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| 題 名 | 建立中藥使用風險管理機制之研究=Mechanism of Risk Management in Traditional Chinese Medicines |
|---|---|
| 作 者 | 陳鴻儀; | 書刊名 | 中醫藥年報 |
| 卷 期 | 3 2014.12[民103.12] |
| 頁 次 | 頁(65)1-(65)79 |
| 分類號 | 418.1 |
| 關鍵詞 | 中藥; 藥物流行病學; 藥物不良反應通報; Traditional Chinese medicine; Pharmacoepidermiology; Adverse drug report; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 隨著中藥臨床應用日趨普及,其安全性和可能引起的毒性風險逐漸被關注。很多中藥不良反應報導,常常都是因為中藥的錯誤使用所造成。 研究目的:希望透過本研究,建立對中醫門診病患提供中藥安全有效的藥事照護模式,減少病人使用中藥造成嚴重不良反應!確保病人使用中藥安全,提高治療效果,發揮藥師中藥臨床服務的功能。 研究方法:訪視全國 36家中醫院門診藥事給藥作業及環境安全風險評估機制。舉行多場專家座談會。舉辦多場臨床中藥安全研討會。以及利用台灣健保資料庫進行肝毒性中藥使用安全流行病學調查。 結果與討論:每年中藥藥物不良反應通報件數為 0件的醫院竟高達 9家佔 25%。沒有使用條碼調劑之醫院有高達幾乎 6成!另外,大部分醫院炮附子並非毒劇藥,不須加以管理。心臟血管功能的中西藥交互作用建議納入警示電腦系統管理。健保資料庫進行中藥使用安全流行病學調查發現有服用可能導致肝毒性中草藥,造成急性肝炎住院患者 (35.5%)中的比例遠高於沒有服用者 (28.3%)。 |
| 英文摘要 | With the growing popularity of traditional Chinese medicines (TCM) in clinical uses, their safety and toxicity may be gradually concerned about. Many adverse effects of TCM are reported, because of the misusing TCM. AIM: We wish to provide safe effective mechanisms to the outpatient pharmaceutical services of the traditional Chinese medicine and reduce their serious untoward effect of using TCM by this study! It might be guaranteed that the patient uses the traditional Chinese medicine more safely. So it could enhance the better outcome of treatment. Therefore, clinical pharmaceutical care of TCM will become more complete and safe. METHODS: We had visited 36 Chinese medicine hospitals to check their outpatient service and the environmental safety appraisal mechanism. We have held four expert symposia in past months this year. Besides, we have held many clinical safe issues about traditional Chinese medicine conference in Taiwan. Besides, we carried on hepatotoxic pharmacoepidemiology of TCM by using the national health insurance research database. RESULTS and DISCUSSION: The zero notification number of Adverse Drug Report (ADR) about TCM reaches as highly to 25% hospitals every year in Taiwan. Nearly 60% hospitals had not used barcode to fill TCM prescriptions. Moreover, most doctors didn’t consider the prepared Fuzi as potent poisonous drug in many hospitals. We suggested the combinatory use of cardiovascular TCM and western drugs might be involved in the alert computer system. We found patients who took the hepatotoxic TCMs had higher incidence rate of acute hepatitis (35.5%) than those who did not (28.3%) according to our NHI's claimed reimbursement database study. |
本系統中英文摘要資訊取自各篇刊載內容。