邓志军,吴菲,李丽明,刘若轩,吴智松,齐耀群
DENG Zhijun,WU Fei,LI Liming,LIU Ruoxuan,WU Zhisong,QI Yaoqun

• 1:广州市中医医院药学部

摘要(Abstract)：

目的了解本院毒性中药的使用情况,探讨其用药规律,为科学有效、合理使用毒性中药提供临床实践依据。方法通过医院HIS医疗信息管理系统,抽取2005~2014年本院使用含毒性中药处方,采用Excel 2010软件对有毒中药用量和含有毒中药的处方进行统计分析,研究临床用药趋势。结果含毒性中药处方中以生半夏的使用量最大,占全部毒性中药使用量的78.09%,其次是生天南星,占16.09%。使用有毒中药的71 898例处方的临床科室中以肿瘤科最多,占75.09%,其后依次为骨科、内分泌科、名中医室、皮肤科、脑病科、血液科,分别占比为9.25%、6.26%、3.07%、3.95%、1.82%、1.96%、0.08%。结论本院毒性中药使用基本合理,建议严格控制其使用剂量使其科学合理,充分有效发挥中医所提倡利用有毒中药"药以治病,因毒为能"的作用。
OBJECTIVE To know the use of toxic Chinese medicine in the hospital and explore its regularity in order to provide a clinical basis for scientific,reasonable and effective application of toxic Chinese medicine. METHODS The prescriptions containing of the toxic Chinese medicine were randomly sampled through Hospital Information System( HIS). The dosage and prescription of the toxic Chinese medicine were analyzed by Excel 2010 based on the statistical method for researching of clinical drug trends. RESULTS Usage of raw Rhizoma Pinelliae was the most within prescriptions containing of the toxic Chinese medicine,which account for 78.09% of total toxic Chinese medicine,secondly was Arisaema heterophyllum Blume,accounted for 16. 09%. In the total 71 898 prescriptions containing of the toxic Chinese medicine,oncology department had the most frequently application rate,which account for75.09%,followed by orthopedics,endocrinology,dermatology,encephalopathy and hematology department,accounting for 9.25%,6.26%,3.07%,1.82%,3.95%,1.96% and 0.08%,respectively.CONCLUSION The use of toxic Chinese medicine in the hospital was basically rational. It is suggested that the dosage of toxic Chinese medicine should be strictly controlled to scientific and rational level,so as to make the toxic Chinese medicine play a role in curing rather than causing diseases which were advocated by traditional Chinese medicine.

关键词(KeyWords)： 毒性中药;生半夏;生天南星;生草乌;生川乌;制马钱子
toxic traditional chinese medicines;raw rhizoma pinelliae;arisaema heterophyllum blume;radix aconiti;radix aconite kusenzoffii;prepared semen strychni

Abstract:

Keywords:

基金项目(Foundation): 建设中医药强省立项资助科研课题(20141225);; 广州市中医药和中西医结合科技项目(20152A011005;20142A011002);; 广东省医院药学研究基金(2014A09);; 广东省卫生经济学会科研研究计划项目(2015-12-02)

作者(Author): 邓志军,吴菲,李丽明,刘若轩,吴智松,齐耀群
DENG Zhijun,WU Fei,LI Liming,LIU Ruoxuan,WU Zhisong,QI Yaoqun

参考文献(References)：

• [1]朱龙涛,龚千锋,易炳学,等.马钱子的炮制和化学成分、药理毒理研究进展[J].江西中医学院学报,2012,24(3):98-100.
• [2]赵军宁,叶祖光.传统中药毒性分级理论的科学内涵与《中国药典》(一部)标注修订建议[J].中国中药杂志,2012,37(15):2193-2198.
• [3]周仲瑛,程海波,周学平,等.中医药辨治肿瘤若干理念问题的探讨[J].南京中医药大学学报,2014,30(2):101-104.
• [4]武峰,秦志丰,李勇进,等.半夏化学成分抗肿瘤研究进展[J].中华中医药学刊,2013,31(2):270-272.
• [5]王芹,许玲,焦丽静,等.天南星抗肿瘤及镇痛作用研究进展[J].上海中医药杂志,2013,47(7):103-105.
• [6]石变,袁秀霞,秦志丰,等.论痰浊内阻与肿瘤发生[J].中华中医药杂志,2012,27(9):2389-2393.
• [7]凌珊,龚千峰.草乌的研究进展[J].江西中医学院学报,2011,23(3):90-94.
• [8]陈笑媚,温天燕,陈远林,等.乌头汤合防己黄芪汤对活动期强直性脊柱炎患者血清TNF-α、IL-1、IL-6的影响[J].今日药学,2015,25(7):491-493.
• [9]刘瑶,焦豪妍.川乌毒理与药理现代研究进展[J].云南中医中药杂志,2010,31(3):66-67.
• [10]刘若轩,李丽明,郭洁文,等.含毒性中药马钱子中成药的剂型与工艺分析[J].今日药学,2014,24(12):848-849.
• [11]Chen J,Qu YG,Wang DY,et al.Pharmacological Evaluation of Total Alkaloids from Nux Vomica:Effect of Reducing Strychnine Contents[J].Molecules,2014,19(4):4395-4408.