ABSTRACT
The present study explored the effective approaches to realize the leading role of traditional Chinese medicine （TCM） in preventing diseases， the synergistic role in treating serious diseases， the core role in the rehabilitation of diseases and summarized the experience to provide feasible plans for the evaluation of other dominant diseases of TCM. To evaluate the effectiveness， safety， and economy of TCM in the treatment of ischemic stroke， encephalopathy project team of the China Center for Evidence-based Traditional Chinese Medicine（CCEBTCM） established an evaluation group to determine the work plan and complete the evaluation work. The concepts of the evaluation involved high-quality evidence， expert opinion survey， expert interview， and drug catalog. Under the guidance of clinical experts and methodologists， the evaluation work was completed in accordance with four steps， i.e.， plan making， data collection and data extraction， evidence synthesis and evaluation， and report writing with the rapid review method. Through the review of TCM and western medicine experts， the advantage of TCM in the treatment of ischemic stroke was positioned in the convalescence period with the predominant effects of improving the neurological function defect and improving the daily living ability. In the convalescence period of stroke， TCM treatment could improve post-stroke motor dysfunction， post-stroke cognitive impairment， consciousness disorder， swallowing disorder， aphasia， constipation， urinary function， diplopia， etc.， and the advantages of acupuncture， Chinese medicine， and traditional exercise were more prominent. In terms of safety， TCM treatment of ischemic stroke showed lower incidence of adverse reactions， fewer adverse events， and a milder degree of related symptoms. In terms of economic performance， the combined treatment of TCM and western medicine played a synergistic role and made the treatment cost more reasonable. Compared with conventional intervention， the integrated TCM and western medicine rehabilitation program showed more economic and social benefits.
ABSTRACT
OBJECTIVE：To provide reference for improving the rationality of discharged prescriptions. METHODS：According to the prescriptions that were often judged as forbidden or not recommended （such as irrational dosage and course of treatment ， off-label drug use ，drug interaction ，medication suitability ，dosage form ） in the pre-audit system of discharged prescriptions （hereinafter referred to as the “audit system ”）of Union Hospital Affiliated to Fujian Medical University （hereinafter referred to as the“our hospital ”），combined with actual case analysis ，the clinical pharmacists looked for evidence-based evidence and evaluate it，communicated with the clinician for feedback ，maintained the content of misjudgment in the intercepted prescription in real time，set up the relevant rules of audit in the audit system ，evaluated the effect and put forward suggestions to improve the scientificity and accuracy of the audit results of the discharged prescription. RESULTS & CONCLUSIONS ：For prescriptions that were judged to be forbidden or not recommended by the system ，such as the limited daily dose of Morphine hydrochloride tablet in patients with cancer pain ，the daily maximum dose of calcium sulfate D 3 after thyoidetomy ，hyper-indication use of megestrol acetate after chemotherapy for rectal cancer ，off-label usage of vitamin B 6 after postpartum delivery ，the combined use of clopidogrel bisulfate and oxcarbazepine after intracranial infection ，clinical contraindication of enteral nutrition powder after intestinal obstruction ，unsuitable dose of Dabigatran ester capsule after atrial fibrillation surgery and so on ，the clinical pharmacist looked for evidence-based evidence ，evaluated and communicated with the clinician . The relevant rules were updated to the audit system in real time. On the whole ，the audit system improves the work efficiency and the scientificity and accuracy of the audit results，but it is necessary to improve the professional knowledge level of the pharmacists ，the ability to find and use evidence-based evidence ，the accuracy of the audit system and the acceptance and recognition of the audit results by doctors ，so as to enhance the rationality of the discharged prescription ，reduce medication security risks.