OBJECTIVE Explore how lean management methods have been studied and applied to reduce the inventory funds of our hospital′s dispensary for western medicine.It changes the management mode of the pharmacy, improves the management level of the dispensary in our hospital.METHODS By checking the hospital information system and deriving our inventory funds（January-June 2018 before Lean implementation）,we set up a pharmacy lean management team, which specializes in the unreasonable growth of our drug inventory funds.This management method is applied to control the drug inventory funds in our western pharmacy, and dynamically monitor 2019,2020 and 2021（after the implementation of lean management） to compare the decline of drug inventory funds in Western Medicine Warehouse before and after the implementation of lean management.RESULTS After the implementation of lean management, the drug inventory fund of our hospital′s western medicine warehouse was lower than that before the implementation, and reached the target value of less than 5 million.CONCLUSION The introduction of lean management into the management of drug stock funds in the western medicine warehouse not only effectively reduces the stock funds in the western medicine warehouse in use in our hospital, does not occupy a large number of circulating funds in the hospital, but also optimizes the drug quality management of the drug warehouse, and significantly improves the management level of the drug warehouse.

目的 为了缩短患者取药等候时间,改善患者就医体验,提高满意度.方法 利用精益管理的原理分析、解决医院药房实际存在的问题.依据HIS系统对我院门诊药房患者取药等候数据进行提取、分析,采取下列措施:设定预警值,实施弹性排班.根据药品使用频次及同一处方上药品的关联度,调整药品摆放位置,减少人员走动距离,提高工作效率.结果 门诊药房流程经过优化后,患者取药等候峰值时间段为上午10:00～11:00,下午3:00～4:00,患者取药人均等候时间由原来的平均429秒,下降到平均308秒.大于10 min的人数比例由原来的22.53％下降到6.13％.利用SPSS 23.0对数据进行统计分析.比较2020年4月与2019年9月患者取药等候时间,人均等候时间明显下降,差异均有统计学意义(P<0.001).结论 在药房管理中,利用精益管理的原理,依靠HIS系统数据分析及采取相应措施,能够节省人力资源,缩短患者取药等候时间.

目的 探讨苯溴马隆治疗高尿酸血症伴慢性肾脏病的临床效果.方法 选取我院2018年01月至2020年01月收治的高尿酸血症伴慢性肾脏病患者82例,将患者随机分为两组,对照组采用别嘌醇片治疗,研究组采用苯溴马隆治疗,对比两组临床治疗总有效率,不良反应发生率,血尿酸、血肌酐、尿蛋白定量、肾小球过滤率指标.结果 临床治疗总有效率比较中,研究组为95.12％,高于对照组75.61％,数据对比差异显著,具有统计学意义,χ2=0.012(P<0.05);不良发应发生率比较中,研究组为7.32％,低于对照组26.83％,数据对比差异显著,具有统计学意义,χ2=0.019(P<0.05);治疗前两组患者血尿酸、血肌酐、尿蛋白定量、肾小球过滤率指标参数无显著数据差异(P>0.05),治疗后研究组血尿酸、血肌酐、尿蛋白定量指标参数明显降低,肾小球过滤率明显升高,与对照组数据对比差异显著,具有统计学意义(P<0.05).结论 高尿酸血症伴慢性肾脏病的临床药物治疗中,采用苯溴马隆进行药物治疗疗效显著,药物不良发应少,安全性高,有利于改善患者肾功能及高尿酸血症,促进病情好转.

OBJECTIVE To establish a HPLC method for the determination of dissolution of atorvastatin calcium tablets. METHODS The chromatographic seperation was performed on Diamonsil C18( 250mm ×4. 6mm,5μm)column,using ammonium acetate buffer solution( pH = 4. 0)-acetonitrile-methanol-tetrahydrofuran( 45∶ 35∶ 13∶ 7) as mobile phase,detected at 244 ran. The flow rate was 1. 0mL·min-1,the column temperature was 30℃. RESULTS The linear range was 128. 2 ~ 278. 5μg·mL-1. The regression euation was y = 23637x-3542,r = 0. 9997. It is found that the dissolution rates of Lipitor and that of atorvastatin calcium tablets were both higher than the National Standards. The results showed that there was some differences between the dissolution behavior of imported atorvastatin calcium tablets and that of domestic atorvastatin calcium tablets. In the early 30 mins,the dissolution rates of imported atorvastatin calcium tabletswas faster than that of domestic atorvastatin calcium tablets. CONCLUSION HPLC method is suitable for the determination of dissolution of atorvastatin calcium tablets.

OBJECTIVE: To evolve the intervention measures on the irrational prescriptions in order to promote clinical rational use of drug and improve the quality of medical care. METHODS: The outpatient emergency prescriptions during the second quarter of 2010-2012( April-June) were sampled for collection of those prescriptions that have undergone intervention from pharmacists,with the relevant problems encountered summarized and analyzed. RESULTS: The statistical analysis revealed that the irrationality lie in 8 aspects including discrepancies between diagnosis and medication,incorrect in frequency,dosage and administration,repeated medication,incompatibility or potential drug interactions. CONCLUSION: It is absolutely necessary to perform real-time intervention on the dispensing of outpatient emergency prescriptions.

目的:系统评价莫西沙星与左氧氟沙星分别治疗慢性阻塞性肺疾病加重期（AECOPD）的临床疗效与安全性,为临床应用提供更优化的方案。方法:计算机检索中国学术期刊全文数据库（CNKI）、万方数据库（WANFANG DATA）、中国生物医学文献数据库,检索时间为2002年至2013年。纳入比较莫西沙星（试验组）与左氧氟沙星（对照组）治疗AECOPD的随机对照试验（RCT）,排除不符合的文献后,使用RevMan5.0软件进行Meta分析。结果:共纳入7个RCT,共计409例慢性阻塞性肺疾病（COPD）患者。在总有效率方面,试验组高于对照组（OR=2.79,95%CI=1.56～5.01,P=0.000 6）;在细菌清除率方面,试验组显著高于对照组（OR=2.27,95%CI=1.23～4.19,P=0.009）。409例患者中,试验组有13例发生不良反应,对照组有22例。结论:莫西沙星治疗AECOPD的总有效率与细菌清除率均显著高于左氧氟沙星,且不良反应较少,可以考虑用莫西沙星代替左氧氟沙星用于AECOPD的治疗。

目的对我院的抗菌药物应用情况进行分析,为临床合理用药提供参考。方法利用本院的计算机管理软件系统检索2009～2011年抗菌药物的名称、规格、使用数量、金额。采用限定日剂量法计算出销售金额前10位抗菌药物的用药频度(DDDS)和日均费用(DDC),比较分析抗菌药物的使用情况。结果本院销售金额前10位抗菌药物主要以注射剂为主,以头孢菌素类为主导,其次为喹诺酮类药物。结论应加强抗菌药物管理,定期公布药敏试验统计资料,提高抗菌药物的有效率。

This article reviews the medication and the details of health instructions for patients with type 2 diabetes mellitus.Both of them play the same important role in the treatment of diabetes.Only after health instruction,can diabetic patients systematically prehension the knowledge of diabetes,e.g.etiology,clinical manifestation,therapy and its possible complications.Then they can use medication reasonably,improve their self-nursing ability,correct their unhealthy behavior,get better quality of life and finally find the best way to fight against this disease.

目的本文对Ⅱ型糖尿病的药物治疗进行了综合论述,并列举出糖尿病患者健康教育的详细内容,表明药物治疗和健康教育都是糖尿病治疗中的重要手段,只有经过健康教育,才能让糖尿病患者系统地掌握糖尿病的致病原因、临床表现、治疗方法及可能发生的并发症等基本知识,才能合理的使用治疗糖尿病的药物,并在此基础上提高自我护理能力,纠正不良健康行为,减少并发症的发生,进一步提高生活质量,寻找到治疗糖尿病的最佳途径。

随机抽取2008年上半年门急诊处方12576张,依据《处方管理办法》的要求,参考药品说明书、药理学知识及国内外资料,包括时辰药理学,遗传药理学,及临床有关治疗指南,循环医学证据等,对抽查的不合格用药处方进行系统分类和统计分析。结果不合格处方456张,占所查处方3.63%。问题处方主要反应在"急三慢七"超量未说明,抗生素越级使用,诊断与用药不相符,重复用药、剂量频次错误,溶媒选择不当,给药方案不当等。

本文结合医院住院药房的用药情况,说明了住院药房面向患者和医护人员开展用药咨询的重要性和必要性,帮助患者提高用药依从性,了解不良反应,获取最佳疗效;帮助医护人员合理用药,改进治疗措施,完善给药方案。