2013-2015年西安交通大学第一附属医院门诊清热类中药饮片使用分析

CJI (Traditional Chinese Medicine) - - 中国中医药信息杂志 -

王思文,田会萍

西安交通大学第一附属医院,陕西 西安 710061

摘要:目的 通过分析西安交通大学第一附属医院门诊清热类中药饮片的临床使用情况,促进中药饮片的合理使用,保障患者用药安全。方法 利用 Excel2013 软件对西安交通大学第一附属医院 2013-2015 年清热类中药饮片的使用频率、功效分类、用量等进行汇总分析。结果 2013-2015 年,西安交通大学第一附属医院使用频率居前15位的清热类饮片中,清热解毒类占总体的40%以上,且平均用量超过现行药典剂量上限的

品种>30%,且超出药典用量率>30%的占总品种数11%,未超出部分仅占39%。结论 使用清热药时应仔细辨证,注意用药合理性,使用剂量也需谨慎且应得到有效规范。关键词:清热药;用药分析;合理用药

DOI:10.3969/j.issn.1005-5304.2017.11.032

中图分类号:R288 文献标识码:A 文章编号:1005-5304(2017)11-0124-04

Analysis on Usage of TCM Decoction Pieces for Heat Clearing in the First Affiliated Hospital of Xi’an Jiaotong University During 2013–2015

WANG Si-wen, TIAN Hui-ping (The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China)

Abstract: Objective To analyze the clinical application of TCM decoction pieces for heat clearing in the First Affiliated Hospital of Xi’an Jiaotong University; To promote rational administration of TCM decoction pieces, and guarantee patients’ medication safety. Methods By using Microsoft Office Excel 2013 software, use frequencies, classifications of pharmacological actions and doses of TCM decoction pieces for heat clearing (DHC) from 2013 to

2015 of the First Affiliated Hospital of Xi’an Jiaotong University were analyzed. Results In our hospital, from 2013 to

2015, in top 15 DHC, the amounts of clearing away heat and toxin were more than 40%, and which of the average doses exceeded the upper limit of pharmacopoeia dosage, were more than 30%. The part that overdoes frequencies greater than 30% were 11.0% of the total, nevertheless, the part that not exceeded was 39.0% of the total. Conclusion The use of medicine for heat clearing should be carefully dialectical, paying attention to the rationality of medication. The dose should be careful and effectively regulated.

Key words: medicine for heat clearing; analysis on medication; rational administration

清热药具有清热泻火、凉血、解毒、燥湿及清虚热等作用,即《内经》“热者寒之”、《神农本草经》“疗热以寒药”之意。临床上,由于发病原因不同、患者体质差异及病情变化趋势不同,故有热在气分、血分之异,有实热、虚热之别。一般而言,根据清热药的功效及其主治证的差异,可将其分为清热泻火、清热燥湿、清热解毒、清热凉血和清虚热5 类[1]。清热药在中医防病治病过程中具有非常重要的作用,在现代 中医临床治疗中也具有举足轻重的地位,应用广泛且用量较大[2-3]。西安交通大学第一附属医院(以下简称“本院”)是国家卫生和计生委员会管辖大型综合性三级甲等医院,中医科为国家中医药管理局“十二五”重点培育专科,中药房年配制汤剂 30 余万剂。笔者通过汇总本院 2013-2015 年门诊清热类中药饮片的使用情况,分析其临床使用现状及存在问题,以促进中药饮片合理应用,更好地保障患者用药安全。

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