1, traditional Chinese medicine dispensing is closely related to many basic disciplines and pharmaceutical professional knowledge.

Achieve accurate dispensing and symptomatic drug payment, and timely discover clerical errors and mistakes in doctors' prescriptions (such as compatibility contraindications, pregnancy contraindications, reopening varieties, incompatibility between drugs and symptoms, and excessive toxic drugs). ), we must seriously study and master the basic knowledge of traditional Chinese medicine, and require qualified dispensers to identify the differences between 400 to 500 kinds of commonly used decoction pieces or medicinal materials (especially decoction pieces with similar names and characteristics) and learn to master the classification of drugs. Such as roots, stems, leaves, flowers, fruit seeds and whole grass, mineral medicinal materials and animal medicinal materials in plant medicinal materials. At the same time, it is required to master the nature, taste, efficacy, dosage, usage and common compatibility of various drugs, and to understand various medicinal materials with the same name and alias. To understand the influence of traditional Chinese medicine processing on the taste and efficacy of drugs; Master the knowledge of prescription, the function of decocting first, then decocting and then decocting, and the knowledge of decocting drugs; Understand the preparation method and dosage form of Chinese patent medicine. It can be seen that traditional Chinese medicine dispensing is a subject based on multidisciplinary theoretical knowledge, and only qualified professionals can be competent [1].

2. Traditional Chinese medicine dispensing has particularity.

Dispensing personnel should have good professional ethics in addition to qualified professional knowledge. Pieces of decoction are a special kind of "commodity", which should be prepared in strict accordance with the doctor's advice, and cannot be mismatched, missed, over-matched or under-matched. Some people think that mismatching and missing matching are really wrong, but they think it has nothing to do with weighing, so there is a substitute for weighing by hand. We should improve the concept of "legal system" in the dispensing work, and it is against the Drug Administration Law not to dispense drugs according to the prescribed formula. The dosage of drugs is of great significance in treatment. Every drug has its prescribed dose, especially toxic drugs [2]. The same medicine, different doses, different curative effects, or even the opposite. For example, rhubarb 9 ~ 1~3g has purgative effect, and if the dosage is 1~3g, it has the effect of invigorating stomach and stopping diarrhea. Another example is Artemisia argyi, which tastes bitter, pungent and warm. Previous drug books rarely recorded that it contained little toxicity. China Pharmacopoeia (85th edition) records that Folium Artemisiae Argyi tastes bitter, pungent, warm and slightly toxic. Its usual dosage is 3 ~ 9g, which has the functions of warming channels to stop bleeding, removing blood stasis and relieving pain. Excessive dose can excite cerebral cortex and subcortical center, cause spasm, and even cause hepatocyte metabolism. It can be seen that it is illegal for dispensing personnel to strictly abide by prescription dispensing obligations without infringing on prescription dispensing rights, and all practices that violate prescription dispensing are illegal.

3. Ensure the quality of traditional Chinese medicine dispensing.

3. 1 Formulate and implement various rules and regulations.

Such as: post responsibility system, matters needing attention in traditional Chinese medicine dispensing, regulations on the management of highly toxic drugs and precious drugs, routine of drug payment, routine of mashing drugs, first frying and then dropping, respectively frying, making bags, taking water, dissolving, grinding into powder and mixing. Let everyone have rules and laws to follow, praise and reward those who perform well, criticize and educate those who perform poorly, and even punish them.

3.2 Ensure the quality of drugs

The prepared decoction pieces must be genuine, clean and hygienic, qualified in processing, moldy, deteriorated, moth-eaten, polluted and mixed with impurity drugs, and shall not be prepared in barrels.

3.3 Dispensing should be accurate and uniform.

Each drug is required to be weighed and evenly distributed. You can use the weight loss method, that is, weigh the total weight at one time and then lose weight several times. For big' also want to say, can't estimate. According to the regulations, the weighing error of general drugs shall not exceed 5%; The error of toxic and fine materials shall not exceed 65438 0%.

3.4 Check dispensing

Checking is the last working procedure of traditional Chinese medicine prescription, and it is also the key to reduce errors and prevent accidents. A strict prescription review system must be established. In order to ensure the safety and effectiveness of patients' medication and prevent mistakes and omissions in deployment, it is necessary to do a good job. Pharmacists must make four checks and ten pairs when dispensing prescriptions: investigator, subject, name and age; Check the name, dosage form, specification and quantity of drugs; Look up the contraindications of compatibility and discuss the characteristics, usage and dosage of drugs; Check the rationality of clinical diagnosis medication. On the basis of self-examination by the dispensing personnel, conduct a comprehensive and careful inspection of the drugs that have been dispensed. The pharmacist who checks must strictly review the prescription, saying whether the prepared decoction pieces meet the prescription, whether the quality of the prepared decoction pieces meets the requirements, whether there are errors such as replacing raw materials with raw materials and not distinguishing raw materials, and whether special treatment is needed, such as whether the first frying, the second frying and the packaging are separated, and whether the expensive drugs and toxic drugs are handled properly. If improper adjustment is found, it should be changed in time, and it can be packaged and signed after review. The label should also indicate the patient's name, department and medical record number, and use labels with different colors to distinguish between oral and external washing, and specify the times and date of decoction for the convenience of patients. If there is any discrepancy, it shall be submitted to the prescription maker for correction in time, otherwise it shall not be issued. Check the patient's name, gender, age, etc. When distributing medicine, use external medicine bag to decoct and take it, especially for external use, and explain it clearly to patients or drug users.

3.5 Establish an error accident register.

Check the quality of the formula to eliminate mistakes and accidents.

3.6 the establishment of traditional Chinese medicine dispensing quality query office

Its purpose is to facilitate patients, accept their inquiries about formula quality and drug knowledge, and play the role of inspection, supervision, consultation, publicity and dispute resolution.

3.7 Quality control of Chinese herbal pieces entering the dispensing room.

On the one hand, it is necessary to unify leadership, strengthen management, designate special personnel to be responsible, and put the responsibility on people. All unqualified parts cannot be put into storage; Unqualified parts found after warehousing cannot be sent out; The dispensing room should not be accepted; If unqualified decoction pieces are found in the dispensing room, the dispensing of the drug should be stopped. Moldy, moth-eaten, unqualified or mixed with impurities and non-medicinal parts should be reprocessed or discarded, and shall not be distributed to patients.

3.8 Prevention of drug stringing

There are many reasons for the impure mixing of decoction pieces, such as too many compartments in the medicine barrel, too full medicine, careless use, and not closing the medicine barrel after weighing the medicine. The ways to overcome this problem are: first, don't fill the dose too full, and pay attention to prevent mixing; Secondly, drugs should be carefully weighed; Third, close the medicine barrel after weighing the medicine.

3.9 Always keep the chest of drawers and dispensing table clean and tidy, and clean them regularly.

The medicine in the medicine bucket of the chest of drawers should be changed from the old to the new, and it should be carefully watched and sorted. After a period of use, it is necessary to clean the bucket and screen out the residual sediment and broken medicine. New drugs are at the bottom, and old drugs are at the surface. It is not allowed to press the old medicine with new medicine, otherwise the old medicine will be moldy, moth-eaten and deteriorated if it is pressed at the bottom of the barrel for too long. As long as the regulators pay attention to this point, clean it regularly and bring forth the new, the above problems can be avoided. At the same time, we should always keep the dispensing table and the surrounding environment clean and create a clean and comfortable environment, which is conducive to work.

3. 10 Attach importance to the construction and management of traditional Chinese medicine warehouses.

Strengthening the maintenance of traditional Chinese medicine and formulating feasible rules and regulations are important measures to ensure the adjustment of traditional Chinese medicine.

To sum up, as long as we strictly abide by the technical regulations of medical operation, act in accordance with hospital rules and regulations, strengthen the sense of responsibility, always take patients as the center, provide quality services for patients, and aim at relieving patients' pain, we can do a better job in dispensing traditional Chinese medicine.

refer to

1 Zhang Tingmo, editor. Chinese medicine. Second edition. Changsha: Hunan Science and Technology Press, March ~ May, 2006.

2 edited by Liu Hanqing and Ni Jian. Pharmacy of traditional Chinese medicine. Beijing: Science Press, 2005.29 ~ 3 1.

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