为了促进药物的合理应用，本文从药物相互作用、配伍禁忌、药物选用、用法用量等方面对临床常见的不合理用药医嘱进行了探讨，指出用药不当的原因和可能的后果，帮助临床有效地防范不合理用药的发生，有利于针对性地提高临床合理用药水平。
Objective Shuanghuanglian injection (SHLI) is a typical Chinese medicine injection which has been used for more than 20 years. This study aims to investigate the compatibility of SHLI with western intravenous agents. Methods An extensive literature search was executed to identify all experimental tests and clinical reports on the topics. Data on the types of infusion solutions and western medical injections, usage and dosage, outcome measures for physical and chemical properties, and changes of drug effect were searched for. The included data was analyzed and described by the category of included western drugs. Compatibility was tested through integrating the evaluations of physical properties, chemical composition, drug metabolism, and safety. Results Sixty articles (38 experimental tests and 22 clinical reports) were included after screening. Fifty–three western medical injections were identified from all the included articles. Most of the research was about the compatibility of SHLI with different types of antibiotics, including β-lactam, aminoglycoside, and quinolone etc. Thirty-one western medical injections were not recommended to be combined with SHLI. The quality of the experimental test design was low because of unbalanced evaluation indicators: more attention to physical changes than drug metabolism, effect, and safety. Conclusions A broad incompatibility exists in the combination of SHLI with western medical injections. Some results are still uncertain, but the combinations should still be avoided until researched clearly. The compatibility and interaction of Chinese herbal injections and western medicines is still a weak area. The pharmaceutical sector should strengthen post-market research to update evidence and improve its distribution.
随着世界现代医药学和我国传统医药学的深入发展,中药和西药的在临床上的联合应用非常普遍。而目前在临床中西药合用过程中往往只注重中西药合用的有效性,却忽视了因配伍禁忌而可能出现疗效降低、产生或增加毒副作用的不合理用药。这不仅造成资源的浪费,同时也增加药源性疾病的发生。这应引起广大医药工作者及患者的高度重视。笔者参考近年来有关文献资料,就临床中西药合用的配伍禁忌问题进行归纳论述。