中成藥臨床應(yīng)用指導(dǎo)原則2

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(kāi)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(chóng)

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(cè).......................................................36

三、開(kāi)展中成藥臨床應(yīng)用監(jiān)測(cè)、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(guó)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(jiǎn)

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(shuō)明書(shū)、最新版本的

《中華人民共和國(guó)藥典》、《中華人民共和國(guó)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(shuō)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(guó)家基本藥物目錄》中的藥物和《國(guó)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(shuō)明書(shū)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(lái)說(shuō)?中成藥無(wú)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(zhǎng)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(guó)歷代醫(yī)藥學(xué)家長(zhǎng)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(kāi)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(jiǎn)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(wú)糖顆粒劑型和有

糖顆粒劑型?近年來(lái)無(wú)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(zhǎng)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(guò)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(yíng)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(guò)胃?且無(wú)

肝臟首過(guò)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(wú)

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(jiǎn)便?兼有外治和內(nèi)治的功能。近年來(lái)發(fā)展起來(lái)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。可用于口腔科、眼科、耳鼻喉科、創(chuàng)傷科、燒傷科、皮膚科及婦科等.作用時(shí)

間長(zhǎng)?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(zhǎng)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(zhǎng)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(lái)無(wú)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(guò)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(guò)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(wú)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?、皮

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(rùn)下、逐水、攻補(bǔ)兼施。

3.和解劑和解少陽(yáng)、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(yíng)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(yáng)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(yáng)、陰陽(yáng)雙補(bǔ)。

9.安神劑重鎮(zhèn)安神、滋養(yǎng)安神。

10.開(kāi)竅劑涼開(kāi)、溫開(kāi)。

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?，活血化瘀、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(rùn)燥、滋陰潤(rùn)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(rùn)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(chóng)劑驅(qū)蟲(chóng)止痛、殺蟲(chóng)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(wèn)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(guò)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(zhǎng)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(guò)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(jiàn)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(guò)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(cè)?完善中藥不良反應(yīng)報(bào)告制度。

,,,注意藥物過(guò)敏史。對(duì)有藥物過(guò)敏史的患者應(yīng)密切觀察其服藥后的反應(yīng)?如

有過(guò)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(zhǎng)期服藥的患者要