中西藥交互作用醫囑警示建置經驗分享

Chinese and Western medicine interaction medical advice warning construction experience sharing

莊樹義(Shu-Yi Chuang)；林宗萱(Tsung-Hsuan Lin)；李俞生(Yu-Sheng Lee)；蘇慧真(Hui-Chen Su)

中藥 ； 用藥安全 ； 中西藥交互作用 ； traditional Chinese medicine ； drug interactions ； safety medication

北台灣中醫醫學雜誌

11卷1期（2019 / 03 / 01）

27 - 37

繁體中文

現代醫學突飛猛進，西醫治療雖為醫學之主流，但民眾對替代及輔助醫學仍有相當程度的需求。替代醫療種類多樣，華人社會以傳統中醫藥為主，在台灣中西醫醫療體系雙軌並行，中醫藥使用者大多同時併用西藥治療，在此背景之下，民眾極可能在無明確醫囑之下，同時服用中藥及西藥，而老年人用藥相對複雜，對醫囑的了解及遵從度亦較差，更可能因為不當用藥習慣而造成身體的傷害。奇美醫療財團法人奇美醫院藥劑部為了方便中西醫的結合，在民國九十二年啟用全國第一套的「中西藥交互作用」的查詢系統，提供中醫師檢視西醫師所開立的處方，並可查詢有無中西藥交互作用，有中西藥交互作用時進一步提供建議方案。本研究進一步建置「中西藥交互作用」醫令即時警示系統，並延伸至雲端藥歷檢核「中西藥交互作用」，期能在第一時間醫囑開立時，輔助醫師針對同時服用中、西藥之病人把關，避免或減少臨床上不良反應的發生，增進民眾用藥安全。

With modern medical advancements, in spite of the fact that Western medicine remains the mainstream in global medical care, there continues to be a considerable demand for alternative and complementary medicine (CAM), and traditional Chinese medicine is the leading type of CAM in Chinese communities worldwide, especially in Taiwan, where many patients taking Western medicine are simultaneously using Chinese medicine, thus forming a two-track, parallel medical care system. However, many patients may be receiving the combined treatment of traditional Chinese and Western medicine without clear medical advice. This in particular can pose serious health problems to elderly patients who usually require more complicated medication and show a lower degree of understanding and compliance with doctors’ medical advice. In order to facilitate the integration of traditional Chinese medicine and western medicines, ChiMei Medical Center Department of Pharmacy launched the first ＂Chinese-Western interaction＂ query system in the Republic of China in 2003 to provide Chinese medicine practitioners to view the prescriptions opened by Western physicians, and to check if any. Western medicine interaction, when there are interactions between Chinese and Western medicine, provide further suggestions. This study further established the ＂Chinese and Western medicine interaction＂ medical alert Instant alert system and extended to cloud medicine calendar ＂Chinese and Western drug interaction＂ check. When the doctor's office was opened for medical treatment at the first time, the assistant doctors were Patients of western medicine are checked to avoid or reduce the occurrence of clinical adverse reactions and improve people's drug safety.

1. 王瑩玉(2003)。Warfarin 及其他抗凝血劑與草藥的交互作用。藥學雜誌，19(1)，5-10。
2. 林孟嬌,謝調揚(2003)。天然草藥製成之健康食品潛在危機。藥學雜誌，19(1)，52-59。
3. 康建功,孫玉國,符亞麗(2003)。中西藥配伍禁忌分析。中國藥師，6(1)，54-55。
4. 陳方周。,中國醫藥大學中西醫結合研究所。
5. 黃怡超(2006)。傳統療法的前景與挑戰。科學發展，401，6-9。
6. 劉桂菊,孟淑芬,張輝(2002)。幾種中西藥的配伍禁忌。齊魯醫學雜誌，17(3)，282。
7. 蔡咏蓁,蔡東湖(2008)。中草藥與藥物交互作用。當代醫學，35(3)，52-56。
8. 鄭秀慧(2007)。淺談中西藥聯合應用的配伍禁忌。工企醫刊，20(5)，49-50。