儿科毒性中药饮片门诊处方临床应用回顾性分析

Retrospective Analysis of Clinical Application on Outpatient Prescriptions of Toxic Traditional Chinese Medicine Decoction Pieces in Pediatrics

关键词:  毒性中药饮片  儿科处方  儿科毒性中药剂量  调查分析

Key words:  toxic traditional Chinese medicine decoction pieces  pediatric prescription  pediatric toxic traditional Chinese medicine dose  investigation and analysis

摘要:

目的 分析毒性中药饮片在儿童专科医院的使用情况及分布特点，为临床安全合理使用毒性中药饮片提供数据参考。方法 根据相关法定文件，收集整理2019—2021年首都医科大学附属北京儿童医院门诊患儿含毒性中药饮片处方数据，对患儿性别、年龄、临床诊断和毒性中药使用频率、使用剂量、超药典剂量使用频率等进行回顾性统计分析。结果 66 294张门诊中药饮片处方中，涉及11味毒性中药饮片，处方18 680张，占比28.18%。据年龄组统计，学龄前期和学龄期患儿使用毒性中药饮片情况最多，男性患儿多于女性患儿。口服含毒性中药饮片处方数多于外用。使用频数前5位的毒性中药饮片分别为炒苦杏仁、盐蒺藜、炒苍耳子、川楝子和全蝎。9味毒性中药饮片存在不同程度的超剂量使用情况，制吴茱萸处方超剂量问题最突出。毒性中药饮片条目数22 309条，单张处方大多使用1味毒性中药饮片，毒性中药饮片联用≥2味的共3 913条。结论 儿科临床应用毒性饮片比较广泛，使用毒性中药饮片基本合理。但需警惕毒性中药连续使用、超药典剂量使用以及毒性中药联用的潜在风险。

Abstract:

OBJECTIVE To analyze the use and distribution characteristics of toxic traditional Chinese medicine decoction pieces in children's specialized hospital, and to provide data reference for the safe and rational use of toxic traditional Chinese medicine decoction pieces in clinical applications.METHODS According to the relevant legal documents, the prescription data of toxic traditional Chinese medicine decoction pieces in outpatients of Beijing Children's Hospital Affiliated to Capital Medical University from 2019 to 2021 were collected and arranged retrospectively, and made retrospective statistical analysis of their gender, age, clinical diagnosis, frequency of use, dosage and use of super pharmacopoeia dosage.RESULTS Among the 66 294 outpatient prescriptions of Chinese herbal pieces, 11 toxic Chinese herbal pieces were involved with 18 680 prescriptions, accounting for 28.18%. According to the statistics of age group, preschool and school-age children used the most toxic traditional Chinese medicine decoction pieces, and male children were more than female children. The number of prescriptions of oral toxic traditional Chinese medicine decoction pieces was more than that for external use. The top five toxic traditional Chinese medicine decoction pieces used frequently were fried Armenicacae Semen Amarum, salt Tribuli Fructus, fried Xanthii Fructus, Toosendan Fructus and Scorpio. There were different degrees of over dose use of 9 toxic traditional Chinese medicine decoction pieces, and the over dose problem of processed Euodiae Fructus prescription was the most prominent. There were 22 309 pieces of toxic traditional Chinese medicine. In a single prescription, more than one piece of toxic traditional Chinese medicine was used and 3 913 pieces of 2 or more toxic traditional Chinese medicine decoction pieces were used in combination. CONCLUSION Toxic traditional Chinese medicine decoction pieces are widely used in pediatric clinic, and it is reasonable. However, it is necessary to be aware of the potential risks of continuous use of toxic traditional Chinese medicine, use of super pharmacopoeia dosage and combination of toxic traditional Chinese medicine.