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含乌头碱中成药是临床安全合理用药的重点,此类药品多含有川乌、草乌附子或雪上一枝蒿,以祛风除湿或温中补阳为功效,需要严格遵照适应症和用法用量使用。但此类药品种类繁多,不仅部分中西医师对于药品性效特征不了解,而且还时常存在多科室联合用药的情况,增加了乌头碱中毒的风险。该文在前期研究基础上,将近2年的含毒中成药处方点评和用药宣教工作经验提炼为“辨证-辨量-辨毒”3个核心要素,并采用客观化、标准化的评价方式,以虎力散胶囊和祛风止痛胶囊为例,构建包含3类9项36个指标的风险评估数字量表,实现对于含乌头碱中成药治疗方案的治疗风险预估和治疗现状评估。以现有上述中成药的不良反应案例报道的验证显示,该风险评估量表可以提示药物治疗方案的风险,标识药物治疗现状的风险等级。为科学、客观地评价含毒中成药的临床用药安全性提供了方法学范例,也有助于不熟悉中医药理论的医师和药师快速掌握含毒中成药合理使用的关键环节和风险防范。
Containing aconitine proprietary Chinese medicines is the focus of clinical safety and rational drug use, such drugs often contain Radix Aconiti, Radix Aconitum or Artemisia snow to expelling wind and dampness or warming the yang for the efficacy, the need to strictly follow the indications and usage dosage use. However, a wide range of such drugs, not only some Chinese and Western doctors do not understand the characteristics of drug efficacy, but also often exist in multiple departments combined with medication, an increase of aconitine poisoning risk. Based on the previous research, the article reviews nearly three years of experience in handling prescriptions of toxic proprietary Chinese medicines and experiences in mission planning and drug treatment as three core elements of “dialectics - discrimination - identification of drugs” and uses objective and standardized evaluation methods Take HuLiSan Capsule and Qufeng ZhiTong Capsule as examples, a risk assessment digital scale containing 36 items of 3 items, 9 items and 36 items was constructed to evaluate the treatment risk prediction and the treatment status of aconitine-containing proprietary Chinese medicine. Validation of the reported cases of adverse effects of the above proprietary Chinese medicines shows that the risk assessment scale can indicate the risk of a medication regimen and identify the risk level of the medical treatment status quo. It provides a methodological example for scientifically and objectively evaluating the clinical drug safety of toxic proprietary Chinese medicines. It also helps physicians and pharmacists who are not familiar with Chinese medicine theory to quickly grasp the key links and precautionary measures for the rational use of toxic proprietary Chinese medicines.