中国药物警戒 ›› 2018, Vol. 15 ›› Issue (12): 721-727.

• 法规与管理研究 • 上一篇    下一篇

685名基层医务人员中药临床用药安全现状调查与思考

李昂1, 张冰1,2*   

  1. 1北京中医药大学中药学院,北京 100029;
    2北京中医药大学中药药物警戒与合理用药研究中心,北京 100029
  • 收稿日期:2019-01-18 修回日期:2019-01-18 出版日期:2018-12-20 发布日期:2019-01-18
  • 通讯作者: 张冰,女,博士,教授·主任医师,药物警戒与合理用药、中药药性理论研究、中药防治代谢性疾病。E-mail: zhangbing6@263.net
  • 作者简介:李昂,男,在读硕士,临床中药学。
  • 基金资助:
    国家自然科学基金资助项目（81874349）：辛热类有毒中药风险-效益阈与效毒机制研究;北京中医药大学新奥奖励基金（1000062720062/009/001）：颜正华临床中药学思想的挖掘与传承模式研究

Survey and Consideration on Safety Status of Traditional Chinese Medicine Application in 685 Primary Healthcare Workers

LI Ang1, ZHANG Bing1,2*   

  1. 1School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing 100029, China;
    2Center for Pharmacovigilance and Rational Use of Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100029, China
  • Received:2019-01-18 Revised:2019-01-18 Online:2018-12-20 Published:2019-01-18

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摘要： 目的 了解和分析我国基层医疗机构中药用药安全现状,为提高基层医务人员中药安全用药意识及合理用药水平提供参考。方法 采用问卷调查方式,对来自28个省、自治区、直辖市的685名基层医务人员以不记名方式进行调查,内容涉及受访者的基本资料、受访者对中药安全用药知识了解情况、对患者的用药告知情况、临床使用中药注射剂发生的不良反应情况。同时随机对52名基层医务人员进行访谈并记录,将回收的调查问卷信息和访谈记录录入Excel表格,并进行分类、归纳、统计与分析。结果 发放问卷685份,回收率100%。在被调查的基层医疗机构的医务人员中,西医专业者占55.04%、中医专业者占12.70%、中西医结合专业者占29.20%。从业者均可开具饮片及中成药;在中药安全认知方面,基层医务人员对含毒性成分和西药成分的中成药了解不足;在诊疗当中,基层医务人员能够考虑到特殊人群的特殊性,并进行用药告知。随机访谈的52名医务人员中,有36名医务人员表示未接受报告药品不良反应的培训。结论 基层医务人员具有一定的中药安全用药意识,能够正确处理药品不良反应。但是对中药安全用药知识了解不足,无法在临床用药中真正做到合理用药,同时药品不良反应报告意识较差。在对基层医务人员开展的培训中,涉及ADR相关内容较少,建议加强对基层医务人员开展中药安全用药和ADR报告方面的培训,促进基层医疗机构合理用药。

关键词: 基层医务人员, 中药, 用药安全, 调查

Abstract: Objective To analyze the current situation of safe use of traditional Chinese medicines (TCMs) in primary medical institutions in China, and to provide reference for improving the awareness and ability of safe and rational drug use in primary healthcare workers. Methods 685 primary healthcare workers from 28 provinces were investigated by anonymous survey questionnaires. The questionnaires included the basic information of respondents, the elementary knowledge of TCM safety, how to inform the patients about the medication, adverse reactions of TCM injections during clinical use. And 52 primary healthcare workers were interviewed randomly. The collected information was recorded in the Excel software, and classified, summarized and analyzed. Results 685 questionnaires were distributed, and the recovery was 100%. 55.04% of the respondents were western medicine professional, 12.70% were Chinese medical professional and 29.20% were integrated Chinese and western medical professional. Practitioners could prescribe Chinese patent drug and decoction pieces. But they did not know enough about Chinese patent drug which contains toxic ingredients and western medicine ingredients. Primary healthcare workers could take the particularity of each patient into account and inform them of drug use. In 52 respondents, 36 respondents had not been trained on reporting adverse drug reactions (ADRs). Conclusion Primary healthcare workers have awareness of safe use of Chinese medicine and can correctly handle ADRs. But they lack knowledge about the TCM safety and awareness of ADR; thus they cannot make rational use of drugs in clinical medication. Due to lack of relevant training content of ADR, it is suggested that strengthen the training of drug safety and ADR reporting in basic medical institutions, to promoting rational use of medicine in medical institutions.

Key words: primary healthcare worker, Chinese traditional medicine, medication safety, investigation

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