药学英语毕业论文范文

去创新医学网一定能找到的，上面24科室的论文都有，而且全部免费，自己去找找吧！

这种比较专业性的好的免费的论文在网上很难找,就算找的应该也不是完整的,特别是免费的,建议你去学校图书馆阅览室,你不有阅览证吗?那里很多,选择性多呀,含金量也比较高.

英语毕业论文答辩稿范文（精选8篇）

一段忙碌又充实的大学生活要即将结束，我们毕业前都要通过最后的`毕业论文，毕业论文是一种比较重要的检验学生学习成果的形式，快来参考毕业论文是怎么写的吧！下面是我帮大家整理的英语毕业论文答辩稿范文，希望对大家有所帮助。

Good morning, all appraises committee members. I am XXX and my supervisor is XXX.

With his constant encouragement and guidance, I have finished my paper.

Now it is the show time. I will present my efforts to you and welcome any correction.

The title of my paper is Comparative Study between English and Chinese idioms.

With the developing globalization, communication demand precise language.

Idioms are not a separate part of the language, we cannot omit. Studying the similarities and differences between English and Chinese idioms would be helpful to cross-cultural understanding and it’s also a good advance to our future if we can learn well.

For the above facts, I select the subject of “comparative study between English and Chinese idioms” as the title of my paper.

In the main part of this paper, I divide it four parts.

Part one presents general introduction to the basic concept and the studying purpose.

Part two presents overview of the Chinese and English idioms; it concludes similar origins and similar functions. Part three emphasize differences between English and Chinese idioms.

Through contrast analysis of well-known Chinese and English language, found the differences cultural discrepancy and the translation of animal words. Part four draws some conclusions that characteristics of English and Chinese idioms. And it is helpful to cross-culture .It’s necessary for a better understanding of international promotional communication. OK, that’s all. Thank you.

Good morning,Distinguished professors and teachers, ladies and gentlemen, thank you for attending the oral defense.

I am XX. First and foremost, I would like to express my sincere gratitude to my supervisor, professorXX, for his intellectual guidance, invaluable instructions and comments on my thesis. It is with his valuable assistance that I have finally accomplished this topic is On the tragedy figures at historical turning points（Comparison of KongYiji and Rip Van ）The whole thesis consists of 6 parts. The first part will give a brief introduction of the negative, evasive and conservative attitudes of Kong and Rip as well as the topic s significance in the real society. And the second part is going to analyze the figures background to show the historical necessity of the tragedies. In the third part, the tragic heroes failing in the character according to their living environment will be further discussed and the fourth part is to talk about their different tendency of dispositions and behaviors in the society. Then the author will dig into the root causes of the tragedies in the fifth part, and sum up the whole paper to reveal the ideological weak points of the two countries separately in the last part.

Good afternoon, all appraiser committee members. I’m Zhang Da and my supervisor is Professor Zhang Jingcai. With her constant encouragement and guidance, I have finished my paper. Now, it is the show time. I will present my efforts to you and welcome any correction.

The title of my paper is On the Significance of Drama Method in the Improvement of English Learning in Chinese Rural Junior High School. I choose this as my topic due to the following reasons. First of all, I really want to be a teacher, so during the four years, I have read many books about how to become a good teacher. Secondly, when I was a freshman in the summer of 2008, I was chosen as a teaching assistant of the summer camp which was organized by the New Oriental English School in Shijiazhuang. In the summer camp, I rewrote a script of an English drama to be one of the programs of the open ceremony. It was very popular among those students. They thought it was very interesting. In 2010, I was practiced as an English teacher at Chenguantun Middle School in Qinhuangdao, I found that the students have little interest towards English learning, so I hoped I could help them. So I use the Drama Method as my teaching method. Almost all of the students were highly motivated by the interesting teaching method and they have made great progress in the exam one month later. So the research proved that the Drama Method can be used as an effective teaching method. For the above facts, I select the subject of On the Significance of Drama Method in the Improvement of English Learning in Chinese Rural Junior High School as the title of my paper. I hope by studying this topic we can find an effective teaching method to help all the students’ English learning in junior high school.

Next, it is an outline of my paper. In the main part of this paper, I divide it into five parts.

Part one presents an introduction to identify the major problem of junior high school students’ English learning problems

Part two overviews all relevant researches in drama application in teaching oral English.

Part three is the research design, the research hypothesis, the subjects of the research, the research methods and the research procedures are conducted.

Part four is the findings from research data. After analyzing the data with Excel 2007, pedagogical findings and implications are delivered before the conclusion of the thesis.

Part five draws some conclusions about the research. As what has been shown in the research, there are a lot of benefits from drama performance; the Drama Method can be used as an effective teaching method. In addition, there are some suggestions for forthcoming researches.

OK! That is all. Thank you! Please ask questions.

Good evening, all the appraiser committee members. I come from HUST, majoring in foreign linguistics and applied linguistics. With her sincere and intellectual guidance, for nearly one whole year's hard work, I have finished my paper. Finally, it is the show time. This evening I will present my efforts to you all and I gratefully welcome any correction.

The title of my paper is A Study of the Causes of the Gothic Style

in from a Feminist Perspective. I choose this as my topic due to the following reasons. Firstly, I am fond of literature works , especially gothic literature works. Secondly, I am quite familiar with this short story as this is one of the texts in our intensive teaching course and I have taught this text for more than 3 times . Last but not the least ,as a female , I am keen on the study of feminism. For the above facts, I select the subject of as the title of my paper.

I hope by studying this short story we can know more about American southern women in certain history and culture and more importantly help women in modern society get a deeper understanding about ourselves ,help us raise our independence and confidence and show more concern for our mental health.

Next , I will present it to you. Here is an outline of my presentation. They are literature review, gothic tradition , the gothic style in the story and the causes of the gothic style .

This paper consists of six parts. Part one presents an introduction to the author William Faulkner and by pointing out the purpose and significance of this study. Part two is literature review which introduces the relevant research about this novel at home and abroad and then points out the theoretical basis and methods. Part three gives a timeline of the gothic tradition in literature and explains the main characteristics of gothic works. Part four explains the three aspects of the gothic style in the novel，that is, the death theme, grotesque characters and mystic atmosphere. Part five then explains in detail the causes of the gothic style in this novel: patriarchal oppression, the myth of southern ladyhood and Emily’s attitude towards love. Finally, in the conclusion, the author summarizes the previous parts and emphasizes the significance of the argument of the thesis again.

Ok, that's all. Now you may raise your questions ! I am ready! Thank you !!!

I will present my efforts to you and welcome any title of my paper is on transformation of parts of speech in translation. i choose this as my topic due to the following reasons. different languages have different standards to distinguish parts of speech. each language has its own special structure. and there are no equivalent parts of speech between different languages. in order to make the target version more idiomatic and standard, the transformation of parts of speech is always used by translators. so the transformation of parts of speech is playing a more important role in english to chinese based on different characteristics of english and chinese. for the above facts, i select the subject of“on transformation of parts of speech”as the title of my hope by studying this topic we can know the importance of the transformation of parts of speech in english to chinese translation. through transformation, we can get the better version and improve the translation way of thinking and expressing is quite different between chinese and english. english is a kind of static languages which tends to use more nouns. while chinese is a dynamic one in which verbs are often when we make translation in english to chinese, we should know this point and shift the parts of , it is an outline of my paper. in the main part of this paper, i divide it into five one presents an introduction to the basic concepts of parts of speech and two discusses the definition of translation and emphasizes the importance of transformation of parts of speech in the course of three gives four basic ways of transformation of parts of speech through illustrative examples. there are transformed english words into chinese verbs, nouns, adjectives and four presents some problems about transformation and gives some advise to solve the five draws some conclusions that transformation between parts of speech is necessary for us to achieve good translation. it is demonstrated that we can have a good master of transformation and improve the translation. in addition, we must continuously study and explore in all kinds of translation ! that is all. thank you!

Good morning,Distinguished professors and teachers, ladies and gentlemen, thank you for attending the oral defense. （或Welcome to attend the oral defense.） :I am XX. First and foremost, I would like to express my sincere gratitude to my supervisor, professorXX, for his intellectual guidance, invaluable instructions and comments on my thesis. It is with his valuable assistance that I have finally accomplished this topic is On the tragedy figures at historical turning points（Comparison of KongYiji and Rip Van ）The whole thesis consists of 6 parts. The first part will give a brief introduction of the negative, evasive and conservative attitudes of Kong and Rip as well as the topic s significance in the real society. And the second part is going to analyze the figures background to show the historical necessity of the tragedies. In the third part, the tragic heroes failing in the character according to their living environment will be further discussed and the fourth part is to talk about their different tendency of dispositions and behaviors in the society. Then the author will dig into the root causes of the tragedies in the fifth part, and sum up the whole paper to reveal the ideological weak points of the two countries separately in the last part.

stant encouragement and guidance, I have finished my paper. Now, it's show time. You and I will work hard to welcome any topic of my thesis is 《Angela carter to mythology research - the female archetype in “new eve passion”, for example》。 I choose this as my topic due to the following Carter （1940-1992） is an outstanding feminist writer whose influence on Britishwomen's writing was “pivotal in this opening and transformation” [“23]. The year 2014 represents the 22”^ anniversary of Angela Carter's death. In those twenty-two years, her works have been widely taught internationally and brought about much critical debate. In a survey conducted by Cristina Bacchilega and Danielle M. Roemer [2],Carter is one of the most commonly taught women writers on North American programs. She has endowed us with an amazingly large number of legacies in her comparatively limited life, setting foot in various fields such as novels,short stories,children stories, dramas, non-fictions and so on. The acute observations with great insights,as well as the devastating wit and poignant mockery in Carter's works have made her stand out as an iconic figure in English literature. Many scholars and critics have devoted themselves to the research on Angela Carter from many perspectives,including gothic, magic realism, feminism,post-modernism and so on. As a prolific writer who is always ready to blur the boundaries between different genres, Carter has left us a wonderful world to delve the emergence of western women's movement as well as the development of feminist criticism in the 1960s,the feminist approach has become a potent weapon for those who are concerned with the emancipation and legal rights of women. Though women's social status has considerably improved due to the contribution made by countless predecessors,the fundamental problem still lingers on. Carter, with her versatile and avant-garde reputation, is best known as a feminist writer. Concerning the dilemmas and predicaments faced by women nowadays,it is very necessary for us to probe into her insightful and penetrating reflections on femininity as well as the relationship between two genders. The Passion of New Eve, as one of Carter's most representative works, is of great value in the research of her feminist thoughts and , is my paper outline. In the main part of this article, I put it into five one is an introduction to the thesis, covering the research background, theobjective and significance as well as the organization of the two presents a broad picture of Angela Carter's life and her works, as well as the background information about The Passion of New Eve. It also reviews previous studies on Angela Carter and her works at home and abroad, summarizing achievements in the past and pointing out new directions in the three conducts a retrospective study on feminism and archetypal criticism. The author attempts to work out the origin and development of feminism, demonstrating the important role feminism plays in Carter's life. Then is the history of archetypal criticism,as well as those classic female archetypes in mythology. Regarding those fossilized and monotonous images as impediments to women's freedom and liberation,Carter endeavors to shatter them in her demythologizing strategy and appeals for a rational attitude toward heterosexual four is the main body of the thesis. Through an in-depth analysis on The Passion of New Eve,it demonstrates Carter's demythologizing of “The Temptress,,,”Mother Goddess“and ”Eve“ respectively in the text. Leilah,the embodiment of Delilah,the famous temptress in the Bible,cannot escape the fate of being objectified by men and herself. By exposing”temptresses“ as mere victims rather than symbols of viciousness. Carter condemns the oppression and exploitation of women in a patriarchal society. ”Mother“ in Beulah serves as a severe satire on those mother goddesses in mythology. Carter smashes the legend by revealing the surgically-made essence of mother and the patriarchal values lurking behind her alleged matriarchal kingdom, warning against the peril and impracticality of extremist her most convincing example goes to Eve, the most important female character in the Bible, Her transformative journey from a chauvinist to a real woman in the story illustrates that gender, rather than a hereditary feature, is the result of social influence and unremitting imitations. Carter concludes the story with proposing ”androgyny“ as a solution to the current problems,implying that mutual respect and understanding is the only way to achieve the harmony between the two five comes to a general conclusion, summarizing the limitations of the theses as well as some suggestions for further ! That is all. Thank you!

Good morning, distinguished professors and teachers, thank you for attending the oral defense. I’m *** and come from class *. My supervisor is professor Li. I would like to express my deepest gratitude to Prof. his consistent guidance and valuable suggestions, I have finished my paper. Now I will present my efforts to you and gratefully welcome any suggestion.

Firstly, I am very interested in the study of ambiguity. Ambiguity is a common phenomenon in all natural languages. As is known to all, in our daily conversations, ambiguity is often employed to achieve the effect of humor, thus creating a relaxing atmosphere and letting people feel at ease. Some jokes caused by ambiguity is very interesting.

Secondly, I have read several articles about ambiguity written by linguistics and scholars. I found my knowledge of ambiguity is very limited, superficial and nonsystematic. What I knew is just the tip of the iceberg. So I plan to learn more about ambiguity by this research.

Thirdly, I found many scholars have carried out numerous studies of ambiguity, but a majority of these studies are focused on single language separately. Articles about comparison between English ambiguity and Chinese ambiguity are not sufficient. So it is necessary to make further study.

For the above facts, I select this title.

Next, I will present the outline of my thesis. It consists of 7 parts.

The first part gives a brief introduction to the ambiguity and structure of the thesis.

The second part is literature review, briefly introducing the development of study of ambiguity and some scholars’s main views.

The third to fifth parts focus on three types of ambiguity in English and Chinese: phonological ambiguity, lexical ambiguity, syntactic ambiguity. In every broad type, I respectively list some detailed branches and cite some vivid English and Chinese examples to explain these ambiguity phenomena. But I put more focus on the third part and point out two differences of ambiguity between English ambiguity and Chinese ambiguity.

The part six will point out positive results by using ambiguity deliberately in daily conversations, advertisements and literary works.

The last part is the conclusion.

I hope by this contrastive research, we will have a better understanding of ambiguity in English and Chinese and apply it to our life and study.

When reading the final draft, I still find my argument is not so comprehensive and improvements are needed. So welcome your precious suggestion.

That’s all. Thank you.

药学专业是一门独立的学科，具有较强的专业性，所以就要求学生要为学好专业课而打下坚实的基础。下文是我为大家整理的关于药学大专 毕业 论文的内容，希望能对大家有所帮助，欢迎大家阅读参考!

试论儿科用药中存在的问题及合理用药

摘要：目的分析儿科用药中存在的不良问题，并结合问题所在探讨合理用药的有效 措施 。 方法 我院自2009年7月起，对儿科用药方面的合理性进行严格管制。研究从我院儿科科室2009年7月~2010年2月(执行用药规范管制后)收治的患儿中选取60例作为研究对象，设为观察组，并选取2009年1月~6月(未执行用药规范管制前)收治60例患儿设为对照组。通过分析两组患儿的临床资料，对两组患儿的用药情况以及不良反应现象进行对比。结果经研究，从患者的用药不良反应以及治疗效果等方面进行比较，观察组明显优于对照组，且观察组与对照组存在显著性差异，(P<)具有统计学意义。结论在儿科疾病的临床治疗中，合理应用药物，对保障药物治疗效果以及降低不良反应发生率均具有积极影响。

关键词：儿科用药;合理性;不良反应;治疗效果

由于 儿童 年纪过小，生理上多方面功能均与成人有明显出入，如内分泌、神经、肝、肾等方面的功能，因此儿童在防御外界疾病方面的能力较弱，染病概率也较大[1]。此外，因为小儿肾功能仍未完全发育，因此在对于药物的代谢能力以及排泄能力较弱，所以在治疗儿科疾病时，若临床医师未指导儿童合理用药，极易引起药物副作用、药源性疾病等。研究通过分析实行用药控制前后的儿科用药情况，从而掌握儿科的用药特征，确保用药的合理性。

1资料与方法

一般资料①观察组：本组60例研究对象为儿科于2009年7月~2010年2月收治的患儿，其中包括33例男性患儿与27例女性患儿，年龄6个月~12岁，平均为(±)岁;②对照组：本组60例研究对象为儿科于2009年1月~6月收治的患儿，其中包括30例男性患儿与30例女性患儿，年龄6个月~12岁，平均年龄为(±)岁;经对比，两组患儿的一般资料无明显差异，(P>)无统计学意义。

方法通过对两组患儿的临床资料进行回顾，比较两组患儿的用药情况以及不良反应现象的差异情况，分析儿科用药中存在的问题，并探讨观察组所采用的的用药合理性管理方法。

观察指标观察两组患儿在用药后，观察患儿有无呕吐、恶心、腹泻等消化系统症状;有无肝功能不全的症状;有无咳嗽、鼻塞等呼吸系统症状;有无皮疹、泌尿系统受损、急性肾功能衰竭等不良症状。

统计学方法采用t或χ2检验两组数据，以百分比表示儿科用药不良反应的发生概率，若(P<)则表示组间差异具有统计学意义。

2结果

经研究，两组患儿在用药治疗后，均有不同程度的不良症状，如皮疹、泌尿系统受损、咳嗽、急性肾功能衰竭、肝功能异常以及呕吐、恶心、腹泻等不良反应，见表1。

由表1可看出，观察组患儿用药后的不良反应率明显低于对照组，(P<)具有统计学意义。

3讨论

临床上药物的滥用情况依旧大量存在。因为患儿正处于生长发育期，患儿的机体生长发育不完善，对药物具有远远高于成人的敏感性，其药物依从性也相对较差，不稳定、不规律用药的情况突出，在临床的治疗方面，临床医生常常选择几类药物联合应用，这样就使药物在应用的过程中泛滥存在。滥用药物对于患者会出现许多不良反应，不良反应发生率增加，而药物间协同作用效率被降低。许多药物经由肝肾代谢之后排出，而药物滥用则会大大增加药品对肝肾脏器的功能损害。

儿科用药方面存在的问题

①未正确掌握用药剂量：儿科临床医师在选择用药剂量时，仅依据自身临床诊断 经验 进行判断，此为引起用药不良反应的一个主要原因[2]。小儿的胃酸浓度通常较低，加上胃部排空的时间比较长，使肠蠕动缺乏一定的规律，因此在药物吸收方面较为容易。若临床医师未注意到小儿的实际情况调整药物剂量，易引起泌尿系统受损的情况。②滥用药物：相比起成人，儿童生理上尚未完全发育，因此对于药物的敏感性较高，相应的对于服用药物的顺从性也较差，常有用药不稳定的情况，而临床治疗中，多种药物共同使用的情况较为多见，普遍存在滥用药物的情况。

如抗生素、解热镇痛药、激素、维生素、微量元素等药物的滥用。此类情况不仅会导致药物的治疗效果降低，还会提高不良反应的发生概率。③忽视了药物剂型：贴剂、注射液、栓剂、喷雾剂、颗粒冲剂、口服液、分散片、控释片、缓释片等均是临床上较为多见的药物剂型。其中，部分剂型若分散使用则会导致治疗效果受到一定的影响，如缓释片等。

儿科临床用药分析

在临床用药不断进步的环境下，具有耳毒性、发育毒性等毒性的抗生素在临床上的使用频率逐渐减少，也降低了用药不良反应情况的发生率。近几年，有相关医学研究表明，抗生素可分为3类[3]：①时间依赖类;②浓度依赖类;③时间依赖+浓度依赖类;对于儿科用药而言，此种分类方法对改变用药的间隔时间、疗效、毒性等起到了直接影响，成为临床上无法忽视的问题。抗生素的后效应(PostantibioticEffect，PAE)属于抗生素在浓度依赖、时间依赖等方面的最主要影响因素。抗生素的后效应是指细菌接触了抗生素后，抗生素中的血清浓度的降低值虽然低于抑菌最低浓度或是消失，但药物对于微生物仍可维持短时间的抑制效果。对于革兰阳性细菌而言，临床上的抗菌药物通常均具备不同程度的抗生素后效应，但是多种抗菌药物中，以喹诺酮类、氨基糖苷类等浓度依赖类抗生素的PAE较为可靠。浓度依赖类抗菌药物的效果由血药峰浓度值所决定，药物持续时间对于药效的影响不明显。然而，在儿童的临床治疗中应用浓度依赖型抗菌药物，引起并发症的可能性较大，因此现阶段儿科用药中采用浓度依赖型抗菌药物的情况较为少见。对于β-内酰胺类药物等时间依赖型抗菌药物，药物峰浓度对于药效的影响不大，儿科临床上多是通过控制用药的间隔时间以及剂量确保用药合理性。

用药管理措施

从2009年7月起，我院从三个方面入手，严格管制儿科的用药情况：①药物选择。在选择药物时，若仅使用一种药物即可达到治疗的目的，则不采取联用其他药物的做法，尤其是抗生素方面，需准确掌握患儿的适应证，若患儿受染情况处于可控制状态，可通过培养细菌后，对治疗方案进行调整，在治疗时尽可能使用毒性较低与窄谱的药物;②剂型选择。原则上，可通过口服给药进行治疗则尽量避免采用注射治疗。积极研制口感较好的药物，以降低患儿对药物的排斥性。尽量给予患儿半衰期较长的药物，从而通过缩短用药时间以及用药频率，增强患儿对口服药物的依从性;③剂量选择。进行用药治疗前，应指导患儿进行相关检查，如肝功能、肾功能等方面，从而掌握患儿的机体情况，确保用药方面的合理性。

4结论

随着临床用药的管理强度增加，临床上的药物副作用发生率已经有效降低。研究表明，抗生素的分类对于患儿用药的效率产生很大的作用，因此，在临床上，医生要认真选择用药。而抗生素的后效应则与药品浓度密切相关。而浓度依赖性药物的使用会产生较多的并发症，而时间依赖型药物如β-内酰胺类药物的临床作用则主要取决于血与药物浓度在组织中高于MIC的时间，药物峰浓度不会对此产生太大的影响。因此临床上常常遵循着"缩短给药时间，减小给药剂量"的原则对患儿进行用药。

参考文献：

[1]姚冰,潘洁,王远光,等.儿科用药现状与分析[J].中国医院用药评价与分析,2011,11(1):41-44.

[2]张法.儿科用药存在的问题与合理用药[J].中国现代药物应用,2010,4(18):179-180.

[3]王爱英,窦传斌.加强合理用药规范儿科抗生素的临床应用[J].中国中医药现代远程 教育 ,2010,8(5):147-148.

中医处方用药中存在的问题分析

【摘要】目的:分析 总结 中医处方用药中存在的某些突出问题,探讨怎样从根本上保证中医处方用药做到科学、安全、有效。方法:随机抽取我院中医处方1000张,从中药的品种来源及其药效成分、药理作用或临床疗效分析存在的突出问题及危害。结果:存在超量用药、药味偏多、同类药合用、脚注遗漏、别名滥用及名称书写混乱。结论:这些问题的解决要依靠临床医师与药房两个方面的协作配合。

【关键词】中医处方用药;中药品种

中医处方是临床医师为患者治疗或预防疾病而开给药房配方用药的重要书面文件,既是给中药调剂人员的书面通知,又是中药调剂工作的依据,也是计价、统计的凭证,且有法律意义。处方用药的科学正确与否,事关患者的治疗效果与用药安全。笔者从药剂专业毕业后曾从事中药配方工作7年,从历年的调剂工作中发现中医处方用药存在某些较突出问题,现分析如下。

一、临床资料

随机抽取我院1999年-2006年中医处方1000张,存在问题的处方有32张,不合格处方率达。其中有些处方同时有多处问题存在,特挑选有代表性的处方分析如下。

1.超量用药

超量用药是目前中医处方十分普遍的现象,指处方中药味的量明显超出《中国药典》规定的常用量。从本质上讲,中药治病的物质基础是其所含的有效化学成分(药效成分)。中医在诊治中按辨证论治的原则为患者所开具的处方,不仅其药物组成,而且各药味的用量大小都直接与药效成分的发挥相关。但不是量越大越好,如细辛的使用自古有“不过钱”之说,即临床用量超过3g时,有使用不安全问题,现已证实其地上部分含肾毒性成分马兜铃酸,故2005年版《中国药典》规定细辛药用部位为根,删除了含毒性成分的地上部分。而在临床的处方中,却用到了20g,马兜铃酸虽中毒缓慢,但严重时可出现肾功衰竭、尿毒症而死亡。

不少中医药人员认为,当前中药存在炮制不规范、人工栽培养殖品增多等问题,引起质量下滑,只有增加用药量才能保证药效。这种看法是片面的。首先,随着中药材生产及中药饮片质量管理的不断加强,中药质量在不断提高[1]。况且中医常用的很多大量品种,数百年或更长时间以来就使用人工栽培品,不存在质量下降的问题。

2.药味偏多

处方药味偏多,即每剂药方由近20味药甚至更多的药味组成,在抽查的处方中发现,由于药味偏多,处方平均用药剂量均高达约200g/剂甚至以上[2],最重有达457g/剂。用药味数偏多使“君、臣、佐、使”的规律难以体现,不仅影响到中药疗效发挥,而且在煎药时由于众多化学成分的干扰或相互作用,可能产生不利的化学变化,导致中药的不良反应,同时也是对药材资源的一种浪费。

3.同类药的合用问题

这里的同类药合用是指中医常将两种药性与疗效特别相近的药味相互 配对 使用或相须为用,目的是增加疗效。如合用“二芽”(麦芽、谷芽)以提高消食健胃作用,并用“乳、没”(乳香、没药)以增强活血止痛生肌作用。但对于有毒性的药物,如川乌与草乌,因二者均主含乌头碱(aconitine)等多种毒性脂型生物碱成分,《中国药典》本身规定其内服时均应先煎或久煎(以降低毒性),如在不减小用量的情况下合用,极可能使毒性成分含量超过药用安全范围。故笔者认为毒性成分相同的药味不可盲目合用。

4.脚注遗漏

这是一个常见而又议论较多的问题。中医处方的“脚注”是指在处方药名前、后注示说明性术语,用以对该药味的来源或产地、规格、炮制加工、煎法用法等情况作出说明。目的是保障用药准确、用药质量及服用后的疗效与安全。一是说明药材的来源或产地,如川贝母、北山楂、怀地黄、川黄柏等,二是控制饮片的特殊质量,如黄芩开“条芩”或“子芩”(指黄芩中较嫩的根)时,则所含药效成分黄芩苷、汉黄芩苷等的量比老根“枯芩”中为高,三是指明炮制要求,如生首乌与制首乌,生用治疗肠燥便秘、降血脂,制用补肝肾、填精血、乌发强筋骨;四是说明特殊煎法服法,如矿石、贝壳、甲壳类药味须注明“先煎”,以便使难煎出的药效成分充分溶出,大黄、番泻叶及含芳香性挥发油类成分的药味应标明“后下”,以免久煎降低疗效或使挥发性有效成分散失。此外,还有另煎、包煎、冲服、烊化等等特殊要求,均有利于患者服用或疗效发挥。

二、讨论与小结

综上所述,中医处方用药是一项十分严谨的技术工作,事关防病治病安全有效的大事,不仅要求书写认真、细致规范,还要求临床医师彻底弄清每一处方药味的品种规格、炮制加工、药效成分、理化性质、毒副作用,以及正名与别名等方面的异同。处方用药涉及到医与药两个方面,在临床医师辨证论证、理法方药完全正确的前提下,还要求药房配方时做到准确无误,药房人员应该能够在用药品种来源、药材饮片的理化性质等方面对医师用药给予咨询建议及监督。此外,医院还应定期组织医药人员学习新的药物知识,不断提高业务技术。这样方可从根本上保证中医处方用药的准确、科学、有效与安全。

参考文献

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[2] 姜翠敏,王洪泉,蔡玉凤.上海市部分医院中医处方用药剂量调查[J].中成药,2001,23(12):907.