【摘要】 目的:构建基于中医思维的中成药处方点评体系,以病毒合剂为例,探索其在儿童合理用药中的应用价值,提升处方规范性、适宜性与临床用药安全。方法:采用按月分层抽样法,从天津市儿童医院医院信息系统(HIS)中抽取2024年7月至2025年6月含病毒合剂的中成药处方3 600张,依据《中成药临床应用指导原则》等规范,结合中医辨证理论与药物组方特点,制定涵盖规范性、适宜性(适应证、用法用量、重复用药、联合用药)及超常处方的多维点评规则,进行系统评价与问题分析。结果:共检出不合格处方121张,处方合格率为96.64%。不合格处方中,不规范处方48张(39.67%),主要问题为开具时限不规范(45张,37.19%);不适宜处方73张(60.33%),以用法用量不适宜为主(50张,41.32%);未发现超常处方。结论:基于中医理论的处方点评体系能有效识别中成药使用中的关键问题,尤其适用于儿童用药的合理性评估。该模式有助于促进中成药处方的规范化与个体化,为临床合理用药提供理论支持与实践路径。更多还原

【Abstract】 Objective: To construct the prescription review system of Chinese patent medicines based on traditional Chinese medicine thinking, and to explore the rational application value of Bingdu mixture in children, so as to improve the standardization, suitability and clinical drug safety of prescriptions. Methods: A total of 3,600 traditional Chinese medicine prescriptions containing Bingdu mixture were extracted by using a stratified monthly sampling method from the hospital information system(HIS) of Tianjin Children’s Hospital from Jul. 2024 to Jun. 2025. According to the Guidelines for Clinical Application of Chinese Patent Medicines and other norms, combined with the theory of traditional Chinese medicine syndrome differentiation and characteristics of drug formulation, the multidimensional review rules covering standardization, suitability(indication, dosage and usage, repeated medication, drug combination) and abnormal prescriptions were formulated, and systematic review and problem analysis were carried out. Results: A total of 121 unqualified prescriptions were detected, with a qualification rate of 96. 64%. There were 48 non-standard prescriptions(39. 67%), with the main problem of non-standard prescribing duration(45 prescriptions, 37. 19%). Seventy-three were inappropriate prescriptions(60. 33%), with inappropriate dosage and usage being the most common issue( 50 prescriptions, 41. 32%). No exceptional prescriptions were detected. Conclusion: The prescription review system based on traditional Chinese medicine theory can effectively identify key issues in the use of Chinese patent medicines, demonstrating particular applicability for assessing rational drug use in children. This model contributes to promoting the standardization and individualization of Chinese patent medicine prescriptions, offering theoretical support and a practical pathway for enhancing clinical rational drug use.更多还原