摘要本文通过对具体病例的分析，指出临床上止咳祛痰药不合理应用的表现，主要包括：1）不符合疾病的特点，如咳嗽的病因、诱因、病理生理、并发症和症状等；2）不符合患者的特点，如患者的生理特征（年龄、性别、妊娠、哺乳等）、职业、伴发症、伴随用药、不良反应史和人文背景等；3）不符合药物的特点，如药物的适应证、禁忌证、药动学、药剂学、不良反应、相互作用和药学监护结果等。临床医师和药师在制定药物治疗方案时应充分考虑这些因素，使药物治疗更加合理。

　　关键词处方分析 止咳药 祛痰药 不合理用药

　　中图分类号：R974；R969.3 文献标识码：C 文章编号：1006-1533(2011)09-0421-04

　　Analysis of the prescription of cough remedy and expectorant

　　Wu Hui-fei1，Ye Xiao-fen2，Jin Mei-ling3，Cai Ying-yun4

　　（1. Department of Pharmacy，Zhongshan Hospital，TCM University of Guangzhou，Zhongshan，528400；

　　2. Department of Pharmacy，Zhongshan Hospital，Fudan University，Shanghai，200032；

　　3. Department of Pulmonary，Zhongshan Hospital，Fudan University，Shanghai，200032；

　　4. Department of Geriatrics，Zhongshan Hospital，Fudan University，Shanghai，200032）

　　AbstractTo discuss the non-rational use of cough remedy and expectorants by analysis of the specific case. Analysing non-rational use of the drug based on: 1) Theprescription does not fit for the disease，especially the etiology of cough and characteristics of cough and sputum；2) The prescription does not fit for the physiological and pathological features of patients；3) The prescription does not fit for the characters of drugs such as mechanisms，pharmacodynamics，pharmacokinetics，efficacy，adverse reactions and drug interactions. Physicians and pharmacists should consider more about the factors above mentioned so as to improve the level for rational drug use.

　　Key Wordsanalysis of drug use；cough remedy；expectorant；non-rational use of drug

　　咳嗽是一种保护性的反射活动，当呼吸道或其它有关器官感受到刺激（如炎症、异物）后，冲动就会传至延髓咳嗽中枢并再经传出神经指挥效应器（呼吸肌、咽肌等），引起咳嗽以排出呼吸道分泌物或异物而保持呼吸道的清洁和通畅，维持正常的呼吸功能。（剩余1454字）

中华医学之家：http://www.xinxi85.com

投稿信箱：zhyxzj85@163.com

联系电话：029--85327298     主编QQ：693891972