毒性中药饮片在门诊老年患者中的临床应用回顾性分析

Retrospective analysis of the clinical application of toxic traditional Chinese medicine decoction pieces in elderly outpatient patients

关键词:  毒性中药饮片  老年患者  门诊  回顾性分析

Key words:  Toxic traditional Chinese medicine decoction pieces  The elderly patients  Outpatient  Retrospective analysis

摘要:

摘要：目的 分析毒性中药饮片在绍兴市中医院门诊老年患者中的临床应用情况，探讨其用药的临床特点。方法 收集整理 2022年6月-2023年6月绍兴市中医院门诊老年患者含毒性中药饮片处方数据，对患者性别、年龄、临床诊断、使用频数、超剂量情况等进行回顾性统计分析。结果 获得毒性中药饮片处方共12946张，涉及 41 味毒性中药，含毒性中药饮片条目数17474 条。据患者年龄组与性别分布统计，60~69岁老年患者使用毒性中药饮片情况最多，女性患者略多于男性患者。据疾病分布统计，毒性中药饮片处方临床诊断多集中在痹证类病、咳嗽病、腰痛病、积聚病和伤筋病等。据使用情况统计，使用频数前 5 位的毒性中药饮片分别为：苦杏仁、艾叶、蜈蚣、川楝子和制川乌。有19 味毒性中药饮片存在不同程度的超剂量使用情况，其中超剂量使用占比前3位的中药为：蛇六谷、雷公藤、山豆根，平均超剂量使用程度前3位的中药为制川乌、蛇六谷、制草乌。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7897条。结论 毒性中药饮片在我院老年患者中应用比较广泛，总体用药情况符合临床疾病需求，但需警惕毒性中药超剂量使用和毒性中药联用可能造成的不良反应。

Abstract:

ABSTRACT: OBJECTIVE To analyze the use and distribution characteristics of toxic traditional Chinese medicine(TCM) pieces in elderly patients in Shaoxing Hospital of Traditional Chinese Medicine, and to provide data reference for safe and rational use of toxic TCM pieces in clinical applications. METHODS The prescription data of elderly patients with toxic TCM decoction pieces in the outpatient department of Shaoxing Hospital of Traditional Chinese Medicine from June 2022 to June 2023 were collected , and analyzed retrospectively on the gender, age, clinical diagnosis, dosage, frequency and overdosage of use. RESULTS Among the 44943 outpatient prescriptions of TCM decoction pieces for elderly patients, 41 toxic TCM were involved, with 12946 prescriptions. According to the statistics of age group and gender distribution of patients, the elderly patients aged 60-79 years used the most toxic Chinese medicine slices (91.85%), and the female patients were slightly more than the male patients. According to the statistics of disease distribution, the application of toxic TCM decoction pieces in elderly patients is mainly concentrated in Bi- syndrome diseases, cough disease, lumbago disease, accumulation disease and tendon disease. According to the statistics of use, The top five toxic TCM decoction pieces used frequently were fried Armenicacae Semen Amarum, Artemisiae Argyi Folium, Scolopendra, Toosendan Fructus and Aconiti Radix Cocta. There were 19 toxic Chinese herbal slices with different degrees of overdose use, among which the top three Chinese herbs with the proportion of overdose use were Amorphophalli Rhizoma, Tripterygii Radix, and Sophorae Tonkinensis Radix and Rhizoma , and the top three Chinese herbs with the degree of overdose use were Aconiti Radix Cocta, Amorphophalli Rhizoma, and Aconiti Kusnezoffii Radix Cocta. There were 17474 items of toxic TCM decoction pieces, 7897 items of ≥2 toxic TCM decoction pieces. CONCLUSION Toxic TCM decoction pieces are widely used in elderly patients in our hospital, and it is reasonable. However, it is necessary to be aware of the potential risks of overdose and combined use of toxic TCM.