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OBJECTIVE：To provide referenc e for the construction and software development of knowledge base for rational use of TCM decoction pieces. METHODS ：By reviewing the literatures on rational drug use software and TCM decoction pieces in recent years ，the clinical characteristics of rational drug use of TCM decoction pieces as well as the characteristics and shortcomings of existing rational drug use software in the detection of rational drug use of TCM decoction pieces were analyzed ， and the core contents and difficulties in the construction of knowledge base of rational drug use software of TCM decoction pieces were summarized. RESULTS & CONCLUSIONS ：Clinical application of TCM decoction pieces was mainly based on “syndrome differentiation”，which reflected the unity of dialectics ，treatment，prescription selection and medication. Therefore ，the consideration of the rationality of clinical use of TCM decoction pieces could not blindly imitate the evaluation method of chemical medicine. Current rational drug use software was not based on the theoretical system of traditional Chinese medicine ，and it was not comprehensive and mature in the aspect of rational drug use review of TCM decoction pieces ，and lacks the knowledge base that could meet the requirements of rational use of TCM decoction pieces. Therefore ，it is necessary to construct a set of knowledge base which can meet the evaluation requirements of “consistency of principle ，method and prescription use ”of TCM decoction pieces under the guidance of TCM theoretical system. Its contents include that patient information collection ，construction of knowledge base related to diseases and syndromes ，selection of processed products of TCM dec oction pieces ，addition andsubtraction of clinical symptoms ，selection taboo of varieties of TCM decoction pieces ， compatibility taboo ， combined application of Chinese patent medicine or chemical medicine ， dosage of TCM decoction pieces ， total dosage and tastquantity of each prescription ， special de coction drugs ， medication methods and administration frequency ，etc. There are still some difficulties in the development of rational drug use software of TCM decoction pieces ，such as the construction of disease and syndrome related knowledge base and the difficulty in judging the rationality of clinical symptom addition and subtraction.
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OBJECTIVE：To estab lish the evaluation criteria for repeated usage of TCM decoction pieces and Chinese patent medicine，and to provide reference for prescription comment. METHODS ：By modified Delphi method ，15 experts of TCM were selected，who had plenty of clinical experience. The questionnaire data and expert opinion were collected and summarized to establish related evaluation index system with two rounds of questionnaire survey. RESULTS ：In this two-rounded survey ，experts’ positive coefficients were 100％；authority coefficient were 0.711 and 0.752；reliability of questionaire were 0.830 and 0.926； coordination degree of experts were 0.579（P＜0.01）and 0.721（P＜0.01），respectively. The evaluation criteria for cross-using and repeated usage of TCM decoction pieces and Chinese patent medicine ，which contained 4 first-level items （component repetition，function and indication repetition ，tumor repetition and others ）and 10 second-level items ，were established finally. CONCLUSIONS：Established criteria are with well expert ’s positive coefficient and high authority ，and good reliability of questionnaire. The evaluation criteria for repeated usage of TCM decoction pieces and Chinese patent medicine is formulated preliminarily.
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Objective To provide technical support for market supervision of TCM decoction pieces in Beijing, Tianjin and Hebei districts; To facilitate the medical treatment of people in the three districts. Methods A comparative study and analysis on processing procedures of TCM decoction pieces in Beijing, Tianjin and Hebei districts was conducted. Results There were some differences in TCM decoction pieces in Beijing, Tianjin and Hebei districts. The quality of TCM decoction pieces is easy to be contradictory according to different standards. Conclusion It is badly in need of a unified standard for the preparation of TCM decoction pieces.
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Objective To analyze usage and development trend of TCM decoction pieces in First Hospital of Zhangjiakou City (hereinafter referred to as "our hospital") from 2014 to 2016; To provide the basis for making reasonable purchase plan, reserving TCM decoction pieces and guaranteeing clinical medication.Methods Computer medicine management system was used to conduct statistical analysis on the prescription or order number, dosage, sales, and top 10 TCM decoction pieces among annual consumption and sales of TCM decoction pieces from 2014 to 2016.Results The results showed that the prescription and the order, dosage and sales of TCM decoction pieces decreased year by year. The top 10 TCM decoction pieces in the three years were the same with nine kinds, namely Astragali Radix, Poria, Angelicae Sinensis Radix, Salviae Miltiorrhizae Radix et Rhizoma, Atractylodis Macrocephalae Rhizoma, Ophiopogonis Radix, Coicis Semen, Citri Reticulatae Pericarpium, and Lycii Fructus. Conclusion The usage of TCM decoction pieces in our hospital is reasonable and the structure of medication is stable.
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Objective To statistically analyze the overdose of Chinese materia medica in Orthopedics and Traumatology Outpatient Clinic of The Affiliated Orthopedics and Traumatology Hospital of Guangzhou University of Traditional Chinese Medicine (hereinafter referred to as "our hospital"); To provide references for rational application of Chinese materia medica in orthopedics and traumatology department. Methods Totaiiy 1200 prescriptions during Sep. 2015 - Sep. 2016 in Orthopedics and Traumatology Outpatient Clinic were randomly selected. Based on the Chinese Pharmacopoeia (2015 Edition) and the second edition of the New Century textbook Chinese Medicine as references, the top 30 of the use of TCM decoction pieces were retrospectively analyzed. Results The top 30 of the use of TCM decoction pieces were 100% overdosed, among which 11 TCM decoction pieces were 50% overdosed; 95.93% prescriptions were with 18 kinds of Chinese materia medica. Conclusion Excessive use of Chinese materia medica prescriptions are common in Orthopedics and Traumatology Outpatient Clinic of out hospital, which causes waste of TCM resources and imposes patients' financial burden.
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Objective To provide references for improving the quality of TCM decoction pieces through the analysis on sample inspection of TCM decoction pieces of Huguosi TCM Hospital of Beijing University of Chinese Medicine (hereinafter referred to as our hospital). Methods In our hospital from January 2014 to December 2015, TCM decoction pieces with problems in this sample inspection were categorized according to reasons. Results Quality problems found in the sample inspection were categorized into 3 types, i.e. collection and preparation (69.79%), storage (20.93%) and other problems (9.31%). Cutting in collection and preparation (13.95%), worming in storage (9.30%) and breaking/crumbing (6.98%) were the most obvious problems. Conclusion Strengthening the management of procurement acceptance, strict control of storage and storage conditions, and paying attention to the use of other aspects of management can improve the quality of TCM decoction pieces.
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Objective To provide references for rational clinical usage and purchase of TCM decoction pieces for blood-activating and stasis-removing. Methods Excel 2013 software was used to conduct statistical analysis on categories, consumption quantity, consumption sum and annual average growth rate of TCM decoction pieces for blood-activating and stasis-removing during 2011-2015 in TCM Hospital of Jiangsu Province (hereinafter refered to as our hospital). Results The consumption quantity and consumption sum of TCM decoction pieces for blood-activating and stasis-removing in our hospital increased year by year. Among all types of TCM decoction pieces for blood-activating and stasis-removing, TCM decoction pieces for activating blood and adjusting maridians occupied the largest amount, followed by TCM decoction pieces for activating blood and relieving pains, breaking up the static blood and eliminating masses, and blood-activating and wound - curing. The TCM decoction pieces with the biggest annual consumption quantity were Salviae Miltiorrhizae Radix et Rhizoma, Chuanxiong Rhizoma, and Curcumae Radix, and the TCM decoction pieces with the biggest annual consumption sum were Notoginseng Radix et Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, and Carthami Flos. Conclusion Both the consumption quantity and the consumption sum of the TCM decoction pieces for blood-activating and stasis-removing in our hospital have been increasing year by year. However, the proportion consumption quantity and the consumption sum of TCM decoction pieces and medicine utilization structure have kept stable, and in basically rational use.
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OBJECTIVE:To provide reference to promote the proper use of TCM decoction pieces.METHODS:According to Beijing TCM Decoction Piece Dispensing Regulation,stratified random sampling method was adopted to select a group of physicians in our hospital and conduct questionnaire survey about their knowledge of the prescription handling of 8 commonly used TCM decoction pieces including Scutellaria baicalensis,Angelica sinensis,Fritillary,Phellodendron chinense,Aconitum carmichaeli,Eucommia ulmoides,Ziziphus jujuba,Rhei Radix et Rhizoma.Then,the survey data was collected and analyzed.RESULTS:A total of 81 questionnaires were given out and all were returned with effective recovery rate of 100％.In terms of professional titles,associate chief physicians showed the lowest average error rates in prescription handling cognition (27.5 ％),compared with physicians (35.8％) and attending doctors (37.0％).They made most mistakes about Fritillary and E.ulmoides.To the contrary,both physicians and attending doctors made most mistakes about E.ulmoides.In the scope of working life,physicians from different groups showed similar average error rates in prescription handing recognition (31.3％-38.8％).All of them made most mistakes about P.chinense and E.ulmoides.As for major,those who study western internal medicine shared larger average error rates (43.8％) than those who study internal medicine of TCM (36.8％),traumatology and orthopedics of TCM (31.8％) and acupuncture (36.5％).Each major showed the highest error rates in E.ulmoides.The order of 8 TCM decoction pieces from the most mistakes to the least mistakes made by physicians was E.ulmoides,P.chinense,Fritillary,Rhei Radix et Rhizoma,S.baicalensis,A.carmichaeli,Z.jujuba and A.sinensis.CONCLUSIONS:Physicians with different professional titles,working life and majors show deficiency in knowledge about the prescription handling of 8 commonly used TCM decoction pieces.Generally,physicians show the worst understanding of E.ulmoides.
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Objective To provide references for clinical rational use and purchase of TCM decoction pieces of tonifying deficiency medicine through analysis on TCM decoction pieces of tonifying deficiency medicine in Jiangsu Hospital of TCM during 2011–2015.Methods Excel 2010 software was used to analyze the categories, dosage and sales of the TCM decoction pieces of tonifying deficiency medicine in our hospital during 2011–2015.Results The dosage of TCM decoction pieces for tonifying deficiency medicine in our hospital during 2011–2015 increased from 526434 kg to 800022 kg, with annual growth rate of 11.09%; consumption sum increased from 72151700 yuan to 125066300 yuan, with annual growth rate of 20.20%; dosage rate was 25.97%–27.03%. Among subtypes of tonifying deficiency medicine, the quantity of medicine for tonifying qi was the largest (accounting for 44.64%–46.07%), followed by medicine for tonifying yin (accounting for 20.63%–21.62%), medicine for tonifying blood (accounting for 17.23%–18.93%), and medicine for tonifying yang (accounting for 15.00%–15.17%). Top 5 TCM decoction pieces for tonifying deficiency medicine in the list of annual quantity were Astragali Radix, Atractylodix Macrocephalae Rhizoma, Paeoniae Radix Alba, Dioscoreae Rhizoma, and Codonopsis Radix during 2011–2015. The top of TCM decoction pieces for tonifying deficiency medicine in the list of consumption sum was Pseudostellariae Radix during 2011–2015.Conclusion Both dosage and consumption sum of TCM decoction pieces for tonifying deficiency medicine in our hospital have increased year by year, but the ratio of the total quantity to total amount and medication structure keep stable. TCM decoction pieces for tonifying qi is the greatest in dosage, which is in line with rational clinical medication regularities. Purchasing staff can purchase medicine predictably according to the Results .
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Objective To analyze the clinical utility of TCM decoction pieces for reinforcing deficiency in the First Affiliated Hospital of Xi'an Jiaotong University (hereinafter referred to as our hospital).Methods By using Microsoft Office Excel 2013 software, use frequency, classifications of pharmacological actions and doses of the TCM decoction pieces for reinforcing deficiency from 2013 to 2015 were analyzed.Results From 2013 to 2015, some TCM decoction pieces for reinforcing deficiency showed relatively high use frequency in our hospital (>30%). In top 15 TCM decoction pieces for reinforcing deficiency, the amounts of medicine for tonifying qi were more than 40%, whose average doses exceeded the upper limit of pharmacopoeia dosage reaching 30%. The total over-use rate of TCM decoction pieces for reinforcing deficiency>50% and the not exceeded part accounted for 36.0%.Conclusion It is suggested that the use of TCM decoction pieces should be careful differentiation of symptoms, and the dose should also meet the specifications.
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OBJECTIVE:To promote the healthy development of TCM decoction piece. METHODS:Based on analyzing the literature,national policy and data,the advantages and urgent problems of bringing TCM decoction piece into the National Essen-tial Medicine List were summarized,and the suggestions for its health development were provided. RESULTS:Bringing TCM de-coction piece into the National Essential Medicine List relieved the economic burden of patients and provided opportunity for the de-velopment of TCM decoction piece industry. However,it existed problems,such as production,circulation,storage and monitor-ing;mutual conflict in the relevant supporting policies;inconsistent medicare reimbursement;and urgent improvement of quality standard. CONCLUSIONS:The relevant departments should establish and improve the quality standard system of TCM decoction piece,and clear the varieties of TCM decoction piece in the National Essential Medicine List,perfecting supporting policies such as medicare reimbursement and attaching importance to the training of professional talents can ensure scientific and rational services for the public health.
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OBJECTIVE:To provide reference for clinical rational use and purchase of TCM decoction pieces for rheumatism. METHODS:Using Excel software,the application of TCM decoction pieces for rheumatism in our hospital during 2010-2014 was analyzed statistically in respects of drug type,consumption quantity and consumption sum,etc. RESULTS:The consumption quan-tity of TCM decoction pieces for rheumatism increased from 46 026 kg to 79 139 kg in our hospital during 2010-2014,and annual growth rate was 14.68%;consumption sum increased from 3 851 300 yuan to 6 403 800 yuan,with annual growth rate was 15.46%;consumption quantity ratio was 2.48%-2.85%. Among antirheumatic drug subtype,the quantity of drugs for antirheumatic and dissipating cold was the largest (accounting for 51.43%-58.42%),followed by drugs for antirheumatic and strengthening the bones and muscles(accounting for 23.05%-28.42%)and drugs for antirheumatic and clearing heat(accounting for 18.53%-21.08%). Top 3 TCM decoction pieces for rheumatism in the list of annual quantity were Viscum coloratum,Cynanchum paniculatum and Clematis chinensis/Chaenomeles sinensis during 2011-2014. Top 3 TCM decoction pieces for rheumatism in the list of consumption sum were Zoacys dhumnades,C. paniculatum and V. coloratum during 2011-2014. CONCLUSIONS:Both consumption quantity and consumption sum of TCM decoction pieces for rheumatism have increased year by year in our hospital,but the ratio of total quantity to total amount and medication structure keep stable,and TCM for expelling wind-damp and dispelling cold is the greatest in consumption quantity which is in line with clinical drug use characteristics. Purchasing staff can purchase drugs predictably ac-cording to the results.
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Objective To provide references for reasonable procurement planning, TCM decoction pieces reserving and clinical medication guarantee by analyzing the usage of TCM decoction pieces and granules from 2011 to 2014 in Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine (hereinafter referred to as Zhuhai Hospital). Methods The sale data of TCM decoction pieces and granules during 2011-2014 in the database of Zhuhai Hospital were analyzed. Sales quantity, sales amount of the category and single pieces of TCM decoction pieces and granules ranking the first 10 were analyzed. Results The sales quantity and amount of TCM decoction pieces and granules were increasing from 2011 to 2014. The usage weight ratio and usage amount ratio between TCM decoction pieces and granules was stable. The top 10 categories and single pieces in sales quantity and amount were also stable. Conclusion Zhuhai Hospital has its own characteristics in TCM types, categories and dosage forms. TCM decoction pieces play an important part in clinical treatment in Zhuhai Hospital.
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Objective To understand the clinic usage of TCM decoction pieces in the First Affiliated Hospital of Xi’an Jiaotong University (hereinafter referred to as our hospital).Methods By using Microsoft Office Excel software, the medicine doses, classification of functions and clinic application of the TCM decoction pieces, which were among the top 50 most frequently used TCM decoction pieces were analyzed.Results In 2014, 60% of the top 50 most frequently used TCM decoction pieces in our hospital exceed the medicine dosage inChinese Pharmacopoeia. According to the functions, the top 3 TCM decoction pieces were medicine for reinforcing deficiency, clearing heat and promoting qi, respectively. Medicine for reinforcing deficiency was mainly used in gastroenteropathy, menopathy and nephropathy. Medicine for clearing heat was mainly used in gastroenteropathy, menopathy and infection of the upper respiratory tract. Medicine for promoting qi was mainly used in gastroenteropathy, tumor and disease of cardiovascular system.Conclusion TCM decoction pieces in our hospital exceed the medicine dosage in Chinese Pharmacopoeia, which requires attention. The top 3 TCM decoction pieces are respectively medicine for reinforcing deficiency, clearing heat and promoting qi, whose clinic applications are basically rational.
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Objective To find out the status of the prescription dosage of TCM decoction pieces in Jiading Hospital of Traditional Chinese Medicine(TCM) .Methods 1 000 prescriptions in 2013 were extracted ,frequency ,number of drug over-dosed ,dosage of poisonous TCM decoction pieces were analyzed .Results The total dose more than 300 grams of prescriptions accounted for 59.6% .The top 10 utility frequency of medicine were Glycyrrhizae radix et rhizoma ,Astragali radix ,Atractyl-odismacrocephalaerhizoma,Poria,Angelicaesinensisradix,Salviaemiltiorrhizaeradixetrhizoma,Paeoniaeradixalba, Coicis semen ,Eucommiae cortex ,Citri Reticulatae pericarpium ,which had varying degrees of overdose .Poisonous TCM de-coction pieces was also overdosed .Conclusion The issues of Chinese herbal medicine prescription was serious ,which need to be improved to ensure rational prescription drug safety .
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Objective To analyze the unreasonable elements in prescriptions from outpatient department through the intervention of unreasonable prescriptions;To provide evidence for reasonable usage of medicine in outpatient department.Methods Prescriptions were examined by senior pharmacists. If they found any unreasonable elements, they would consult doctors, and record all the unreasonable elements in the prescriptions to avoid unreasonable prescriptions. A total of 663 unreasonable prescriptions from Jan. 2011 to May 2013 were analyzed.Results A total of 709 unreasonable elements were found in these prescriptions. The man elements were following three types:overdose of toxic decoction pieces (73.76%), incompatible prescriptions without signature (12.13%), wrong inputting of prescription and decoction (7.76%).Conclusion With early intervention in prescriptions, the quality of prescriptions and the safety and effectiveness of medication can be improved.
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Objective To know the utilization and development trend of TCM decoction pieces for clearing damp and promoting diuresis in our hospital;To provide references for rational medicine use and purchase in clinic. Methods Excel software was used to analyze the utilization of TCM decoction pieces for clearing damp and promoting diuresis in our hospital during 2009-2013 from the aspects of consumption quantity, consumption sum, and annual average growth. Results The consumption quantity of TCM decoction pieces for clearing damp and promoting diuresis in our hospital increased year by year with average growth rate of 10.58%;the consumption sum increased year by year with average growth rate of 20.21%. The consumption quantity of TCM decoction pieces for inducing diuresis to alleviate edema took the lead among all kinds of medicine, followed by medicine for inducing dampness for treating jaundice, and medicine for inducing diuresis for treating stranguria. Conclusion Both the consumption quantity and the consumption sum of TCM decoction pieces for clearing damp and promoting diuresis in our hospital have been increasing year by year. The proportion of which in total quantity and the consumption sum of TCM decoction pieces and the medicine utilization structure have kept stable, and its usages is rational on the whole.
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Objective To analyze the usage of TCM decoction pieces in our hospital during 2011-2014;To provide references for clinical reasonable medicine using. Methods Statistic analysis was carried out from the aspects of annual amount of prescription, dosage, annual sales, and top 10 TCM decoction pieces among sales rank through management system of hospital pharmacy. Results Sales amount and dosage of TCM decoction pieces increased significantly. During the four years, six same TCM decoction pieces ranked among the dosage of top 10 TCM decoction pieces, namely Astragali Radix, Paeoniae Radix Alba, Angelicae Sinensis Radix, Salviae Miltiorrhizae Radix et Rhizoma, fried Atractylodis Macrocephalae Rhizoma, and Chuanxiong Rhizoma. The amount of prescription increased obviously. Conclusion TCM decoction pieces are commonly used in our hospital;dosage increased continuously;usage is generally reasonable.
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Objective To analyze the utilization and the development trend of TCM decoction pieces for relieving exterior syndrome in Affiliated Hospital of Nanjing University of TCM;To provide references for clinical rational medicine use and purchase. Methods Excel software was used to analyze the consumption quantity and consumption sum of TCM decoction pieces for relieving exterior syndrome in our hospital during 2009-2013. Results The consumption quantity of TCM decoction pieces for relieving exterior syndrome in our hospital increased year by year with average growth rate of 11.52%, among which the consumption quantity of medicine for diverging wind-cold was more than medicine for diverging wind-heat. Conclusion Both the consumption quantity and the consumption sum of TCM decoction pieces for relieving exterior syndrome in our hospital have been increasing significantly. The proportion of which in the total TCM decoction pieces for relieving exterior syndrome and the medicine utilization structure were stable, and the use of TCM decoction pieces for relieving exterior syndrome was rational on the whole.
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OBJECTIVE:To evaluate the quality of TCM decoction pieces in our hospital preliminarily and explore the solu-tions for the problem of the quality of decoction pieces purchased by the hospital. METHODS:In Jun. 2012,a system was estab-lished by our hospital,where the quality inspector was designated to daily inspect new batches of TCM decoction pieces such as ap-pearance provided by suppliers. The batches of TCM decoction piece samples inspected and those of unqualified products from Jun. 2012 to May 2014 were calculated. The reasons of unqualified products were analyzed and corresponding solutions were made. RE-SULTS&CONCLUSIONS:Over two years,a total of 94 671 batches of TCM decoction piece samples were inspected by our hos-pital,among which 737 were unqualified products predominantly because of mildew,damage by worms,greasing,containing for-eign substances and others. The solutions to such problems included interviewing the suppliers,returning or discontinuing the use of crude drugs and special focus on particular seasons and on the demand for key varieties. The unqualified products rate in the quality inspection reduced from 0.56%in Jun. 2012 to 0.34%in May 2014. Therefore,setting the post of drug quality inspector in the hos-pital can ensure the quality of TCM decoction piece purchased,however,it need to improve the inspection and acceptance of quali-ty inspection by sampling,scoring and using the new technology.
