中国临床药学杂志

目的 发现中成药重复使用问题，建立精细化审方规则，优化审核标准以提升用药合理性与安全性。方法 抽取2025年1月1日至4月30日医院门诊处方中品种数量≥2种的中成药联用处方5 000张，依据中成药重复用药评分标准表评分、划分风险等级，建立前置审方规则，实施用药干预。结果 5 000张中成药联用处方中，710张（占14.2%）存在重复用药，涉及30种不同风险等级药物联用，其中高风险17种（共468例，含肛泰栓联合肛泰软膏196例、复方丹参滴丸联合速效救心丸105例等），中风险6种（共159例），低风险7种（共83例）。据此制定28项审方规则，包含“警示提醒+系统拦截”15项、“警示提醒+医师双签确认”6项和“警示提醒+系统通过”7项。结论 该院门诊中成药重复用药较为普遍，且不乏高风险情况。为降低用药安全隐患，建议通过信息化系统实施前置审方干预。

AIM To identify the problem of duplicate medication use of Chinese patent medicines, establish refined prescription review rules, and optimize review standards to improve the rationality and safety of medication use. METHODS A total of 5 000 prescriptions for the combined use of two or more kinds of Chinese patent medicines were selected from the outpatient prescriptions from January 1 to April 30, 2025. The prescriptions were scored and classified into risk levels according to the scoring criteria for duplicate medication use of Chinese patent medicines, and pre-prescription review rules were established accordingly to implement medication intervention. RESULTS Of the 5 000 prescriptions with combined use of Chinese patent medicines, 710(14.2%) involved duplicate medication use, covering 30 drug combinations of various risk levels. Among them, there were 17 high-risk combinations(468 cases, including 196 cases of Gangtai Suppository combined with Gangtai Ointment and 105 cases of Compound Danshen Dripping Pills combined with Suxiao Jiuxin Pills), 6 medium-risk combinations(159 cases), and 7 low-risk combinations(83 cases). Based on these findings, 28 prescription review rules were formulated, including 15 rules of "warning reminder + system interception", 6 rules of "warning reminder + physician double-signature confirmation", and 7 rules of "warning reminder + system approval". CONCLUSION Duplicate medication use of Chinese patent medicines in outpatient settings of this hospital is relatively common, including high-risk cases. To reduce potential medication safety hazards, it is necessary to implement a prospective prescription review intervention through an information system.