| Because drug-induced damage and adverse drug reactions have brought great harm to patients and society,safe and rational drug use has become an urgent need.At present,China's medical policy is imperfect,and the development of clinical pharmacists is at the initial stage of development and rational use of drugs.The lack of supervision and management methods has led to an increasingly prominent problem of irrational drug use.Prescription reviews are based on relevant regulations and technical specifications to evaluate the standardization of prescription writing and the suitability of clinical use of drugs,and to formulate and implement intervention measures for existing or potential drug use problems,thereby promoting quality comprehensive evaluation management work for the rational use of drugs and the safety of patients.The quality of prescriptions has an important impact on the adjustment of traditional Chinese medicines.The prescription drug name issued by doctors is specified which is conducive to the correct allocation and payment of medicines by pharmacists;the prescription usage and dosage are correct,especially the processing requirements of Chinese medicine decoction pieces and special usage standards are clearly indicated,it is conducive to the pharmacist to give patients the correct prescription of medicine;appropriate prescription diagnosis and medication can ensure the safety and effectiveness of the adjustment of drugs,so the development of prescription reviews is an important prerequisite and guarantee for the accurate implementation of Chinese medicine.Dry eye syndrome is one of the common diseases in ophthalmology.This study takes Chinese medicine as a foothold in the treatment of dry eye syndrome,combines meta-analysis and database analysis methods,summarizes and analyzes the characteristics of clinical medication for treating dry eye syndrome,initially explores the ideas and methods of ophthalmic Chinese medicine prescription review,and the "five-step progressive" ophthalmic traditional Chinese medicine prescription reviews is proposed.Objective:Systematically compiled the ancient and modern literature on the treatment of dry eye syndrome,combined with modern scientific analysis methods,summarized the clinical medication rules of dry eye syndrome,initially explore the ideas and methods of ophthalmic Chinese medicine prescription review to promote clinical rational drug use.Methods:(1)Using "dry eye syndrome" and "treatment" as the key words,it is searched Chinese and foreign databases,Wanfang database,Weipu network,PubMed as well as other Chinese and foreign language databases,collected 2,989 articles,and applied Revman5.3 software to some of the retrieved documents for Meta.analysis and systematic evaluate the traditional Chinese medicine for dry eye syndrome.(2)In the outpatient prescription of the Melody Eye Hospital(hereinafter referred to as"our hospital")from December 2016 to January 2018,by the TCM inheritance platform software(v2.5)in order to establish a database,206 qualified cases that diagnosed as dry eye syndrome are used frequency analysis,association analysis,cluster analysis and data mining techniques to summarize the clinical drug rules.(3)Combing the above two parts of syndrome differentiation and treatment of commonly used prescriptions and commonly used drugs,and based on this,from the prescription normative,prescription suitability,supernormal prescription,explore the ideas and methods of ophthalmic Chinese medicine.Results:(1)Chinese medicine has a long history of understanding dry eye syndrome,and the relationship between the five organs and the body fluid has long been discussed.Modern Chinese medicine has been inherited and improved from the theoretical basis,diagnostic methods,and traditional Chinese medicine treatment methods,forming a special feature of Chinese medicine ophthalmology.Through the search database,16 articles were selected according to the inclusion and exclusion criteria.The total sample size was 1773,including 901 in the treatment group and 872 in the control group.Meta-analysis of the retrieved literature,Chinese medicine treatment of dry eye syndrome or Chinese medicine combined with artificial tears treatment effect is significantly better than artificial tears alone.(2)Summarize 20 high-frequency drugs(?50)for high-frequency drugs in our hospital,21 groups for high-frequency drugs,and 41 groups for core combinations of 3 and 4 drugs.The top 10 high-frequency drugs are:licorice root(sauteed licorice),angelica,Bupleurum,wind,scorpion,cassia twig,Chuanxiong,Astragalus,fried white peony,jujube.(3)By analyzing and summarizing the above two parts of dry eye syndrome type,prescription and traditional Chinese medicine decoction pieces,it is initially formed the prescription of Chinese medicine ophthalmology(Chinese patent medicine and traditional Chinese medicine decoction pieces)of the"five-step progressive"Review ideas and methods including comb the literature,analyze the basis,summarize the rules,review the prescription,and compare the implementation.That means combing the literature according to the disease type,summarizing the rule of governance--using modern analytical methods to provide clinical treatment basis--analyzing and summarizing the law of clinical drug use in our hospital--the prescription review(standardization of prescriptions,prescription medication suitability,super prescription)--Review and analysis of prescription review results,comparison of prescription evaluation results at different time points,planning and implementation of the next stage of work.This review method can continuously find and solve new problems,and continuously improve the evaluation basis.It is a gradually improving process.Conclusion:Through the combing of the literature,it is found that traditional Chinese medicine has a long history of treatment for dry eye syndrome.The results of Meta analysis suggest that Chinese medicine or traditional Chinese medicine combined with artificial tears have good curative effect on dry eye syndrome.Through the database analysis of effective prescriptions for our hospital,it is collected the preliminary analysis of the dry eye syndrome rules in our hospital.After combined with the development of the prescription review work in our hospital,it is established a new five-step progressive method for ophthalmology prescriptions,continuously improved the quality of outpatient pharmacy work,and promoted the clinical practice of our hospital,guaranteed patients' medication safety. |
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