| Background:Most of the prescriptions of traditional Chinese medicine decoction slices are compound prescriptions,which need to be rationally compatible with drug taste under the guidance of traditional Chinese medicine theories,so as to form an overall regulating function superior to each single drug.The proper compatibility of prescription groups directly affects the clinical efficacy.In recent years,traditional Chinese medicine prescriptions have the tendency to ignore the compatibility rule,group prescription is not strict,and drug taste is too much.The phenomenon of prescription splicing is serious,which not only leads to serious adverse reactions of traditional Chinese medicine and the occurrence of drug-induced diseases,but also causes economic burden to patients by wasting the medicine.At present,China’s laws and regulations on traditional Chinese medicine(TCM)are almost blank in terms of prescribing traditional Chinese medicine(TCM).In this paper,through the investigation and analysis of the traditional Chinese medicine decoction slice prescription in a hospital of Nanjing,The reasonable suggestion is put forward for the quality assurance of the traditional Chinese medicine decoction slice prescription.Objective:Through research and analysis of herbal number of Chinese medicine decoction prescription and its influencing factors,improve the quality of clinical traditional Chinese medicine prescription,and ensure patients to use traditional Chinese medicine reasonably and safely.Methods:1,200 prescriptions of traditional Chinese medicine decoction slices were randomly selected from the hospital’s clinic from March 2017 to March 2018.The gender,age,department,clinical diagnosis,herbal number of Chinese medicine decoction prescription,prescription doctor’s title,dispensing errors,and prescription comment results were recorded in the EXCEL form.Statistical analysis wasperformed using SPSS 18.0 statistical software.Results:(1)General condition of prescription Among the 1,200 prescriptions surveyed,522 patients accounted for 43.5 percent of male patients,678 patients accounted for56.5 percent of female patients,and the proportion of male and female patients was1.30,with more female patients than male patients.The average age of the patients is51 years old,the maximum age is 93 years old,and the minimum age is 5 years old.Among the 26 departments of the hospital,497 TCM prescriptions accounted for41.42% at the most,followed by 16.58% in oncology and 8.08% in gynecology.The largest number of prescriptions by chief physicians was 652,accounting for 54.33%,followed by 338 for junior physicians,28.17% for junior physicians,147 for associate chief physicians,12.25% for senior physicians and 63 for senior physicians.(2)General situation of herbal number Among the 1200 prescriptions,the minimum number of herbal number is 5 and the maximum is 40,and the average number of prescriptions is 16.36.The frequency of drug flavor was concentrated in 15 to 18 flavors,and the number of prescriptions with 15 flavors was up to 162,accounting for 13.5%.82.17% of the prescription herbal number concentrated in 11 to20.(3)Analysis of the influencing factors of herbal number There was significant difference in the number of drug flavors between the two groups(P<0.05).The mean value of prescription drug flavor of doctors with different professional titles was compared and analyzed,and the difference was significant(P <0.05),indicating that the difference in average number of prescription drug flavor between doctors with different professional titles was statistically significant.Among the 26 departments surveyed,the mean number of prescription drug flavors was the highest in the oncology department,followed by the general surgery department and the digestive department.There was no significant difference in the mean value of the four seasons.(4)Dispensing error statistics of 1,200 prescriptions,60 prescriptions with dispensing error,accounting for 5% of the total.Among them,the most missing prescriptions were 46,accounting for 3.83%.Of the 60 prescriptions for dispensingerrors,the least number of ingredients was 13 and up to 40.The probability of dispensing error was 0,11 to 20,986,42,151 and 18 respectively.(5)Among the 1200 prescriptions in the irrational prescription statistics,67 were unreasonable prescriptions,accounting for 5.58% of the total number of prescriptions in the survey.Among the nonstandard prescriptions,there were 14 nonstandard prescriptions,accounting for 20.9% of the total number of unreasonable prescriptions,11 non-standard diagnoses,accounting for 16.42%,and 5 pre-recorded missing items,accounting for 7.46%.There were 7 misuses and dose errors in the inappropriate prescription,accounting for 10.45%,6 incompatibility and repeated medication,accounting for 8.96%,and 11 overdoses of toxic prepared tablets,accounting for16.42%.(6)The large prescription statistics of traditional Chinese medicine consider the prescriptions of more than 25 herbs as large prescriptions of traditional Chinese medicine.Of the 34 large prescriptions of traditional Chinese medicine,82.35% of the drug flavors are concentrated in 26-29 flavors.Among the large prescription departments of traditional Chinese medicine,22 pieces account for 64.71% in the oncology department at most.All of these prescriptions come from specialist clinics.Conclusion:There is still room for the decline of the number of traditional Chinese medicine prescription medicine in this hospital.The number of prescription drug flavors of traditional Chinese medicine decoction slices is affected by the patient’s gender,age,doctor’s title and the patient’s department.Over-prescription of Chinese herbal slices will lead to the increase of dispensing errors and the frequency of unreasonable prescriptions will also increase.In addition,the hospital has a small number of large prescriptions of traditional Chinese medicine,which should be paid more attention to,advocating physicians to simplify drug use,promoting rational and safe use of traditional Chinese medicine decoction slices in clinic,and eliminating the occurrence of adverse reactions of traditional Chinese medicine. |
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