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中成藥臨床應(yīng)用指導(dǎo)原則
2010年6月
iofopticalfiberintranet,extranet24datapoints,andsetaside
reserve.Logarithmiccoppercableusedforvoicecommunications,
verticalTrunkcoppercableshouldmeet1voiceatleast1setof
twistedandmustbereserved.1,and2#floorandtheinjury
rehabilitationfloorofcablefromintegratedmedicalfloor,by
rehabilitationcenterweaktuberespectivelyintroductiontomonomerof
firstlayerweakbetween,themonomerfirstlayerweakbetween
respectivelyasthismonomerofequipmentroom,networkswitchdolevel
jointHourespectivelywiringtobuildingsofOfficeregional,wiring
alongthelayershaftpointslineboxHoualongslotlayinginthelayer
ceiling,toendsocketlinewearplatingzinctubedarkenoughYuwall
Boardwithin.4)maindistributionframebetweendevices(BD)locatedin
themedicalbuildinginformationnetworkcentermachineroom,complete
internalLANconnectionandexternalbroadbandnetworkconnections,
providingavarietyofinformationservicestothehospital.Thedevice
asawholehospitalnetworkandexternalnetworkcoreswitch.5)
managementonworkareas,equipment,intothelinebetweenthewiring
devices,cableandinformationoutletmoduleidentifiesandrecords
accordingtoacertainpattern,suchas,tofacilitatecommunication
completetheconnectionlines,linemanagementoflocalizationand
translocation.6)cablelayingtheverticaltrunkcablesalongacable
trayinweakcurrentshaftinstallation,horizontaltrunkcablelaying
inthehallwayceilingalongacabletray,horizontalcablesintothe
room,intheceilingandputalongthewallgalvanizedpipeunderground
toinformationoutlets.Arrangementofinformationrequirementsareas
follows:regionalnursingunit:1unit:eachbed
目錄
前
s.........................................................................
...2第一部分中成藥概
述..............................................................3—、中成
藥的劑型................................................................3
二、中成藥分
類..................................................................7三、
中成藥安全
性...............................................................9第二部
分中成藥臨床應(yīng)用原則....................................................11
一、中成藥臨床應(yīng)用基本原
則....................................................11二、聯(lián)合用藥原
則..............................................................12三、孕
婦使用中成藥的基本原則...................................................13
四、兒童使用中成藥的基本原
則..................................................14第三部分各
論..................................................................16一、
解表
劑.....................................................................16
二、瀉下
劑.....................................................................17
三、和解
劑.....................................................................18
四、清熱
劑.....................................................................19
五、祛暑
劑.....................................................................20
六、溫里
劑.....................................................................21
七、表里雙解
劑................................................................22八、
補(bǔ)益
劑.....................................................................23
九、安神
劑.....................................................................24
十、開竅
劑.....................................................................25
十一、固澀
劑...................................................................25+
二、理氣
劑...................................................................26+
三、理血
劑...................................................................27+
四、治風(fēng)
劑...................................................................28+
五、治燥
劑...................................................................29+
六、祛濕
劑...................................................................30+
七、祛痰
劑...................................................................31+
八、止咳平喘
劑..............................................................32十九、
消導(dǎo)化積劑...............................................................33
二十、殺蟲
劑...................................................................34第
四部分中成藥臨床應(yīng)用的管
理..................................................35—、含毒性中藥材的
中成藥臨床應(yīng)用的管理.......................................35二、中成藥
不良反應(yīng)的監(jiān)測.......................................................36
三、開展中成藥臨床應(yīng)用監(jiān)測、建立中成藥應(yīng)用點(diǎn)評(píng)制
度...........................37
quirementsareasfollows:regionalnursingunit:1unit:each
bedroom,intheceilingandputalongthewallgalvanizedpipe
undergroundtoinformationoutlets.Arrangementofinformationreo
theakcurrentshaftinstallation,horizontaltrunkcablelayinginthe
hallwayceilingalongacabletray,horizontalcablesintlines,line
managementoflocalizationandtranslocation.6)cablelayingthe
verticaltrunkcablesalongacabletrayinweectionnoutletmodule
identifiesandrecordsaccordingtoacertainpattern,suchas,to
facilitatecommunicationcompletetheconnnetworkcoreswitch.5)
managementonworkareas,equipment,intothelinebetweenthewiring
devices,cableandinformatioernalorkconnections,providingavariety
ofinformationservicestothehospital.Thedeviceasawholehospital
networkandextinthemedicalbuildinginformationnetworkcenter
machineroom,completeinternalLANconnectionandexternalbroadband
netwcatedoendsocketlinewearplatingzinctubedarkenoughYuwall
Boardwithin.4)maindistributionframebetweendevices(BD)logto
buildingsofOfficeregional,wiringalongthelayershaftpointsline
boxHoualongslotlayinginthelayerceiling,twirinnomerfirstlayer
weakbetweenrespectivelyasthismonomerofequipmentroom,network
switchdoleveljointHourespectivelyedmedicalfloor,by
rehabilitationcenterweaktuberespectivelyintroductiontomonomerof
firstlayerweakbetween,themotegratlvoiceatleast1setoftwisted
andmustbereserved.1,and2#floorandtheinjuryrehabilitation
floorofcablefrominints,andsetasidereserve.Logarithmiccopper
cableusedforvoicecommunications,verticalTrunkcoppercableshould
meetiofopticalfiberintranet,extranet24datapol
前_X4.百—s—
為加強(qiáng)中成藥臨床應(yīng)用管理?提高中成藥應(yīng)用水平?保證臨床用藥安全?國家
中醫(yī)藥管理局會(huì)同有關(guān)部門組織專家制定了《中成藥臨床應(yīng)用指導(dǎo)原則》,以下簡
稱《指導(dǎo)原則》…《指導(dǎo)原則》由四部分組成?第一部分為中成藥概述,第二部分
為中成藥臨床應(yīng)用基本原則,第三部分為各類中成藥的特點(diǎn)、適應(yīng)證及注意事項(xiàng),第
四部分為中成藥臨床應(yīng)用的管理。
《指導(dǎo)原則》是為適應(yīng)中成藥臨床應(yīng)用管理需要而制定的?是臨床應(yīng)用中成藥
的基本原則。每種中成藥臨床應(yīng)用的具體要求?還應(yīng)以藥品說明書、最新版本的
《中華人民共和國藥典》、《中華人民共和國藥典-臨床用藥須知-中藥卷》為準(zhǔn)。
在醫(yī)療工作中?臨床醫(yī)師應(yīng)遵循中醫(yī)基礎(chǔ)理論?根據(jù)患者實(shí)際情況?選用適宜的藥
物?辨證辨病施治。
第三部分各論中為更好地說明各類中成藥的特點(diǎn)?列舉了部分中成藥?列舉的
藥物是《國家基本藥物目錄》中的藥物和《國家基本藥物目錄》未包括但又屬臨床
常用的中成藥。
中藥注射劑的臨床應(yīng)用及使用管理?《指導(dǎo)原則》提出了具體要求?同時(shí)還應(yīng)
遵照《衛(wèi)生部關(guān)于進(jìn)一步加強(qiáng)中藥注射劑生產(chǎn)和臨床使用管理的通知》,衛(wèi)醫(yī)政發(fā)
?2008?71號(hào),執(zhí)行。
nrequirementsareasfollows:regionalnursingunit:1unit:each
bedtheroom,intheceilingandputalongthewallgalvanizedpipe
undergroundtoinformationoutlets.Arrangementofinformatiosintoin
weakcurrentshaftinstallation,horizontaltrunkcablelayinginthe
hallwayceilingalongacabletray,horizontalcabletionlines,line
managementoflocalizationandtranslocation.6)cablelayingthe
verticaltrunkcablesalongacabletrayconnecationoutletmodule
identifiesandrecordsaccordingtoacertainpattern,suchas,to
facilitatecommunicationcompletethenalnetworkcoreswitch.5)
managementonworkareas,equipment,intothelinebetweenthewiring
devices,cableandinformexternetworkconnections,providingavariety
ofinformationservicestothehospital.Thedeviceasawholehospital
networkandtedinthemedicalbuildinginformationnetworkcenter
machineroom,completeinternalLANconnectionandexternalbroadband)
locag,toendsocketlinewearplatingzinctubedarkenoughYuwall
Boardwithin.4)maindistributionframebetweendevices(BDiringto
buildingsofOfficeregional,wiringalongthelayershaftpointsline
boxHoualongslotlayinginthelayerceilinvelywemonomerfirstlayer
weakbetweenrespectivelyasthismonomerofequipmentroom,network
switchdoleveljointHourespectigratedmedicalfloor,by
rehabilitationcenterweaktuberespectivelyintroductiontomonomerof
firstlayerweakbetween,thminteeet1voiceatleast1setoftwisted
andmustbereserved.1,and2#floorandtheinjuryrehabilitation
floorofcablefroapoints,andsetasidereserve.Logarithmiccopper
cableusedforvoicecommunications,verticalTrunkcoppercableshould
miofopticalfiberintranet,extranet24dat2
第一部分中成藥概述
中成藥是在中醫(yī)藥理論指導(dǎo)下?以中藥飲片為原料?按規(guī)定的處方和標(biāo)準(zhǔn)制成
具有一定規(guī)格的劑型?可直接用于防治疾病的制劑。中成藥有著悠久的歷史?應(yīng)用
廣泛?在防病治病、保障人民群眾健康方面發(fā)揮了重要作用。
中成藥的處方是根據(jù)中醫(yī)理論?針對(duì)某種病證或癥狀制定的?因此使用時(shí)要依
據(jù)中醫(yī)理論辨證選藥?或辨病辨證結(jié)合選藥。
中成藥具有特定的名稱和劑型?在標(biāo)簽和說明書上注明了批準(zhǔn)文號(hào)、品名、規(guī)
格、處方成分、功效和適應(yīng)證、用法用量、禁忌、注意事項(xiàng)、生產(chǎn)批號(hào)、有效期等
內(nèi)容。相對(duì)于中藥湯劑來說?中成藥無需煎煮?可直接使用?尤其方便急危病癥患
者的治療及需要長期治療的患者使用?且體積小?有特定的包裝?存貯、攜帶方
便。
一、中成藥的常用劑型
中成藥劑型種類繁多?是我國歷代醫(yī)藥學(xué)家長期實(shí)踐的經(jīng)驗(yàn)總結(jié)?近幾十年?
中成藥劑型的基礎(chǔ)研究取得了較大進(jìn)展?研制開發(fā)了大量新劑型?進(jìn)一步擴(kuò)大了中
成藥的使用范圍。
中成藥的劑型不同?使用后產(chǎn)生的療效、持續(xù)的時(shí)間、作用的特點(diǎn)會(huì)有所不
同。因此?正確選用中成藥應(yīng)首先了解中成藥的常用劑型。
,一,固體制劑
固體劑型是中成藥的常用劑型?其制劑穩(wěn)定?攜帶和使用方便。
L散劑系指藥材或藥材提取物經(jīng)粉碎、均勻混合而制成的粉末
ernalorkconnections,providingavarietyofinformationservices
tothehospital.Thedeviceasawholehospitalnetworkandextinthe
medicalbuildinginformationnetworkcentermachineroom,complete
internalLANconnectionandexternalbroadbandnetwcatedoendsocket
linewearplatingzinctubedarkenoughYuwallBoardwithin.4)main
distributionframebetweendevices(BD)logtobuildingsofOffice
regional,wiringalongthelayershaftpointslineboxHoualongslot
layinginthelayerceiling,twirinnomerfirstlayerweakbetween
respectivelyasthismonomerofequipmentroom,networkswitchdolevel
jointHourespectivelyedmedicalfloor,byrehabilitationcenterweak
tuberespectivelyintroductiontomonomeroffirstlayerweakbetween,
themotegratlvoiceatleast1setoftwistedandmustbereserved.1,
and2#floorandtheinjuryrehabilitationfloorofcablefrominints,
andsetasidereserve.Logarithmiccoppercableusedforvoice
communications,verticalTrunkcoppercableshouldmeetiofoptical
fiberintranet,extranet24datapoquirementsareasfollows:regional
nursingunit:1unit:eachbedroom,intheceilingandputalongthe
wallgalvanizedpipeundergroundtoinformationoutlets.Arrangementof
informationreotheakcurrentshaftinstallation,horizontaltrunk
cablelayinginthehallwayceilingalongacabletray,horizontal
cablesintlines,linemanagementoflocalizationandtranslocation.6)
cablelayingtheverticaltrunkcablesalongacabletrayinweectionn
outletmoduleidentifiesandrecordsaccordingtoacertainpattern,
suchas,tofacilitatecommunicationcompletetheconnnetworkcore
switch.5)managementonworkareas,equipment,intothelinebetween
thewiringdevices,cableandinformatio3
狀制劑?分為內(nèi)服散劑和外用散劑。散劑粉末顆粒的粒徑小?容易分散?起效
快。外用散劑的覆蓋面積大?可同時(shí)發(fā)揮保護(hù)和收斂作用。散劑制備工藝簡單?劑
量易于控制?便于嬰幼兒服用。但也應(yīng)注意散劑由于分散度大而造成的吸濕性、化
學(xué)活性、氣味、刺激性等方面的影響。
2.顆粒劑系指藥材的提取物與適宜的輔料或藥材細(xì)粉制成具有一定粒度的顆
粒狀劑型。顆粒劑既保持了湯劑作用迅速的特點(diǎn)?又克服了湯劑臨用時(shí)煎煮不便的
缺點(diǎn)?且口味較好、體積小?但易吸潮。根據(jù)輔料不同,可分為無糖顆粒劑型和有
糖顆粒劑型?近年來無糖顆粒劑型的品種逐漸增多。
3.膠囊劑系指將藥材用適宜方法加工后?加入適宜輔料填充于空心膠囊或密
封于軟質(zhì)囊材中的制劑?可分為硬膠囊、軟膠囊,膠丸,和腸溶膠囊等?主要供口
服。膠囊劑可掩蓋藥物的不良?xì)馕?易于吞服,能提高藥物的穩(wěn)定性及生物利用度,
對(duì)藥物顆粒進(jìn)行不同程度包衣后?還能定時(shí)定位釋放藥物。
4.丸劑系指將藥材細(xì)粉或藥材提取物加適宜的粘合劑或其他輔料制成的球形
或類球形制劑?分為蜜丸、水蜜丸、水丸、糊丸、蠟丸、濃縮丸等類型。其中?蜜
丸分為大蜜丸、小蜜丸?水蜜丸的含蜜量較少,水丸崩解較蜜丸快?便于吸收,糊丸
釋藥緩慢?適用于含毒性成分或藥性劇烈成分的處方,蠟丸緩釋、長效?且可達(dá)到
腸溶效果?適合毒性和刺激性較大藥物的處方,濃縮丸服用劑量較小。
5.滴丸劑系指藥材經(jīng)適宜的方法提取、純化、濃縮?并與適宜
nalnetworkcoreswitch.5)managementonworkareas,equipment,
intothelinebetweenthewiringdevices,cableandinformexternetwork
connections,providingavarietyofinformationservicestothehospital.
Thedeviceasawholehospitalnetworkandtedinthemedicalbuilding
informationnetworkcentermachineroom,completeinternalLAN
connectionandexternalbroadband)locag,toendsocketlinewear
platingzinctubedarkenoughYuwallBoardwithin.4)maindistribution
framebetweendevices(BDiringtobuildingsofOfficeregional,wiring
alongthelayershaftpointslineboxHoualongslotlayinginthelayer
ceilinvelywemonomerfirstlayerweakbetweenrespectivelyasthis
monomerofequipmentroom,networkswitchdoleveljointHou
respectigratedmedicalfloor,byrehabilitationcenterweaktube
respectivelyintroductiontomonomeroffirstlayerweakbetween,thm
inteeet1voiceatleast1setoftwistedandmustbereserved.1,and
2#floorandtheinjuryrehabilitationfloorofcablefroapoints,and
setasidereserve.Logarithmiccoppercableusedforvoice
communications,verticalTrunkcoppercableshouldmiofopticalfiber
intranet,extranet24datnrequirementsareasfollows:regionalnursing
unit:1unit:eachbedtheroom,intheceilingandputalongthewall
galvanizedpipeundergroundtoinformationoutlets.Arrangementof
informatiosintoinweakcurrentshaftinstallation,horizontaltrunk
cablelayinginthehallwayceilingalongacabletray,horizontal
cabletionlines,linemanagementoflocalizationandtranslocation.6)
cablelayingtheverticaltrunkcablesalongacabletrayconnecation
outletmoduleidentifiesandrecordsaccordingtoacertainpattern,
suchas,tofacilitatecommunicationcompletethe4
的基質(zhì)加熱熔融混勻后?滴入不相混溶的冷凝液中?收縮冷凝而制成的球形或
類球形制劑。滴丸劑服用方便?可含化或吞服?起效迅速。
6.片劑系指將藥材提取物、或藥材提取物加藥材細(xì)粉、或藥材細(xì)粉與適宜輔
料混勻壓制成的片狀制劑。主要供內(nèi)服?也有外用或其它特殊用途者。其質(zhì)量較穩(wěn)
定?便于攜帶和使用。按藥材的處理過程可分為全粉末片、半浸膏片、浸膏片、提
純片。
7.膠劑系指以動(dòng)物的皮、骨、甲、角等為原料?水煎取膠質(zhì)?經(jīng)濃縮干燥制
成的固體塊狀內(nèi)服制劑?含豐富的動(dòng)物水解蛋白類等營養(yǎng)物質(zhì)。作為傳統(tǒng)的補(bǔ)益
藥?多爛化兌服。
8.栓劑系由藥材提取物或藥材細(xì)粉與適宜基質(zhì)混合制成供腔道給藥的制劑。
既可作為局部用藥劑型又可作為全身用藥劑型?用于全身用藥時(shí)?不經(jīng)過胃?且無
肝臟首過效應(yīng)?因此生物利用度優(yōu)于口服?對(duì)胃的刺激性和肝的副作用小?同時(shí)適
合不宜或不能口服藥物的患者。
9.丹劑系指由汞及某些礦物藥?在高溫條件下燒煉制成的不同結(jié)晶形狀的無
機(jī)化合物?如紅升丹、白降丹等。此劑型含汞?毒性較強(qiáng)?只能外用。
10.貼膏劑系指將藥材提取物、藥材和/或化學(xué)藥物與適宜的基質(zhì)和基材制成
的供皮膚貼敷?可產(chǎn)生局部或全身作用的一類片狀外用制劑。包括橡膠膏劑、巴布
膏劑和貼劑等。貼膏劑用法簡便?兼有外治和內(nèi)治的功能。近年來發(fā)展起來的巴布
膏劑?是以水溶性高分子材料為主要基質(zhì)?加入藥物制成的外用制劑?和傳統(tǒng)的中
藥貼膏劑相比?
noutletmoduleidentifiesandrecordsaccordingtoacertain
pattern,suchas,tofacilitatecommunicationcompletetheconnnetwork
coreswitch.5)managementonworkareas,equipment,intotheline
betweenthewiringdevices,cableandinformatioernalorkconnections,
providingavarietyofinformationservicestothehospital.Thedevice
asawholehospitalnetworkandextinthemedicalbuildinginformation
networkcentermachineroom,completeinternalLANconnectionand
externalbroadbandnetwcatedoendsocketlinewearplatingzinctube
darkenoughYuwallBoardwithin.4)maindistributionframebetween
devices(BD)logtobuildingsofOfficeregional,wiringalongthelayer
shaftpointslineboxHoualongslotlayinginthelayerceiling,twirin
nomerfirstlayerweakbetweenrespectivelyasthismonomerofequipment
room,networkswitchdoleveljointHourespectivelyedmedicalfloor,by
rehabilitationcenterweaktuberespectivelyintroductiontomonomerof
firstlayerweakbetween,themotegratlvoiceatleast1setoftwisted
andmustbereserved.1,and2#floorandtheinjuryrehabilitation
floorofcablefrominints,andsetasidereserve.Logarithmiccopper
cableusedforvoicecommunications,verticalTrunkcoppercableshould
meetiofopticalfiberintranet,extranet24datapoquirementsareas
follows:regionalnursingunit:1unit:eachbedroom,intheceilingand
putalongthewallgalvanizedpipeundergroundtoinformationoutlets.
Arrangementofinformationreotheakcurrentshaftinstallation,
horizontaltrunkcablelayinginthehallwayceilingalongacabletray,
horizontalcablesintlines,linemanagementoflocalizationand
translocation.6)cablelayingtheverticaltrunkcablesalongacable
trayinweection5
能快速、持久地透皮釋放基質(zhì)中所包含的有效成分?具有給藥劑量較準(zhǔn)確、吸
收面積小、血藥濃度較穩(wěn)定、使用舒適方便等優(yōu)點(diǎn)。
11.涂膜劑系指由藥材提取物或藥材細(xì)粉與適宜的成膜材料加工制成的膜狀制
劑??捎糜诳谇豢啤⒀劭?、耳鼻喉科、創(chuàng)傷科、燒傷科、皮膚科及婦科等.作用時(shí)
間長?且可在創(chuàng)口形成一層保護(hù)膜?對(duì)創(chuàng)口具有保護(hù)作用。一些膜劑尤其是鼻腔、
皮膚用藥膜亦可起到全身作用。
(二)半固體劑型
1.煎膏劑系指將藥材加水煎煮?取煎煮液濃縮?加煉蜜或糖,或轉(zhuǎn)化糖,制成
的稠厚狀半流體制劑。適用于慢性病或需要長期連續(xù)服藥的疾病?傳統(tǒng)的膏滋也屬
于此劑型?以滋補(bǔ)作用為主而兼治療作用。
2.軟膏劑系指將藥材提取物、或藥材細(xì)粉與適宜基質(zhì)混合制成的半固體外用
制劑。常用基質(zhì)分為油脂性、水溶性和乳劑基質(zhì)。
3.凝膠劑系指藥材提取物與適宜的基質(zhì)制成的、具有凝膠特性的半固體或稠
厚液體制劑。按基質(zhì)不同可分為水溶性凝膠和油性凝膠。適用于皮膚黏膜及腔道給
藥。
(三)液體制劑
1.合劑系指藥材用水或其他溶劑?采用適宜方法提取制成的口服液體制劑?
是在湯劑基礎(chǔ)上改進(jìn)的一種劑型?易吸收?能較長時(shí)間貯存。
2.口服液系指在合劑的基礎(chǔ)上?加入矯味劑?按單劑量灌裝?滅菌制成的口
服液體制劑??诟休^好?近年來無糖型口服液逐漸增多。
inweakcurrentshaftinstallation,horizontaltrunkcablelayingin
thehallwayceilingalongacabletray,horizontalcabletionlines,line
managementoflocalizationandtranslocation.6)cablelayingthe
verticaltrunkcablesalongacabletrayconnecationoutletmodule
identifiesandrecordsaccordingtoacertainpattern,suchas,to
facilitatecommunicationcompletethenalnetworkcoreswitch.5)
managementonworkareas,equipment,intothelinebetweenthewiring
devices,cableandinformexternetworkconnections,providingavariety
ofinformationservicestothehospital.Thedeviceasawholehospital
networkandtedinthemedicalbuildinginformationnetworkcenter
machineroom,completeinternalLANconnectionandexternalbroadband)
locag,toendsocketlinewearplatingzinctubedarkenoughYuwall
Boardwithin.4)maindistributionframebetweendevices(BDiringto
buildingsofOfficeregional,wiringalongthelayershaftpointsline
boxHoualongslotlayinginthelayerceilinvelywemonomerfirstlayer
weakbetweenrespectivelyasthismonomerofequipmentroom,network
switchdoleveljointHourespectigratedmedicalfloor,by
rehabilitationcenterweaktuberespectivelyintroductiontomonomerof
firstlayerweakbetween,thminteeet1voiceatleast1setoftwisted
andmustbereserved.1,and2#floorandtheinjuryrehabilitation
floorofcablefroapoints,andsetasidereserve.Logarithmiccopper
cableusedforvoicecommunications,verticalTrunkcoppercableshould
miofopticalfiberintranet,extranet24datnrequirementsareas
follows:regionalnursingunit:1unit:eachbedtheroom,intheceiling
andputalongthewallgalvanizedpipeundergroundtoinformation
outlets.Arrangementofinformatiosinto6
3.酒劑系指將藥材用蒸播酒提取制成的澄清液體制劑。酒劑較易吸收。小
兒、孕婦及對(duì)酒精過敏者不宜服用。
4.酊劑系指將藥材用規(guī)定濃度的乙醇提取或溶解而制成的澄清液體制劑。有
效成分含量高?使用劑量小?不易霉敗。小兒、孕婦及對(duì)酒精過敏者不宜服用。
5.糖漿劑系指含藥材提取物的濃蔗糖水溶液。比較適宜兒童使用?糖尿病人
慎用。
6.注射劑系指藥材經(jīng)提取、純化后制成的供注入體內(nèi)的溶液、乳狀液及供臨
用前配制成溶液的粉末或濃溶液的無菌制劑。藥效迅速?便于昏迷、急癥、重癥、
不能吞咽或消化系統(tǒng)障礙患者使用。
(四)氣體劑型
氣霧劑:系指將藥材提取物、藥材細(xì)粉與適宜的拋射劑共同封裝在具有特殊閥
門裝輅的耐壓容器中?使用時(shí)借助拋射劑的壓力將內(nèi)容物噴出呈霧狀、泡沫狀或其
他形態(tài)的制劑。其中以泡沫形態(tài)噴出的可稱泡沫劑。不含拋射劑?借助手動(dòng)泵的壓
力或其他方法將內(nèi)容物以霧狀等形態(tài)噴出的制劑為噴霧劑??捎糜诤粑牢搿⑵?/p>
膚、粘膜或腔道給藥。
二、中成藥分類
中成藥分類的方法較多?按中成藥的功效可分為以下20類:
1.解表劑辛溫解表、辛涼解表、扶正解表。
2.瀉下劑寒下、溫下、潤下、逐水、攻補(bǔ)兼施。
3.和解劑和解少陽、調(diào)和肝脾、調(diào)和胃腸。
akcurrentshaftinstallation,horizontaltrunkcablelayinginthe
hallwayceilingalongacabletray,horizontalcablesintlines,line
managementoflocalizationandtranslocation.6)cablelayingthe
verticaltrunkcablesalongacabletrayinweectionnoutletmodule
identifiesandrecordsaccordingtoacertainpattern,suchas,to
facilitatecommunicationcompletetheconnnetworkcoreswitch.5)
managementonworkareas,equipment,intothelinebetweenthewiring
devices,cableandinformatioernalorkconnections,providingavariety
ofinformationservicestothehospital.Thedeviceasawholehospital
networkandextinthemedicalbuildinginformationnetworkcenter
machineroom,completeinternalLANconnectionandexternalbroadband
netwcatedoendsocketlinewearplatingzinctubedarkenoughYuwall
Boardwithin.4)maindistributionframebetweendevices(BD)logto
buildingsofOfficeregional,wiringalongthelayershaftpointsline
boxHoualongslotlayinginthelayerceiling,twirinnomerfirstlayer
weakbetweenrespectivelyasthismonomerofequipmentroom,network
switchdoleveljointHourespectivelyedmedicalfloor,by
rehabilitationcenterweaktuberespectivelyintroductiontomonomerof
firstlayerweakbetween,themotegratlvoiceatleast1setoftwisted
andmustbereserved.1,and2#floorandtheinjuryrehabilitation
floorofcablefrominints,andsetasidereserve.Logarithmiccopper
cableusedforvoicecommunications,verticalTrunkcoppercableshould
meetiofopticalfiberintranet,extranet24datapoquirementsareas
follows:regionalnursingunit:1unit:eachbedroom,intheceilingand
putalongthewallgalvanizedpipeundergroundtoinformationoutlets.
Arrangementofinformationreothe7
4.清熱劑:清氣分熱、清營涼血、清熱解毒、清臟腑熱、清退虛熱、氣血兩
清。
5.祛暑劑祛暑清熱、祛暑解表、祛暑利濕、清暑益氣。
6.溫里劑溫中祛寒、回陽救逆、溫經(jīng)散寒。
7.表里雙解解表攻里、解表清里、解表溫里。
8.補(bǔ)益劑補(bǔ)氣、補(bǔ)血、氣血雙補(bǔ)、補(bǔ)陰、補(bǔ)陽、陰陽雙補(bǔ)。
9.安神劑重鎮(zhèn)安神、滋養(yǎng)安神。
10.開竅劑涼開、溫開。
11,固澀劑固表止汗、澀腸止瀉固脫、澀精止遺、斂肺止血、固崩止帶。
12.理氣劑理氣疏肝、疏肝散結(jié)、理氣和中、理氣止痛、降氣。
13.理血?jiǎng)┗钛钛?、益氣活血、溫?jīng)活血、養(yǎng)血活血、涼血散瘀、化
瘀消i?、散瘀止痛、活血通絡(luò)、接筋續(xù)骨,、止血,涼血止血、收澀止血、化瘀止
血、溫經(jīng)止血,。
14.治風(fēng)劑疏散外風(fēng)、平熄內(nèi)風(fēng)。
15.治燥劑清宣潤燥、滋陰潤燥。
16,祛濕劑燥濕和中、清熱祛濕、利水滲濕、溫化水濕、祛風(fēng)勝濕。
17.祛痰劑燥濕化痰、清熱化痰、潤燥化痰、溫化寒痰、化痰熄風(fēng)。
18.止咳平喘劑清肺止咳、溫肺止咳、補(bǔ)肺止咳、化痰止咳、溫肺平喘、清肺
平喘、補(bǔ)肺平喘、納氣平喘。
nrequirementsareasfollows:regionalnursingunit:1unit:each
bedtheroom,intheceilingandputalongthewallgalvanizedpipe
undergroundtoinformationoutlets.Arrangementofinformatiosintoin
weakcurrentshaftinstallation,horizontaltrunkcablelayinginthe
hallwayceilingalongacabletray,horizontalcabletionlines,line
managementoflocalizationandtranslocation.6)cablelayingthe
verticaltrunkcablesalongacabletrayconnecationoutletmodule
identifiesandrecordsaccordingtoacertainpattern,suchas,to
facilitatecommunicationcompletethenalnetworkcoreswitch.5)
managementonworkareas,equipment,intothelinebetweenthewiring
devices,cableandinformexternetworkconnections,providingavariety
ofinformationservicestothehospital.Thedeviceasawholehospital
networkandtedinthemedicalbuildinginformationnetworkcenter
machineroom,completeinternalLANconnectionandexternalbroadband)
locag,toendsocketlinewearplatingzinctubedarkenoughYuwall
Boardwithin.4)maindistributionframebetweendevices(BDiringto
buildingsofOfficeregional,wiringalongthelayershaftpointsline
boxHoualongslotlayinginthelayerceilinvelywemonomerfirstlayer
weakbetweenrespectivelyasthismonomerofequipmentroom,network
switchdoleveljointHourespectigratedmedicalfloor,by
rehabilitationcenterweaktuberespectivelyintroductiontomonomerof
firstlayerweakbetween,thminteeet1voiceatleast1setoftwisted
andmustbereserved.1,and2#floorandtheinjuryrehabilitation
floorofcablefroapoints,andsetasidereserve.Logarithmiccopper
cableusedforvoicecommunications,verticalTrunkcoppercableshould
miofopticalfiberintranet,extranet24dat8
19.消導(dǎo)化積劑消食導(dǎo)滯、健脾消食。
20.殺蟲劑驅(qū)蟲止痛、殺蟲止癢。
三、中成藥安全性
中成藥的歷史悠久?應(yīng)用廣泛?大量研究和臨床實(shí)踐表明?在合理使用的情況
下?中成藥的安全性是較高的。合理使用包括正確的辨證選藥、用法用量、使用療
程、禁忌癥、合并用藥等多方面?其中任何環(huán)節(jié)有問題都可能引發(fā)藥物不良事件。
合理用藥是中成藥應(yīng)用安全的重要保證。
藥物的兩重性是藥物作用的基本規(guī)律之一?中成藥也不例外?中成藥既能起到
防病治病的作用?也可引起不良反應(yīng)。
1.中成藥使用中出現(xiàn)不良反應(yīng)的主要原因
,1,中藥自身的藥理作用或所含毒性成分引起的不良反應(yīng);
,2,特異性體質(zhì)對(duì)某些藥物的不耐受、過敏等;
,3,方藥證候不符?如辨證不當(dāng)或適應(yīng)證把握不準(zhǔn)確;
,4,長期或超劑量用藥?特別是含有毒性中藥材的中成藥?如朱砂、雄黃、蟾
酥、附子、川烏、草烏、北豆根等?過量服用即可中毒;
,5,不適當(dāng)?shù)闹兴幓蛑形魉幍穆?lián)合應(yīng)用。
2.中成藥使用中出現(xiàn)的不良反應(yīng)有多種類型?臨床可見以消化系統(tǒng)癥狀、皮膚
粘膜系統(tǒng)癥狀、泌尿系統(tǒng)癥狀、神經(jīng)系統(tǒng)癥狀、循環(huán)系統(tǒng)癥狀、呼吸系統(tǒng)癥狀、血
液系統(tǒng)癥狀、精神癥狀或過敏性休克等為主要表現(xiàn)的不良反應(yīng)?可表現(xiàn)為其中一種
或幾種癥狀。
ectionnoutletmoduleidentifiesandrecordsaccordingtoacertain
pattern,suchas,tofacilitatecommunicationcompletetheconnnetwork
coreswitch.5)managementonworkareas,equipment,intotheline
betweenthewiringdevices,cableandinformatioernalorkconnections,
providingavarietyofinformationservicestothehospital.Thedevice
asawholehospitalnetworkandextinthemedicalbuildinginformation
networkcentermachineroom,completeinternalLANconnectionand
externalbroadbandnetwcatedoendsocketlinewearplatingzinctube
darkenoughYuwallBoardwithin.4)maindistributionframebetween
devices(BD)logtobuildingsofOfficeregional,wiringalongthelayer
shaftpointslineboxHoualongslotlayinginthelayerceiling,twirin
nomerfirstlayerweakbetweenrespectivelyasthismonomerofequipment
room,networkswitchdoleveljointHourespectivelyedmedicalfloor,by
rehabilitationcenterweaktuberespectivelyintroductiontomonomerof
firstlayerweakbetween,themotegratlvoiceatleast1setoftwisted
andmustbereserved.1,and2#floorandtheinjuryrehabilitation
floorofcablefrominints,andsetasidereserve.Logarithmiccopper
cableusedforvoicecommunications,verticalTrunkcoppercableshould
meetiofopticalfiberintranet,extranet24datapoquirementsareas
follows:regionalnursingunit:1unit:eachbedroom,intheceilingand
putalongthewallgalvanizedpipeundergroundtoinformationoutlets.
Arrangementofinformationreotheakcurrentshaftinstallation,
horizontaltrunkcablelayinginthehallwayceilingalongacabletray,
horizontalcablesintlines,linemanagementoflocalizationand
translocation.6)cablelayingtheverticaltrunkcablesalongacable
trayinwe9
3.臨床上預(yù)防中成藥不良反應(yīng)?要注意以下幾個(gè)方面:
,1,加強(qiáng)用藥觀察及中藥不良反應(yīng)監(jiān)測?完善中藥不良反應(yīng)報(bào)告制度。
,,,注意藥物過敏史。對(duì)有藥物過敏史的患者應(yīng)密切觀察其服藥后的反應(yīng)?如
有過敏反應(yīng)?應(yīng)及時(shí)處理?以防止發(fā)生嚴(yán)重后果。
,?,辨證用藥?采用合理的劑量和療程。尤其是對(duì)特殊人群?如嬰幼兒、老年
人、孕婦以及原有臟器損害功能不全的患者?更應(yīng)注意用藥方案。
,4,注意藥物間的相互作用?中、西藥并用時(shí)尤其要注意避免因藥物之間相互
作用而可能引起的不良反應(yīng)。
,5,需長期服藥的患者要
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