某醫院中藥藥物不良反應研究及探討

Research and Discussion on Adverse Drug Reaction of Traditional Chinese Medicine in Hospital

1998 年「全國藥物不良反應通報系統計畫」設置藥物不良反應通報中心，並於2001 年獨立建置「中草藥不良反應線上通報系統」，2014 年12月起中藥和西藥的不良反應通報整合在同一個網頁，更便通報者上網通報。本研究以某中醫院2010 年至2016 年9 月做為取樣區間，收集院內通報至藥劑科之藥物不良反應通報案件（40 件）進行分析，通報案件經Naranjo 評估表確認關聯性後，屬於“可能”的案例最多佔21 件(52.5%)；發生部位以皮膚最為常見；依嚴重度區分本院的案例皆為輕度，目前為止沒有任何重度或死亡的通報案例。病人後續的處理方式皆以「只停藥」並觀察為主。對於處方中藥治療病人的過程中，產生不預期的症狀，都歸類為潛在的中藥不良反應，並且就應該通報的觀念及教育，仍然相對薄弱。因此，只有不多的中醫師充分明瞭不良反應的意義，並且進行通報，所以多年來全國的中藥不良反應通報的案件累積仍太少。希望藉由中藥藥品不良反應建構模式讓醫療人員可以駕輕就熟掌握中藥藥品不良反應，達到用藥安全之目標。

In 1998, the National Drug Adverse Reaction Bulletin System Program set up a drug adverse reaction notification center, and in 2001 independently established 'Chinese herbal medicine adverse reaction line notification system'. From December 2014 the traditional Chinese medicine and Western medicine adverse reactions to the integration of the same page, more informants of the Internet notification. From 2010 to September 2014, a Chinese medicine hospital as sampling interval, the collection of hospital informed to the Pharmacy Branch of the Drug adverse reaction notification cases (40 cases) were analyzed and informed cases were confirmed by the Naranjo assessment form , the majority of cases that are 'likely' are 21 (52.5%); the most common parts of the skin are common; the distinction between the case of the case is mild, so far there is no case of serious or death notification. Patient Follow-up treatment is based on 'only withdrawal' and observe the main. For the prescription of traditional Chinese medicine treatment of patients in the process, produce unexpected symptoms, are classified as potential adverse reactions to traditional Chinese medicine, and should be informed of the concept and education, is still relatively weak, so only a small number of Chinese medicine practitioners fully understand the significance of adverse reactions, and the notification, so over the years the country's traditional Chinese medicine adverse reactions reported cases accumulated too few. Hope to borrow by the traditional Chinese medicine adverse drug construction model so that medical staff can easily grasp the traditional Chinese medicine adverse drug reactions, to achieve the goal of drug safety.