某儿童医院含毒性中成药临床使用及合理性评价OA
Clinical Use and Rationality Evaluation of Toxic Chinese Patent Medicines in a Children's Hospital
目的 为儿童医院门急诊含毒性中成药的临床使用提供参考.方法 采用横断面调查法,通过医院信息系统收集医院门急诊药房 2023 年每季度首月第 10日含毒性中成药处方,收集使用量、药品毒性成分、用法用量、适应证与临床诊断、联合用药情况等数据并汇总分析.结果 25种含毒性中成药中,口服类 19 种,使用量排名前 3 的依次为小儿定喘口服液、小儿咳喘灵口服液和小儿豉翘清热颗粒.外用类 6 种,使用量排名前 3 的依次为开喉剑喷雾剂、小儿清热宣肺贴膏和川百止痒洗剂.口服类含毒性中成药用法用量正确率为 46.96%,剂量及频次均正确的药品有 4 种,其余大多为单次剂量和/或频次偏低;疗程不合理 2 例;诊断与用药相符率为 99.15%;口服类和外用类含毒性中成药联合用药不适宜分别为 75 例和 7 例,不适宜原因多为重复用药,包括含相同毒性成分、功效重复、主治重复.结论 该院口服类含毒性中成药的用量正确率较低,且为剂量偏小,难以保证用药的有效性;诊断与用药相符率较高;重复用药情况较多,尤其是含相同毒性成分的 2 种毒性中成药的联用.医院应加强对含毒性中成药的管理,强化医师和药师的用药教育.
Objective To provide a reference for the clinical use of toxic Chinese patent medicines in outpatient and emergency settings of children's hospitals.Methods Prescriptions for toxic Chinese patent medicines from the outpatient and emergency pharmacy of the hospital on the 10th day of the first month of each quarter in 2023 were collected through the hospital information system by using cross-sectional survey method.Data on usage volume,toxic components,usage and dosage,indications and clinical diagnoses,and drug combination were collected and analyzed.Results Among the 25 toxic Chinese patent medicines,19 were oral preparations.The top three oral preparations by usage volume were Xiao'er Dingchuan Oral Liquid,Xiao'er Kechuanling Oral Liquid,and Xiao'er Chiqiao Qingre Granules.There were six topical preparations,with the top three by usage volume being Kaihoujian Spray,Xiao'er Qingre Xuanfu Tiegao,and Chuanbai Zhiyang Lotion.For oral toxic Chinese patent medicines,the correct rate of usage and dosage was 46.96%.Only four medicines had both correct dosage and frequency,while the rest mostly had low single doses and/or low frequency.There were 2 cases of unreasonable course of treatment.The consistency rate between diagnosis and medication was 99.15%.There were 75 cases of irrational concomitant use of oral toxic Chinese patent medicines and 7 cases of irrational concomitant use of topical toxic Chinese patent medicines,with the main reason being repeated medication,including the same toxic components,overlapping efficacy,and overlapping indications.Conclusion The correct rate of usage and dosage for oral toxic Chinese patent medicines in the hospital is low,with most cases involving low doses,making it difficult to ensure therapeutic efficacy.The consistency rate between diagnosis and medication is high.There is a high incidence of repeated medication,particularly the combination use of two toxic Chinese patent medicines containing the same toxic components.Hospitals should strengthen the management of toxic Chinese patent medicines and enhance medication education for physicians and pharmacists.
李云;李帅锋;王二款
苏州大学附属儿童医院,江苏 苏州 215025苏州大学附属儿童医院,江苏 苏州 215025苏州大学附属儿童医院,江苏 苏州 215025
医药卫生
含毒性中成药儿童医院合理用药用药安全
toxic Chinese patent medicineschildren's hospitalrational drug usemedication safety
《中国药业》 2026 (10)
31-35,5
江苏省苏州市应用基础研究(医疗卫生)科技创新项目[SYWD2024276].
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