基层医院《药品处方集》的编制要切合实际

目的探讨基层医院编制《药品处方集》的实用性与必要性。方法结合我院实际,自主设计编制了《药品处方集》,提供给医、药、护及相关管理人员。结果自主设计编制的《药品处方集》,适用面较广、信息可靠、优势明显。结论医院编制的《药品处方集》,实用性强,在促进药物治疗的安全、合理、有效,促进医院管理方面发挥了重要作用。     

A dose-response study in animals to evaluate the anticoagulant effect of the stage 2 unfractionated heparin USP monograph change

The United States Pharmacopeia (USP) monograph for unfractionated heparin (UFH) was revised in October 2009. This revision was anticipated, based upon in vitro tests, to reduce UFH potency by approximately 10%. To study the potential in vivo consequences of the monograph change, we evaluated activated partial thromboplastin time (aPTT) and activated clotting time (ACT) responses in animals. Female mini-pigs and monkeys (n=8/species) were administered intravenously 60, 54, 48, or 42 U/kg and 50, 45, 40, or 35 U/kg "old" (pre-USP revision) UFH, respectively, in a Williams 4×4 crossover design. Blood samples for aPTT and ACT were collected at 15 min after dosing. The same study design was then repeated using "new" (post-USP revision) UFH. Mean "new" UFH aPTT and ACT values were generally lower than those for "old" UFH although individual animal responses varied considerably. The aPTT and ACT response was generally dose-proportional for both "old" and "new" UFH. These studies indicate that the USP monograph alteration for UFH may result in a modest reduction in the anticoagulant response across a population, but the variability in animal responses underscores the importance of individualization of clinical UFH dosing and the importance of anticoagulant test monitoring.     

信息技术在我院处方集系统管理中的应用

目的:利用现代信息技术对我院处方集系统进行管理,以提高医院药事管理水平。方法:以我院的信息技术平台为基础,从药品采购、处方评价、药品信息等方面围绕处方集系统进行现代化管理。结果:信息技术的应用,使医院药品采购环节更加规范;使处方评价更加规范、准确、高效;使药品信息的获取更加方便、快捷、准确。结论:现代信息技术使药事管理变得更加快捷、高效,将在医院处方集系统管理中得到更为广泛的应用。     

2007～2009年我院口服心脑血管类中成药用药分析

目的：评价我院口服心脑血管类中成药使用情况,为临床合理用药提供参考。方法：对我院2007～2009年口服心脑血管类中成药的种类、年销售金额、用药频度（DDDs）、日均费用（DDC）等进行统计分析。结果：我院2007～2009年口服心脑血管类中成药呈上升趋势;该类药品以胶囊、片剂及滴丸为首选剂型;排序比值同步性较好。结论：我院口服心脑血管类中成药临床使用基本合理,以新剂型、疗效确切、价格低廉的中成药在临床应用中具有优势,但也存在仍需改进的地方。     

WHO“药物和治疗学委员会”解读

目的：论述WHO“药物和治疗学委员会”的组织、功能和作用。方法：文献检索及述评。结果：对WHO“药物和治疗学委员会”在实施国家药物政策,特别是合理使用药物和医院管理方面的阐述。结论：“药物和治疗学委员会”是在医院建立“处方集系统”,实施国家药物政策和基本药物制度和支持医院管理重要组织。     

Rational pharmacotherapy in The Netherlands: formulary management in Dutch hospitals

A survey regarding the management of rational pharmacotherapy was conducted among all Dutch general hospitals in 1998. The response was 99% (n = 120). The presence of a drugs and therapeutics committee and antibiotic policies in Dutch general hospitals appears independent of hospital characteristics. However, formulary agreements and treatment guidelines are less likely to be present in hospitals that employ only 1 pharmacist or those served by community pharmacies. More than half of the hospitals claim to have restrictive formulary agreements. Large hospitals, hospitals in the eastern and southern provinces and those served by hospital pharmacies more often tend to have restrictive agreements compared to small hospitals, hospitals in the northern, central, and western provinces, and those served by community pharmacies. Various methods to impose restriction and ensure formulary compliance are mentioned. It must be noted that hospitals tend to operate rather solely regarding the large number of different formularies. Surprisingly just a small majority of pharmacists evaluates formulary agreements positively as a management tool. Many drawbacks appear to be present. The results of this survey indicate that in the future Dutch hospitals will favour disease management (treatment guidelines) over drug management (formulary agreements) in the management of rational pharmacotherapy and that information technology will be used to influence clinicians' prescribing behaviour.     

朱端章及其卫生家宝系列方书略考

朱端章 ,福建长乐人 ,南宋淳熙年间曾任江西南康郡守 ,为官而喜医道。因见当时产科专书较少 ,故将家中所藏医书中有关产科内容 ,辑成《卫生家宝产科方》 ;又将先世所传及手录单验方等集成《卫生家宝方》 ;此外还辑有《卫生家宝小儿方》和《卫生家宝汤方》。该系列方书录存了唐宋多家胎产及小儿著作 ,内容涉及内、外、妇、儿、五官各科 ,对于整理研究宋及宋以前产科文献和发掘中医产科精粹内涵方面具有重要的参考价值 ,在研究南宋时期药物炮制及中医临床各科发展方面亦有一定意义。     

重视《伤寒论》方剂的剂量

依据《伤寒论》中的主要方剂,从四个方面论述探讨了《伤寒论》方剂药物的用量:1、重视单一方剂中的药物用量;2、重视复合方剂中的方剂用量;3、重视加减方剂中的方药用量;4、重视方剂的每次服用量。     

试论《三因司天方》与《辅行诀》五脏用药法要的互补性

[目的]研究《三因司天方》与《辅行诀》协同应用于临床的可行性。[方法]采用文献法对《三因司天方》与《辅行诀》进行研究,从诊断和治疗两方面作梳理分析和比较,依据中医经典理论体系,结合临床实践经验,合理推导得出结论。[结果]《三因司天方》以五运六气为理论核心,《辅行诀》以五脏补泻为理论核心。《三因司天方》的诊断以发病时间和临床表现为依据,重视症状。《辅行诀》的诊断以临床表现为依据;除症状外,更加注重发病以及就诊时间这个重要因素。《三因司天方》的组方思路基于五行生克之理,利用药物的五味,而不是单纯依据药物的功效来治疗。《辅行诀》方药更有特点,结构严谨,有明确的组方规则;从五行五脏论治的角度,细分药物。[结论]《三因司天方》与《辅行诀》都以《内经》为理论基础,并加以发挥和创新,在疾病的诊断和治疗上是互通的,同时又各有侧重和优势,可以互为补充。对《三因司天方》与《辅行诀》的互补性进行深入研究和阐发,并在临床实践中应用与验证,具有现实意义。