例（药占比）下降10.3％；抗菌药物临床使用

指标逐步优化，门诊患者抗菌药物处方比例由57.1％降至19.3％，住院患者抗菌药物使用率由90.2％降为56.5％，Ⅰ类切口手术患

者预防使用抗菌药物比例由94.6％降为28.6％，接受抗菌药物治疗的住院患者抗菌药物使用前微生物检验样本送检率由8.4％升

至32.7％；基本药物使用品种比例上升25.5％，使用金额比例上升24.1％。该体系的建立和应用促进了我院合理用药和药事管理

水平的提高，也帮助我院顺利通过国家三级乙等综合医院的评审。结论：本研究建立的合理用药管理指标体系具有全面性和可行

性，可为县级公立医院强化合理用药管理提供借鉴。

OBJECTIVE：To provide reference for improving the level of rational drug use in public hospitals at county level.

METHODS：The relevant indicator data of rational drug use in our hospital was analyzed，and the relevant indicator data of the hospitals

at county level around it was investigated and analyzed，a total of 36 parts of rational drug use management indicator system

was established，including administrative management indicators，outpatient management indicators，hospital management indicators，

and drug procurement management indicators，and it was constantly improved and optimized. Meanwhile，relevant indicator

data of rational drug use from 2010 to 2014 was statistically analyzed to evaluate the effect of the effectiveness of the system. RESULTS：

In the 5 years，the drug revenues accounted for revenue ratio（the ratio of drug）decreased by 10.3％；the use indicators

of antibiotics in clinic showed gradual optimization，the proportion of outpatient antibiotic prescriptions decreased from 57.1％ to

19.3％，the use rate of inpatient antibiotic decreased from 90.2％ to 56.3％，the proportion of type I incision operation preventive

use of antibiotics decreased from 94.6％ to 28.6％，and the submission rate of microbiological sample of inpatients before they received

the treatment of antibiotics increased from 8.4％ to 32.7％；the proportion of essential medicines increased 25.5％，and proportion

of use amount increased to 24.1％；the application of the system promoted the improvement of rational drug use and pharmacy

management level in our hospital，and also helped the hospital successfully passed the national three class comprehensive hospital

evaluation. CONCLUSIONS：The established rational drug use management indicator system is comprehensive and feasible，

and can provide reference for strengthening rational drug use management and medical and health system decision in China.