全国13家中医院中药饮片处方剂量现状调研与分析
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篇名: 全国13家中医院中药饮片处方剂量现状调研与分析
TITLE: Investigation and Analysis of the Dose Status of TCM Decoction Piece Prescription in 13 TCM Hospitals
摘要: 目的:为规范中药饮片临床合理应用提供依据。方法:通过电子问卷的方式对全国10个省(区、市)12家中医院中药饮片处方使用情况(处方剂量、药味数)进行调研;通过医院信息系统收集并分析河南中医药大学第一附属医院(我院)2016年5月-2019年4月共计416100张门诊中药饮片处方的处方剂量、药味数及处方中饮片使用情况,同时分析不同科室中药饮片处方使用情况,探讨中药饮片处方临床应用现状并提出相关建议。结果:12家中医院的中药饮片处方平均剂量为129.60~245.00g,平均药味数为11.90~18.25味;儿科中药饮片处方平均剂量均低于其他科室。我院中药饮片处方平均剂量为242.21g,剂量分布在201~300g的处方数占55.75%,超过300g的处方数占15.22%;处方平均药味数为15味,药味数分布在11~20味的处方数占87.75%,超过20味的处方数占6.64%。我院中药饮片处方中使用频次排名前20位的中药饮片均有不同程度的超剂量使用情况,超剂量使用频率最高的3味饮片为醋郁金(占85.51%)、麸炒白术(占82.10%)和白术(占79.13%);我院内科中药饮片处方数占40.84%;内科和外科中药饮片处方剂量超过300g(分别占11.98%、18.69%)、药味数超过18味(分别占14.60%、9.53%)的处方较多;儿科中药饮片处方药味数超过18味的处方占24.09%。结论:中药饮片处方整体剂量偏高、药味数过多,处方中单味中药饮片超剂量使用现象普遍存在。其中,内、外科应着重把控中药饮片处方药味数、单味中药饮片用量以规范处方剂量,妇科需着重控制单味中药饮片用量,儿科应特别关注处方药味数的使用,以保证更加科学、合理地规范中药饮片处方临床应用。
ABSTRACT: OBJECTIVE:To provide reference for r ational use of TCM decoction piece. METHODS :Electronic questionnaire survey was conducted on the use (dose,ingredient number )of TCM decoction piece prescriptions in 12 TCM hospitals from 10 provinces(regions,cities). Through the hospital information system ,416 100 outpatient prescriptions of TCM decoction piece were collected from the First Affiliated Hospital of Henan University of TCM (our hospital )during May 2016 to Apr. 2019,and were analyzed in terms of prescription dose ,the number of ingredients and use of TCM decoction pieces. At the same time ,the use of TCM decoction piece prescription were analyzed in different departments ,and the clinical application status of TCM decoction pieces prescription were investigated and relevant suggestions were put forward. RESULTS :The average dose of TCM decoction piece prescriptions in 12 hospitals were 129.60-245.00 g,and the average number of ingredients were 11.90-18.25;the average dose of TCM decoction piece prescriptions in pediatric department was lower than other departments. The average dose of TCM decoction piece prescriptions in our hospital was 242.21 g;55.75% of the prescription dose were distributed in 201-300 g,and 15.22% were over 300 g. The average number of ingredients in prescriptions was about 15,and the prescriptions with 11-20 ingredients accounted for 87.75%,those with more than 20 ingredients accounted for 6.64%. Top 20 TCM decoction pieces in TCM prescriptions of our hospital had different degrees of overdose. Three decoction pieces with the highest frequency of overdose were Radix Curcumae processed by vinegar (85.51%),Atractylodes macrocephala stir-fried with bran (82.10%)and A. macrocephala(79.13%). The number of TCM decoction piece prescriptions in internal medicine department accounted for 40.84% in our hospital ;there were a lot of TCM prescriptions with dose exceeding 300 g(11.98% and 18.69%)and the number of ingredients exceeding 18(14.60% and 9.53%)in internal medicine department and surgery department. The proportion of pediatric TCM decoction piece prescriptions with more than 18 ingredients accounted for 24.09%. CONCLUSIONS :The overall dosage of TCM decoction piece prescriptions is relatively high ,the number of ingredients is too much ,and the overdose of single-flavored TCM decoction piece is common. Internal medicine department and surgery department should focus on controlling the number of and the dosage of single-flavored decoction pieces of TCM prescriptions to standardize the prescribed dosage. Gynecology department needs to focus on controlling the dosage of single-flavored TCM pieces and pediatrics department should pay special attention to the use of prescription ingredients ,so as to ensure a more scientific and reasonable standard for the clinical application of TCM decoction piece.
期刊: 2021年第32卷第01期
作者: 陈玉欢,凌霄,刘淑钰,王盼盼,马志欢,李学林
AUTHORS: CHEN Yuhuan ,LING Xiao,LIU Shuyu,WANG Panpan ,MA Zhihuan ,LI Xuelin
关键字: 中药饮片处方;剂量;药味数;规范
KEYWORDS: TCM decoction piece prescripti ons;Dosage;Ingredient number ;Standard
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