Article(id=1236342822102692658, tenantId=1146029695717560320, journalId=1235980733773295621, issueId=1236342820131361209, articleNumber=null, orderNo=null, doi=null, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=1665590400000, acceptedDateStr=2022-10-13, onlineDate=1772696698928, onlineDateStr=2026-03-05, pubDate=1677513600000, pubDateStr=2023-02-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1772696698928, onlineIssueDateStr=2026-03-05, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1772696698928, creator=13701087609, updateTime=1772696698928, updator=13701087609, issue=Issue{id=1236342820131361209, tenantId=1146029695717560320, journalId=1235980733773295621, year='2023', volume='32', issue='4', pageStart='329', pageEnd='440', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1772696698458, creator=13701087609, updateTime=1772696766437, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1236343105318875204, tenantId=1146029695717560320, journalId=1235980733773295621, issueId=1236342820131361209, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1236343105318875205, tenantId=1146029695717560320, journalId=1235980733773295621, issueId=1236342820131361209, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=364, endPage=371, ext={EN=ArticleExt(id=1236342822299824950, articleId=1236342822102692658, tenantId=1146029695717560320, journalId=1235980733773295621, language=EN, title=Discussion on the problem and current situation of the use of Chinese patent medicine based on literature of prescription comment and prescription analysis, columnId=null, journalTitle=Chinese Journal of New Drugs, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective: To discuss the problem and current situation of the use of Chinese patent medicine based on literature of prescription analysis and prescription review in the past four years.
Methods: Literature of prescription analysis and prescription review from January 2019 to July 2022 was obtained by searching the CNKI, Wanfang and VIP databases. After two times of screening, the proportion of irrational use of Chinese patent medicine in the selected literature, the irrational use of Chinese patent medicine in different regions, hospitals, and that of medicines with different efficacies, and the influencing factors of irrational use of Chinese patent medicine were analyzed.
Results: A total of 66 articles were included. The overall irrational rate of Chinese patent medicine prescription was 4.91%. Among them, Hainan, Xinjiang, and Shanghai had the highest proportion of irrational use, which were 22.08%, 18.03% and 11.98%, respectively, while the proportions of irrational use of Chinese medicine in other regions were less than 10%. Irrational prescription in tertiary hospitals was the lowest, accounting for 4.36%, in secondary hospitals for 7.99%, and in primary community hospitals for 12.55%. Irrational use of drugs for oncology accounted for 10.94%, rehabilitation 10.55%, cardiovascular 7.09%, gynecology 5.30%, and irrational drug use in other departments was less than 5%. Among the Chinese patent medicines with various effects, the proportion of irrational use of medicines for promoting blood circulation and removing blood stasis was the highest, which was 18.85%. Irrational use of Chinese patent medicine for regulating qi and relieving pain accounted for 10.38%, while the irrational use of other types of Chinese patent medicine accounted for less than 10%. Improper usage and dosage, inappropriate drug selection and inappropriate indications were the most common problems in the use of proprietary Chinese patent medicines, with a cumulative proportion of more than 60%.
Conclusion: The problem of irrational use of Chinese patent medicine shows an inversely proportional relationship with the hospital grade. Chinese patent medicine for activating blood circulation and removing blood stasis has the highest frequency of irrational use. Usage and dosage, selection of drugs, and indications may be the main factors affecting the rational use of Chinese patent medicines. The rational use of Chinese patent medicine still needs to receive more attention from medical institutions and clinicians at all levels, and corresponding guidelines and norms are needed for standardized drug use.
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目的： 基于近4年的中成药处方分析与处方点评文献，探讨中成药合理用药的问题与现状。
方法： 通过检索中国知网CNKI、万方、维普数据库获得2019年1月—2022年7月的中成药处方分析与处方点评。经过二次筛选后提取文献中中成药不合理用药的占比，不同地区、医院、功效的中成药不合理用药分布情况，以及中成药不合理用药的因素进行统计分析。
结果： 共纳入文献66篇，中成药处方不合理率为4.91%。其中海南、新疆和上海的平均中成药不合理用药占比最高，分别为22.08%，18.03%和11.98%，其余地区均低于10%。三级医院中成药不合理用药处方占比4.36%，二级医院占比7.99%，基层社区医院占比12.55%。肿瘤科中成药不合理用药占比10.94%，康复科占比10.55%，心血管科占比7.09%，妇科占比5.30%，其余科室占比均低于5%。各种功效的中成药中，活血化瘀类中成药不合理用药占比为18.85%，理气止痛类占比为10.38%，其余类型占比均低于10%。用法用量不适宜、遴选药品不适宜和适应证不适宜是中成药不合理处方中最常见的3个因素，累积构成比超过60%。
结论： 中成药不合理用药问题与医院等级呈现反比趋势。活血化瘀类中成药是不合理用药最多的一类中成药。用法用量、遴选药品和适应证不适宜可能是影响中成药不合理用药的主要因素。中成药合理用药仍需要得到各级医疗机构和临床医师更多的重视，同时也需要相应的指南和规范进行标准化的指导。
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高蕊，女，主任医师，主要从事中医药临床评价关键技术研究。联系电话：(010)62835651，E-mail:
ruigao@126.com。
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尹昀东，男，博士后，主要从事中医药临床评价关键技术研究。E-mail: yyd0030@163.com。
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尹昀东，男，博士后，主要从事中医药临床评价关键技术研究。E-mail: yyd0030@163.com。
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