【摘要】 目的 调查抗血小板药物联用中草药潜在不良药物相互作用（pADIs），据此制定精细化审方规则，提高联合用药的安全性。方法 抽取2023年1月1日至2024年10月31日期间蚌埠市第三人民医院抗血小板药物联用中草药的所有门诊处方，依据Lexicomp、Micromedex等权威循证数据库，对处方pADIs情况进行鉴别，并对其风险严重性进行分级；据此利用合理用药管理系统制定精细化审方规则，对开具存在pADIs的处方行为进行实时干预。结果 699张抗血小板药物联用中草药处方中，654张（93.56%）存在1 578例次pADIs，包括阿司匹林联用丹参、甘草、黄芪、山楂和蒲公英等632例次，氯吡格雷联用丹参、甘草、黄芪、当归和葛根等939例次，以及替格瑞洛联用五味子和人参7例次。pADIs风险严重性分级为严重、中度和轻度的分别有43例次、1 532例次和3例次；据此制定19项精细化审方规则，包括“警示信息弹框提醒+医师双签确认”规则2项、“警示信息弹框提醒+系统处方通过”规则16项和“注意信息弹框提醒+系统处方通过”1项。结论 该院门诊抗血小板药物联用中草药处方存在pADIs，且不乏严重风险等级情况，为有效防范用药风险，有必要利用信息化平台进行前置审方干预。更多还原

【Abstract】 Objective To investigate potential adverse drug interactions(pADIs) in the combined use of antiplatelet drugs and Chinese herbal medicines,and based on this,to develop refined prescription review rules to improve the safety of combination therapy. Methods All the outpatient prescriptions for antiplatelet drugs combined with Chinese herbal medicines were extracted from the Third People’s Hospital of Bengbu City from January 1,2023 to October 31,2024. Based on authoritative evidence-based databases such as Lexicomp and Micromedex,the pADIs in prescriptions were identified,and their risk severity was graded. Based on this,the rational drug use management system was used to develop refined prescription review rules,and real-time intervention was carried out for prescribing behaviors with pADIs. Results Among 699 prescriptions of antiplatelet drugs combined with Chinese herbal medicines,654(93. 56%) had 1 578 cases of pADIs,including 632 cases of aspirin combined with Danshen,licorice,astragalus,hawthorn,and dandelion,939 cases of clopidogrel combined with Danshen,licorice,astragalus,Danggui,and kudzu root,and 7 cases of ticagrelor combined with schisandra and ginseng. There were 43 cases classified as severe,1 532 cases classified as moderate,and 3 cases classified as minor for the severity of pADIs risk. Based on this,19 refined prescription review rules were formulated,including 2 items of "warning information pop-up reminder+ double signature confirmation of physician",16 items of "warning information pop-up reminder+system prescription approval",and 1 item of "attention information pop-up reminder+system prescription approval". Conclusion There are pADIs in the prescription of antiplatelet drugs combined with Chinese herbal medicine in the outpatient department of the hospital,and there are also severe grade of risk. In order to effectively prevent medication risks,it is necessary to use an information platform for pre-review intervention.更多还原