世界中医药

目的:探讨中成药处方点评在药物合理使用中的作用及分析典型案例，为临床合理用药提供依据。方法：选取2017年5月至2017年7月佛山市中医院开具的中成药处方890张，根据时间点将中成药处方分为对照组（n＝454张，2017年5月至2017年6月）和观察组（n＝436张，2017年6月至2017年7月）。对照组不进行中成药处方点评，观察组对开具中成药处方进行点评，记录并统计处方超疗程用药、重复给药、配伍不合理、用药不符等情况，记录2组不合理用药纠纷发生情况；采用自拟问卷调查表对2组开具药方医师处方药理作用、性味归经、配伍关系、用药剂量及疗程进行评定，比较2组药物合理使用情况及典型案例。结果：观察组点评后共有32张处方不合理，占7.34%，低于对照组53张处方不合理，占11.67%（P<0.05）；观察组经中成药处方点评后大处方、重复用药、用药不符、配伍禁忌、用药禁忌发生率，均低于对照组（P<0.05），2组处方书写不规范发生率无统计学意义（P>0.05）；观察组中成药处方点评后不合理用药纠纷发生率，低于对照组（P<0.05）；观察组中成药处方点评后药理作用、性味归经、配伍关系、用药剂量及疗程评分，均高于对照组（P<0.05）。结论：将中成药处方点评在中成药合理使用中具有重要的作用，有助于降低药物不合理使用发生率，降低用药纠纷，不断提高医师对中药的使用能力。

English Summary:

To discuss the role of typical prescriptions of proprietary Chinese medicines in the rational use of drugs and to provide a basis for clinical rational drug use.Methods:A total of 890 prescriptions of proprietary Chinese medicines issued by the hospital from May 2017 to July 2017 were selected as research objects，and prescriptions of proprietary Chinese medicines were divided into control group according to time points (n＝454，May 2017-June 2017 ) and observation group (n＝436，June 2017-July 2017).The control group did not comment on the prescriptions of proprietary Chinese medicines.The observation group commented on the pharmacy that issued the proprietary Chinese medicines，and recorded and counted prescription medication over the course of treatment，repeated administration，unreasonable combination and discrepancies in medication，and recorded the occurrence of two unreasonable drug disputes.A self-made questionnaire was used to evaluate the prescription pharmacology，nature and flavor，channel tropism，the compatibility and the dose and course of treatment of the two groups of prescription doctors.The rational use of the two groups of drugs and typical cases were compared.Results:A total of 32 prescriptions were found to be unreasonable in the observation group，accounting for 7.34%，which was lower than the control group of 53 prescriptions，accounting for 11.67% (P<0.05).In the observation group，the prescriptions，repeated medications，medication inconsistencies，incompatibility contraindications，and medication contraindication rates were lower than those in the control group (P<0.05).There was no significant difference in the incidence of non-standard prescriptions between the two groups (P>0.05).After prescription reviews，the incidence of disputes due to the irrational use of drugs in the observation group was lower than that of the control group (P<0.05).The pharmacological action，nature and flavor，channel tropism，compatibility，dosage and course of treatment were all higher in the observation group than in the control group (P<0.05).Conclusion:The prescription of proprietary Chinese medicines plays an important role in the rational use of proprietary Chinese medicines.It is helpful to reduce the incidence of unreasonable use of medicines，reduce disputes over medication and improve the doctors' ability to use traditional Chinese medicines.It is worthy of promotion and application.

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