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作者中文名	作者英文名	单位中文名	单位英文名	E-Mail
赵思进	ZHAO Si-jin	北京中医药大学中药学院，北京 100029 北京中医药大学中药调剂标准化研究中心，北京 100029	School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100029, China Standardization Research Center of Traditional Chinese Medicine Dispensing, Beijing University of Chinese Medicine, Beijing 100029, China
张囡	ZHANG Nan	北京中医药大学中药学院，北京 100029 北京中医药大学中药调剂标准化研究中心，北京 100029	School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100029, China Standardization Research Center of Traditional Chinese Medicine Dispensing, Beijing University of Chinese Medicine, Beijing 100029, China
赵学龙	ZHAO Xue-long	南京市中医院，江苏南京 210006	Nanjing Hospital of Traditional Chinese Medicine, Nanjing 210006, China
马传江	MA Chuan-jiang	山东中医药大学附属医院药学部，山东济南 250011	Department of Pharmacy, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, China
刘国秀	LIU Guo-xiu	北京中医药大学中药学院，北京 100029 北京中医药大学中药调剂标准化研究中心，北京 100029	School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100029, China Standardization Research Center of Traditional Chinese Medicine Dispensing, Beijing University of Chinese Medicine, Beijing 100029, China
金世元	JIN Shi-yuan	北京中医药大学中药调剂标准化研究中心，北京 100029	Standardization Research Center of Traditional Chinese Medicine Dispensing, Beijing University of Chinese Medicine, Beijing 100029, China
翟华强*	ZHAI Hua-qiang	北京中医药大学中药学院，北京 100029 北京中医药大学中药调剂标准化研究中心，北京 100029	School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100029, China Standardization Research Center of Traditional Chinese Medicine Dispensing, Beijing University of Chinese Medicine, Beijing 100029, China

基金项目:国家重点研发计划项目（2019YFC1712000，2019YFC1712002）

中文摘要:目的规范含朱砂、雄黄中成药临床调剂技术，明确临床药师工作流程，指导临床合理用药。方法梳理《中华人民共和国药典》2020年版（一部）和《国家基本药物目录》（2018版），建立“含朱砂、雄黄中成药数据库”，向南京市中医院和山东中医药大学附属医院药学部多位药师开展调研，结合国内外期刊数据库和问卷调研结果，分析含朱砂、雄黄中成药在临床调剂与使用过程中的痛点和难点问题，构建包括采购验收、贮存养护、处方审核、处方调配、处方复核、发药与用药交代、处方点评、用药监测和用药警戒在内的9项调剂关键技术体系。结果根据我国现行的药品不良反应关联性评价，73.53%的不良反应可能由含朱砂、雄黄的中成药导致，用药过程中存在的主要问题为长期、超量、超适应症用药；影响含朱砂、雄黄中成药调剂的重点环节包括采购验收、贮存养护、处方审核、处方调配、处方复核、发药与用药交代、处方点评、用药监测和用药警戒等。结论规范含朱砂、雄黄中成药临床调剂技术对规范影响临床用药安全的调剂流程、促进中医临床药学服务的高质量发展具有重要的指导意义和现实价值。

中文关键词:毒性中成药朱砂雄黄调剂技术药学服务

Clinical Dispensing Technology for Chinese Patent Medicines Containing Cinnabaris and Realgar

Abstract:Objective To standardize the clinical dispensing technology for Chinese patent medicines containing Cinnabaris and Realgar, clarify the workflow for clinical pharmacists, and provide guidance for rational drug use in clinical practice.Methods The 2020 edition of the Chinese Pharmacopoeia (Vol. Ⅰ) and the National Essential Drug Catalogue (2018 edition) were reviewed to establish a database of Chinese patent medicines containing Cinnabaris and Realgar. Surveys were conducted with multiple pharmacists from Nanjing Hospital of Traditional Chinese Medicine and the Department of Pharmacy, Affiliated Hospital of Shandong University of Traditional Chinese Medicine. Additionally, pain points and challenges in the clinical dispensing and use of Chinese patent medicines containing Cinnabaris and Realgar were analyzed based on the journal databases in China and abroad and questionnaire surveys. A key dispensing technology system consisting of nine components was constructed, including procurement and acceptance technology, storage and maintenance technology, prescription review technology, prescription dispensing technology, prescription verification technology, dispensing and medication explanation technology, prescription assessment technology, medication monitoring technology, and medication alert technology.Results According to the current adverse drug reaction association assessment in China, 73.53% of adverse reactions were highly likely to be caused by Chinese patent medicines containing Cinnabaris and Realgar. The main issues during drug use included long-term use, excessive dosages, and off-label use. Key aspects affecting the dispensing of Chinese patent medicines containing Cinnabaris and Realgar included procurement and acceptance, storage and maintenance, prescription review, prescription dispensing, prescription verification, dispensing and medication explanation, prescription assessment, medication monitoring, and medication alert.Conclusion Standardizing the clinical dispensing technology for Chinese patent medicines containing Cinnabaris and Realgar has significant guidance and practical implications for standardizing dispensing technology that affects clinical drug safety and promoting the high-quality development of clinical pharmacy services in traditional Chinese medicine.

keywords:toxicity Chinese patent medicine Cinnabaris Realgar dispensing technology clinical pharmacy service

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