陈蓓蓉 赵赟 张东梅

[摘要] 目的 通过对门诊处方的点评，旨在了解上海交通大学附属第六人民医院扎冲十三味丸的用药情况及存在的问题。 方法 利用医院计算机系统，通过用药监测数据确定点评药品品种。采取回顾性处方评价方法，抽取2017年5月门诊各科室扎冲十三味丸处方共663张进行统计分析。从各科室不合理处方占比、药物用法用量不合理、重复给药、适应证不适宜、有配伍禁忌的药物联用，以及疗程和时长几个方面进行统计分析。 结果 5月扎冲十三味丸不合理处方占比15.84%。不合理用药比例居首为骨科。不合理处方中药物用法用量不合理占67.62%，重复给药占33.33%，适应证不适宜占0.95%，有配伍禁忌的药物联用占2.86%，疗程和用药时长问题占2.86%，部分处方存在多项不合理。 结论 扎冲十三味丸在临床使用中存在一定的不合理情况，需要对其加强监督管理。临床需重视中成药的合理使用情况，以保证患者用药安全，减少不良反应的发生。

[关键词] 不合理处方；处方分析；合理用药

[中图分类号] R942 [文献标识码] A [文章编号] 1673-7210（2018）08（c）-0168-04

[Abstract] Objective To understand the usage and existing problems of Zhachong Shisanwei Pills in the Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University by reviewing the outpatient prescriptions. Methods Medications reviewed during the research were chosen according to the medication usage evaluation data by using the hospital network. 663 prescriptions from the outpatient pharmacy in May 2017 were randomly selected to be reviewed by using a retrospective method and the results were analyzed statistically. The analysis was conducted based on the rate of irrational prescriptions in different departments， irrational usage and dosage， repeated administration， inappropriate medication use， drug interaction and duration of treatment. Results The overall rate of irrational prescriptions was 15.84%， the most were from Department of Orthopedics. Among the problems in these irrational prescriptions， 67.62% of them were irrational usage and dosage， 33.33% were repeated administration， 0.95% were inappropriate medication use， 2.86% were drug interaction， and 2.86% were duration of treatment. Some prescriptions contained more than one mistake. Conclusion The usage of Zhachong Shisanwei Pills in clinic has some existing problems， the closer drug monitoring is needed， clinical staff need to pay more attention to the use of Chinese patent medicines to make sure patients' safety and to reduce the occurrence of adverse drug reactions.

[Key words] Irrational prescriptions； Prescription analysis； Rational drug use

上海交通大學附属第六人民医院（以下简称“我院”）成立了“临床用药动态监控小组”，由分管院长任组长，医保办牵头负责，医务处、药剂科等多个职能部门协同合作。由计算机中心每月提交全院用药监测数据，药剂科每月统计全院前30位用药情况及发生的总费用，医保办统计科室用药前10位情况，结合临床工作量及病种结构，分析用药及药占比变化及费用的合理性。……