徐州市中医院毒性中药饮片超剂量使用情况分析及多层次干预模式构建OA
Analysis of Excessive Dosage Application of Toxic Chinese Herbal Decoction Pieces and Construction of a Multilevel Intervention Model at Xuzhou Hospital of Traditional Chinese Medicine
目的 分析徐州市中医院门诊毒性中药饮片超剂量使用特征,识别高危品种、重点科室及高风险人群,并在此基础上构建多层次干预模式,为提高临床合理用药水平和保障患者用药安全提供依据.方法 回顾性整理2024年6月—2025年6月徐州市中医院门诊含毒性中药饮片处方,统计超剂量使用及联合应用情况,分析超剂量处方在不同品种、科室及患者特征中的分布,并比较超剂量组与非超剂量组在人口学特征及基础疾病方面的差异.结果 共纳入含毒性中药饮片处方13 725张,其中超剂量处方2 686张,占19.56%.肿瘤科、消化内科及神经内科为超剂量处方主要来源科室;制川乌、制草乌、水蛭、全蝎、蜈蚣等为主要超剂量品种.合并基础疾病患者更易出现超剂量使用,且超剂量处方中两种及以上毒性中药饮片联用较为常见.结论 徐州市中医院毒性中药饮片临床应用较为普遍,超剂量及联用风险不容忽视.应在现有管理基础上进一步完善处方预警、药师审核干预及重点科室教育相结合的多层次管理模式,以促进毒性中药饮片合理使用并提升用药安全.
Objective To analyze the characteristics of excessive dosage application of toxic Chinese herbal decoction pieces in outpatient prescriptions at Xuzhou Hospital of Traditional Chinese Medicine,to identify high-risk varieties,key clinical departments and vulnerable populations.On this basis,a multilevel intervention model was established,so as to provide evidence for improving the standard of rational clinical medication and ensuring patients'medication safety.Methods The outpatient prescriptions containing toxic Chinese herbal decoction pieces at Xuzhou Hospital of Traditional Chinese Medicine from June 2024 to June 2025 were retrospectively collected and sorted out.The conditions of excessive dosage application and combined medication were statistically analyzed.The distribution of over-limit prescriptions across different medicinal varieties,clinical departments and patient characteristics was explored.In addition,demographic characteristics and underlying diseases were compared between the excessive dosage group and the normal dosage group.Results A total of 13,725 outpatient prescriptions containing toxic Chinese herbal decoction pieces were enrolled,among which 2,686 prescriptions involved excessive dosage application,accounting for 19.56%.The Department of Oncology,Department of Gastroenterology and Department of Neurology were the primary departments generating excessive-dose prescriptions.Processed Aconiti Radix,Processed Aconiti Kusnezoffii Radix,Hirudo,Scorpio and Scolopendra were the major varieties with frequent excessive dosing.Patients complicated with underlying diseases were more prone to receive overdosed prescriptions.Besides,the combined use of two or more types of toxic herbal decoction pieces was prevalent in excessive-dose prescriptions.Conclusion Toxic Chinese herbal decoction pieces were widely applied clinically in Xuzhou Hospital of Traditional Chinese Medicine,and the risks arising from excessive dosage application and combined medication cannot be ignored.On the basis of the current management system,a multilevel management model integrating prescription early warning,pharmacist review and intervention,and professional education for key departments should be further optimized,so as to promote the rational clinical application of toxic herbal decoction pieces and improve medication safety.
宋洪伟
徐州市中医院药剂科,江苏 徐州 221000
医药卫生
毒性中药饮片超剂量使用联用多层次干预管理模式
toxic Chinese herbal decoction piecesexcessive dosage applicationcombined medication applicationmultilevel interventionmanagement model
《光明中医》 2026 (13)
46-51,6
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