| Objective:To promote the development of smart pharmacy,this study inherited the idea of"Medication guidance of TCM" in ancient classics such as "Treatise on Febrile Diseases" and"Valuable Prescriptions for Emergency",analyzed the current policies concerning clinical pharmaceutical care,and built the "Clinical medication instruction service system of TCM"and "Medication instructions of TCM decoction pieces" relying on information technology.Methods:(1)Literature research:This study sorted out the policies concerning the standardized development of clinical pharmacy services issued by national and local government departments and relevant academic groups as of 2021 to clarify the work connotation and standardized development status of clinical pharmacy services and TCM clinical pharmacy services in our country.This study also studied the origin and development process of the idea of "Medication guidance of TCM",as well as the usage methods and precautions recorded in"Treatise on Febrile Diseases" "Valuable Prescriptions for Emergency" and other classics to construct the content system of Medication instructions of TCM decoction pieces.(2)Clinical research:For TCM pharmacists of different professional titles in different hospitals in Beijing area,this study used the "Questionnaire Star" application software to investigate their knowledge of TCM decoction techniques and decoction norms for traditional Chinese pharmacists Online.Finally,104 valid questionnaires were recovered,and SPSS 23.0 was used for data statistics and analysis.(3)Research on Construction of clinical medication instruction service system of TCM:?Construction of standard information database of Chinese herbal medicine:Referred to the "Pharmacy of the People's Republic of China(2020 edition)" "Beijing Chinese Medicine Preparation Regulations(revised in 2011)""Clinical Chinese Materia Medica" and other literature,use Microsoft Office software to enter basic information and usage methods of 636 Chinese herbal medicine in pharmacopiea and 433 in hospital.?Construction of classical prescription database of TCM:Refer to "Treatise on Febrile Diseases" and "Lecture Notes on Treatise on Febrile Diseases",use Microsoft Office software to enter the basic information and usage methods of 113 classic prescriptions.?Construction of rule control database for prescriptions of Chinese herbal medicine:Refer to the "Pharmacy of the People's Republic of China(2020 edition)" "Beijing Chinese Medicine Preparation Regulations(revised in 2011)" "Clinical Chinese Materia Medica" and other literature,use Microsoft Office software to enter "Eighteen clashes","Nineteen incompatibilities" and precautions for medications for special populations etc..?Construction of terminology database of medication guidance of TCM:Refer to "Chinese Medicine Preparation" "Beijing Chinese Medicine Preparation Regulations(revised in 2011)","Clinical Chinese Materia Medica" and other literature,use Microsoft Office software to enter the knowledge of Chinese herbal medicine decoction methods,taking methods,etc..At last,this study used the Cache database and CSP-based component technology,M technology,workflow technology and security protection technology and other information technology to build the prescription review center,prescription rechecked center,medication guidance center,monitoring center and traffic center,based on the SOA framework and the B/S/S framework.And the IMedical digital hospital system was used to integrate 4 basic information databases and 5 functional centers to build Clinical medication instruction service system of TCM.(4)Study on the application of Medication instructions of TCM decoction pieces:For patients in the outpatient Chinese pharmacy of Beijing Hospital of Traditional Chinese Medicine,this study investigated their satisfaction on Medication instructions of TCM decoction pieces.A total of 150 questionnaires were issued,and 142 valid questionnaires were finally recovered.The SPSS 23.0 was used for data statistics and analysis.Results:(1)Literature research:At present,there is standardized guidance documents for prescription comment,prescription dispensing,prescription review,and adverse reaction monitoring and reporting in our country,but not for medication guidance.This study found the idea of "Medication guidance of TCM" originated in "Shen Nong's Materia Medica",developed in "Treatise on Febrile Diseases",perfected in "Valuable Prescriptions for Emergency",and matured in "Compendium of Materia Medica",laying a foundation for the development of Medication instructions of TCM decoction pieces.And this study constructed the content system of Medication instructions of TCM decoction pieces,which including decoction technology,medication specifications,medication notification and medication storage methods of TCM.(2)Clinical research:A total of 104 valid questionnaires were collected from the online survey.After analysis,we found that more than 60%of Chinese pharmacists have a unified understanding of the decoction equipment,whether the Chinese medicine needs to be soaked,the method of judging the time of soaking and the amount of water added for decoction,the amount of water,and the temperature of the decoction,but the soaking time and decoction time of different types of prescriptions have not yet been unified.And more than 50%of Chinese pharmacists have a unified understanding of the judgment of the temperature of medication,the choice of medication time,and the dosage of adults and children of different ages.(3)Research on Construction of clinical medication instruction service system of TCM:?The standard information database of Chinese herbal medicine contains a total of 2025 basic information of Chinese herbal medicine,including 1592 in pharmacopiea and 433 in hospital.The data includes "Name of Decoction Pieces" "Prescribing" "Alias of Decoction Pieces""Latin Name of Decoction Pieces" "Jiyuan" "Pharmaceutical Part" "Four Qi" "Five Flavors" "Gui Jing" " "Toxicity""Efficacy" "Functions and Indications" "Usage and Dosage""Special Decoction Method" "Contraindications""Precautions for Use" "Notification of Medication" "Medication for the Elderly" "Medication for Children""Whether It is processed products" "Processing methods" "Is it expensive medicinal materials" "Diet taboos" "Storage methods" and "Executive standards",a total of 25 items.?The classical prescription database of TCM contains basic information of 113 prescriptions from "Treatise on Febrile Diseases",including "Name of Prescription""Composition of Prescription""Types of Medicine" "Indicating Diseases" "Decoction Method" "Taking Methods" and "Caution in Use",a total of 7 items.?The rule control database for prescriptions of Chinese herbal medicine contains "Eighteen clashes" "Nineteen incompatibilities" "Minimum Dosage""Maximum Dosage" "The Audit Maximum Dosage" of Chinese herbal medicines,and precautions for medications for special populations.?The terminology database of medication guidance of TCM includes the decoction method of Chinese medicine decoction pieces(decocting times,decoction time,decoction water addition,decoction temperature,and special decoction method),and the method of taking Chinese medicine decoction(drug dose,number of doses,temperature of medication),Medication time and special medication methods),medication notification(after medication care,medication contraindications and health guidance)and medication storage methods in four categories.At last,this study constructed a Clinical medication instruction service system of TCM with the "four databases and five centers" as the main framework.Four databases including the standard information database of Chinese herbal medicine,the classical prescription database of TCM,the rule control database for prescriptions of Chinese herbal medicine,and the terminology database of medication guidance of TCM.And five functional centers including the prescription review center,prescription rechecked center,medication guidance center,monitoring center and traffic center.(4)Study on the application of Medication instructions of TCM decoction pieces:A total of 150 questionnaires were issued to patients,and 142 valid questionnaires were returned.The results showed that more than 50%of the respondents believed that the Medication instructions of TCM decoction pieces has rich instruction content and easy-to-understand language,and 87.32%of the respondents believed it is effective for patients to refer how to decocte and take medicines.97.89%of respondents were satisfied with the Medication instructions of TCM decoction pieces.Conclusion:The standardized development of clinical pharmaceutical care of TCM should be based on the traditional practice experience of TCM and learn from ancients.The development of Wise Information Technology of med(WITMED)has facilitated the development of informatization of clinical pharmaceutical care.The establishment of Clinical medication instruction service system of TCM based on the "Four Databases and Five Centers" has promoted the informatization and standardized development of clinical pharmacy services of TCM,and improved the capability to provide clinical pharmacy services of TCM of medical institutions Service. |
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