肿瘤科毒性中药处方临床应用分析

Analysis of Clinical Application on Prescriptions of Toxic Traditional Chinese Medicine Decoction Pieces in Oncology Outpatient Department

关键词:  毒性中药饮片  肿瘤科  超剂量

Key words:  toxic traditional Chinese medicine  oncology outpatient department  overdose

摘要:

目的 分析毒性中药饮片在肿瘤科门诊使用情况，为临床安全合理使用毒性中药饮片提供数据参考。方法 抽取安徽中医药大学第二附属医院2022年肿瘤科门诊含毒性中药饮片处方838张，对患者性别、年龄、临床诊断、毒性中药品种、毒性中药使用频次、超剂量频次及毒性中药联合使用等问题进行回顾性统计分析。结果 含毒性中药饮片处方838张中，共涉及22味毒性中药饮片，占医院毒性中药81.48%，50~60岁使用毒性中药饮片的处方居多(217例，占25.89%)，且每张处方药味多集中在11~15味，临床主要用于各类肿瘤疾病、消化系统类疾病、妇科疾病等。除了土荆皮、白果、蜈蚣3种以外，其他毒性中药均存在超剂量现象。毒性中药联用≥2味处方231张，以2味联用190张最多(占比22.67%)。配伍禁忌处方78张，以炮附片与半夏配伍居多，临床用于治疗慢性萎缩性胃炎、失眠、郁病等。结论 毒性中药饮片在肿瘤科使用普遍，超剂量现象多，需警惕毒性中药超剂量使用及毒性中药联用配伍导致的潜在风险，应加强药物管理，促进合理应用，保障患者用药安全。

Abstract:

OBJECTIVE To analyze the use and distribution characteristics of toxic traditional Chinese medicine decoction pieces in oncology outpatient department, and to provide data reference for the safe and rational use of toxic traditional Chinese medicine decoction pieces in clinical applications. METHODS The 838 prescriptions data of toxic traditional Chinese medicine from the Oncology Outpatient Department of The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine in 2022 were collected and made retrospective statistical analysis of patient gender, age, clinical diagnosis, variety of toxic traditional Chinese medicine, frequency of use, frequency of overdose, and combination use of toxic traditional Chinese medicine. RESULTS Among the 838 prescriptions of toxic Chinese herbal medicines, 22 toxic Chinese herbal medicines were involved, accounting for 81.48% of the hospital's toxic Chinese herbal medicines. The majority of prescriptions (217 cases, accounting for 25.89%) aged 50 to 60 years old. Most of the single prescriptions were concentrated in 11 to 15, and the toxic Chinese herbal decoction pieces were mainly used in various tumor diseases, digestive system diseases and gynecological diseases, etc. In addition to golden larch bank, ginkgo and centipede, the other toxic traditional Chinese medicines all had the overdose problem. 231 prescriptions of toxic traditional Chinese medicine were used in combination with≥2 , with 190 prescriptions of 2 ingredients being the most commonly used (accounting for 22.67%). There were 78 incompatibilities, most of which were the combination of Aconiti Lateralis Radix Praeparata and Pinelliae Rhizoma. It was used to treat chronic Atrophic gastritis, insomnia and depression. CONCLUSION Toxic traditional Chinese medicine decoction pieces are widely used in oncology department. However, the overdose phenomenon is serious, it is necessary to be aware of the potential risks of overdose and combination of toxic traditional Chinese medicine. Therefore, it is necessary to further strengthen drug management, promote rational application, and ensure patient medication safety.