Traditional Chinese medicine injectable preparation should strengthen management to use clinically

Traditional Chinese medicine injectable preparation should strengthen management to use clinically
Staff reporter Dan Wang LeMin Wang In recent years, the injectable preparation bad reaction incident of traditional Chinese medicine happens in succession, by not needing traditional Chinese medicine injectable preparation to already become the problem that some hospitals have to face. The statistics show, from 1999 to 2006, the average growth rate of the market of national traditional Chinese medicine injectable preparation exceeded 30%, there are nearly 300 million the patients who uses traditional Chinese medicine injectable preparation every year, the annual sales amount is about 17 billion yuan; The traditional Chinese medicine injectable preparation products have already covered 21 provinces, districts in the whole country, more than 1400 hospitals of the market, mainly apply to vascular disease of the heart brain, tumour, respiratory disease,etc. and treat the field. Recently, the reporter uses the situation of traditional Chinese medicine injectable preparation to carry on the investigation to some hospitals in Beijing.
Every hospital uses clinically " The treatment " Differ
"Our hospital is very happy, the traditional Chinese medicine injectable preparation going wrong in recent years was not entered, even there are the same kind of medicines, are not produced by the producer going wrong. " The third Deputy Director of hospital pharmacy dept. Yang YiHeng in Peking University introduces, the traditional Chinese medicine injectable preparation which this institute buys has a dozen varieties at present, injectable preparation to traditional Chinese medicine of board of trustee of medicine thing of the hospital one " The entry " Very much tight all the time, introduce traditional Chinese medicine injectable preparation of new brand or new variety in recent years. But in period repeatly going wrong in traditional Chinese medicine injectable preparation, three institutes in Peking University have not rejected the variety of traditional Chinese medicine injectable preparation from the dispensary either.
It says too, besides inactive traditional Chinese medicine injectable preparation defective in quality that Beijing hangs down the willow hospital medicine head of the department Xia Wenbin, hospital reduce the intersection of traditional Chinese medicine and the intersection of injectable preparation and kind sedulously, demand of citizen appear too loud to fluctuate either. In " open liquid of spring and autumn " In season, a lot of old men still demand to use traditional Chinese medicine injectable preparation voluntarily as usual. Xia Wenbin introduces, traditional Chinese medicine injectable preparation of this institute is owned in common, included 6 varieties such as powder injection of a pair of the rhizome of Chinese goldthread, phlegm hot clear parenteral solution at present, its sales amount accounts for about 3% of all therapeutic medicines.
Deputy Director of Chinese-Japan Friendship Hospital pharmacy dept. Lu Jin tells reporters, this institute is a western chinese hospital, the quantity of traditional Chinese medicine injectable preparation of clinical practice is still larger, there are 27 varieties at present. Though has made a reduction of the repeated variety of several pieces of indication from the emergency call, has still kept refreshment used for rescuing and treating promptly and waited medicines quietly.
The reporter knows, different from several above-mentioned hospital situations, already overall inactive traditional Chinese medicine injectable preparation as early as 56 years ago of BJ Children's Hospital of Capital University of Medical Sciences. The relevant person tells reporters, first, because does not rest assured about the quality of traditional Chinese medicine injectable preparation very much, two because patients are all children, present the bad reaction easily.
In addition Capital University of Medical Sciences subsidiary the intersection of Beijing and God Temple Hospital begin, use variety go on " reduce weight " from 2006 to the intersection of traditional Chinese medicine and injectable preparation too . The medicine head of the department Zhao Zhies of this institute just introduced, parenteral solution of inactive Puerarin 3 years ago of hospital, inactive pairs of the intersection of the rhizome of Chinese goldthread and parenteral solution before the 2 year, inactive to assassinate five plus parenteral solution and clear away heat the intersection of traditional Chinese medicine and injectable preparation of detoxifying etc. 2008, present left the intersection of traditional Chinese medicine and injectable preparation including oil lamp spend plain, the intersection of Rhizoma Chuanxiong and piperazine, the intersection of refreshment and quiet, the intersection of ginkgo and the intersection of leaf and 4 of parenteral solution, used in the treatment of vascular disease of the brain. "Used in the medicine curing cerebrovascular diseases clinically limitedly, traditional traditional Chinese medicine injectable preparation is proved to be valuable through long-term clinical observation. In addition, the traditional Chinese medicine injectable preparation composition staying is relatively single, stable, can know, so, medicine security is relatively secure. "
Use links to need to reduce " Cure the source " Hidden danger
In the course of interviewing, the administrative staff of pharmacy dept. of each hospital says to the reporter simultaneously, remove the quality problem of medicines, because traditional Chinese medicine injectable preparation brought in clinical unreasonable application " cures the source" Safe problems generally exist too.
"Have a fever with clear to make the intersection of fairy and needle, infect, take pairs of the intersection of the rhizome of Chinese goldthread and the intersection of powder and needle, this it seems to be in the some the intersection of doctor of Western medicine and unwritten rule of using medicine. And Chinese medicine catch a cold, divide the intersection of chill and cold, the intersection of wind and hot cold,etc. into, injectable preparation effective to hot cold of wind only. " Yang YiHeng says, this kind does not follow the dialectical theory of Chinese medicine and manage the theory, by administration method to the ill of medicine mechanically, cause " Cure the source " One of the reasons of the bad incident of traditional Chinese medicine injectable preparation.
China's Chinese medicine professor of pharmacy of pharmacy dept. of Guang'anmen hospital of academy of sciences Wang LiXia tells reporters, think traditional Chinese medicine comparative security, side effect little, it does not matter to use and click, use few more in clinical a lot of doctor. So, while using traditional Chinese medicine injectable preparation, go beyond the manual to stipulate the phenomenon of maximum consumption is very general. "In fact, the course of treatment of useful medicine of traditional Chinese medicine injectable preparation, should stop medicines in time when the course of treatment finishes. In addition, should also mark according to the manual and control medicines to instil the speed strictly. Too fast ermatitis,etc. in the capillary some density of medicine is too high, make the insoluble particle build up, stop up and cause dizzy, pain, stimulating dermatitis,etc. in the capillary; It is slow to instil, traditional Chinese medicine injectable preparation oxidizing, changing color, pH value easy to hydrolyze changes and causes the emergence of the bad reaction. "
Zhao Zhi just emphasized, about 60% of the traditional Chinese medicine injectable preparation bad reactions took place within 10 minutes after using medicine, the clinical medical personnel should pay close attention to about an hour to the patient who finishes the liquid, in order to find the bad reaction in time. In addition, begin from patient's administration, will make good preparations for rescuing anaphylactic shock soon.
The expert points out, the inappropriate union administration is one of the reasons causing the injectable preparation bad reaction incidence of traditional Chinese medicine to increase too. Because traditional Chinese medicine injectable preparation mostly the intersection of group and square compatibility, single the intersection of flavor and composition of medicine on very much complicated already among them, and then jointly use with other injectable preparation, will increase the safe risk, and the one that still lack traditional Chinese medicine injectable preparation and Western medicine injectable preparation compatibility and use clinically at present follows the card data. So, the expert should try hard to use traditional Chinese medicine injectable preparation to call upon alone. If while needing to use at the same time, Western medicine injectable preparation, should use parenteral solution of glucose, sodium chloride parenteral solution,etc. to separate two kinds of medicines among infusion.
Using clinically should strengthen management conscientiously
"In fact the bad reaction rate of traditional Chinese medicine injectable preparation is not high. From 2001 to 2005, 22 took place altogether in the traditional Chinese medicine injectable preparation bad reaction of our academy. So long as it is appropriate to employ, it is comparatively still safer. " Yang YiHeng says, any medicine uses the risk, traditional Chinese medicine injectable preparation is no exception. So in use link need, lead the intersection of risk management and consciousness into while being clinical, namely find out one feasible method, in the certainly risky environment, minimise the risk. From the viewpoint of this, it is a feasible good method to strengthen the management of the hospital.
The reporter finds in the interview, whether the pharmacy dept. of each hospital has already or propagated the page through the internal publication, propagate all kinds of traditional Chinese medicine injectable preparation and use information to the clinical department rationally, including the existing traditional Chinese medicine injectable preparation variety of the hospital, the manual is recommended usage consumption, dissolve matchmaker, medicines to use contents such as attentive matters,etc. dailily.
Relevant expert emphasize, clinical in the course of using traditional Chinese medicine injectable preparation, should follow, " can take orally the intersection of skin and note, Yes the skin note does not infuse " Principle. In addition, the conditional hospital should set up the intravenous medicine and dispose the centre, the pharmacist strengthens the verification of the doctor's order employed to traditional Chinese medicine injectable preparation and Western medicine injectable preparation compatibility emphatically, supervise and guide to doctor's order of the infusion through the pharmacist, the ones that reduce in the infusion are unreasonable to use medicine, further guarantee infusion safety of patient.
Xia Wenbin says, after Ministry of Public Health issues " guide to the injectable preparation clinical practice of traditional Chinese medicine ", hanging down the board of trustee of the medicine thing of willow hospital and training the special topic in the industry, in order to make the traditional Chinese medicine injectable preparation use guidelines suitable for our institute. Lu Jin introduces, Chinese-Japan Friendship Hospital has already raised " threshold " to traditional Chinese medicine injectable preparation at the beginning of of 2008 ,All traditional Chinese medicine injectable preparation entered newly is after examining and approving through the board of trustee of the medicine thing, need first in pass to 30 observation of operating position of patient while being clinical also, it has to be can in begin large-scale application clinically after the obvious bad reaction. Zhao Zhi just introduced, Beijing God Temple Hospital will be also through adding the plug-in package in HIS system, when the doctor opens the traditional Chinese medicine injectable preparation prescription, reveal " for medicines, amount of medicine recommended, drip the speed, dissolve matchmakers alone " automatically When the method to limit slogans, solve the problem that traditional Chinese medicine injectable preparation is used clinically unstandardly at present progressively.
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