没有玻璃窗，也没有隔板，北京和睦家医院的药剂师冀连梅和医生一样，面对面和患者交流。

No window,No partition,Beijing united family hospital pharmacists ji mei and even as a doctor,Face to face communication and patients.

　　一个冬日的午后，她正详细地给一个父亲解释两瓶喷雾剂的区别。大夫给他5岁的儿子开了两种治疗哮喘的药物，但打开说明书根本看不出来两者的区别，更别提小孩子该如何使用了。

A winter afternoon,She is detailed to a father to explain the difference between the two bottles of spray.The doctor gave him five year old son opened two treatment of asthma drugs,But open specification can't see out the difference between the two,Not to mention children how to use.

　　这几乎是每位父母遭遇过的尴尬。整整一层楼的药店里，儿童药品只占据了巴掌大的一层货架。打开说明书，提到儿童用药大多是笼统的一句“请遵医嘱”或“酌情减量”，让心急火燎的家长无所适从。好不容易找到一瓶标明服用剂量的退烧糖浆，还要按照不同年龄甚至不同体重来服用，大人不得不找出计算器进行千克和毫升之间的换算。

It is almost every parents encountered embarrassment.A whole floor in the pharmacy,Children's drug only accounted for life in a layer of shelves.Open specification,Children's medicine mentioned are mostly general one"Please follow the doctor's advice"or"Discretionary decrement",Let burning with impatience parents at loose ends.Very not easy to find a bottle of marked take doses of defervescence syrup,Also according to different age and different weight to take,Adults have to find out the calculator for kg and ml of the conversion between.

　　“在中国当父母，只知道阿司匹林可不行，你要明白什么叫麦角胺、氯霉素和乙酰氨基酚，学会用半衰期来计算药物排出体外的时间，甚至要像金庸笔下的小龙女一样练习玉女素心剑法，这样才能准确地把指甲盖大小的一粒药劈成8瓣，”一位母亲忍不住叹了口气说，“不学点儿科医学知识，根本不放心。”

"When parents in China,Only know that aspirin may not,Do you want to know what call ergotamine/Chloramphenicol and acetaminophen,Learn to use half life to calculate drug eduction body outside of time,Even like the jin yong's little dragon female as practice herself heart jianfa,In order to accurately ZhiJiaGai the size of a grain of medicine split into eight disc,"A mother can't help but said with a sigh,"Don't learn some pediatric medical knowledge,Don't trust."

　　“一种是紧急发作时缓解症状用的，一种是让孩子长期使用改善体质的。”冀连梅对那位父亲解释说。她指出在药学的临床研究中，儿童通常不作为观察对象。这意味着不仅缺乏专门针对儿童开发的配方药物，更缺乏对儿童用药安全性和有效性的解释。据统计，我国每天有数百人死于不良用药，其中儿童占32%。

"One is emergency onset of symptoms,One kind is to let the children use for a long time to improve the constitution."Hebei even mei to the father explained.She points out that in pharmaceutical clinical study,Children usually do not as the observation object.This means that not only the lack of specific to children's development of the drug formulation,More children lack of drug safety and effectiveness of interpretation.According to the statistics,Every day in our country there are hundreds of people died from bad medicine,The children's 32%.

　　“儿童虽然是个小人，但并不是缩小版的成人，儿童用药要慎之又慎。”从2011年起，冀连梅开始通过微博向公众普及儿童的安全用药问题。

"Although children is a dog,But not smaller versions of adult,Children's medicine to err on the side of caution."Since 2011,Hebei even may start through the micro bo to public popularity children's safety drug problem.

　　“什么，”那位母亲大吃一惊，“那中国的孩子怎么办？” "what,"The mother surprised,"The children in China?"

　　按照世界卫生组织(WHO)的说法，儿童用药安全是个全球性问题。数据表明，全世界每年约有900万5岁以下的儿童死亡，其中许多儿童死于原本可以治愈的病症。不仅如此，许多儿童使用的药物对儿童的作用尚无定论，甚至没有获得许可对儿童使用。

According to the world health organization(who)that,Children safe drug use is a global problem.Data show that,The world each year about 9 million children under the age of five die,Many of these children die from originally can cure disease.Not only that,Many children use drugs to children's role is uncertain,Even without a license for use by children.

　　而来自卫生部药品不良反应监测中心数据显示，我国儿童用药不良反应率是12.9%，新生儿高达24.4%，成人只有6.9%。据中国聋儿康复中心统计，我国7岁以下聋儿，超过30%是因药物过量造成的毒副作用所致。

From the ministry of health and adverse drug reaction monitoring center data display,Children in our country medicine adverse reaction rate is 12.9%,Neonatal reaches as high as 24.4%,Only 6.9% of adults.According to Chinese statistics for rehabilitation center,Our country under the age of seven children,More than 30% for drug overdose caused by side effects.

　　这其中的首要问题是无药可用。来自北京首都儿科研究所的数据表明，我国儿童专用药物剂型同现有药物剂型的比例高达1:59，90%的药品没有适宜儿童的专用剂型。在我国2009年发布实施的《国家基本药物目录》中，儿童药物数量偏少，尤其是在102种中成药中，只有1个儿童专用品种。来自北京协和医院的数据则显示，以专门治疗婴儿腹泻的一二线抗生素为例，北京协和共有西药1300种，儿科专用药品只有31种。

The first question is no medicine can be used.From Beijing capital institute of pediatrics data shows,Children in our country special drug dosage forms with the existing drug dosage forms of rates as high as it happened,90% of the drugs are not suitable for children's special dosage form.In our country the implementation of published in 2009[National essential drugs list]in,Children's drug too few quantity,Especially in 102 kinds of traditional Chinese medicine,Only one children special varieties.From Beijing union medical college hospital data is display,With special treatment of infantile diarrhea a second line antibiotics as an example,There are 1300 species of western medicine Peking union medical college,Pediatric special drugs only 31 species.

　　一位姓翟的儿科医生依然记得，一位父亲为了给5个月的孩子喂药，先拿着剪刀在药片上剪出几个豁口，再找出一只玻璃杯将其压碎，最后小心翼翼地挑拣出近三分之一的药量。

A man surnamed debugging of the pediatric doctor still remember,A father to give five months child feeding,First with a pair of scissors in the tablets cut out a few yawns,To find out a glass the crush,The last carefully pick out nearly a third of the drug.

　　他的儿子得了重症肾病，每天需要两次服用一种名为“强的松”的特效药物。对于这个还不到半岁的小宝宝来说，即使是磨成芝麻粒大小的药片，仍然巨大得难以吞咽。不得已，这位父亲把药片磨碎后，还要将其泡在水里，用奶瓶给孩子喂进去。

His son had severe kidney disease,Need every day two take a name"prednisone"Effects of the drug.For the less than half years for the baby,Even if it is ground into sesame seeds the size of the tablets,Still huge difficult to swallow.forced,The father put the tablets after grinding,And the bubble in the water,To the child with a bottle feed in.

　　“即使如此，剂量仍然不够准确，”翟医生很是无奈，“在国外这种药物有液体的口服剂，可以用针管来抽取适当剂量。”

"Even so,Dose still was not accurate enough,"Debugging the doctor is very helpless,"In a foreign country the drug has liquid oral agent,Can use the needle to extraction appropriate dose."

　　儿童药品剂型、种类的缺乏，与儿童药品研发市场的不景气脱不开关系。目前，我国很多制药企业以生产成人药品为主，多数儿童药品是由制药企业附带进行小批量的生产。以呼吸系统药物为例，眼下只有上海、沈阳、无锡、温州等6地的一些医疗机构参与试验，可儿童呼吸系统疾病种类繁多，药品更新和淘汰速度又过快，药品厂难以赢利。

Children of pharmaceutical dosage forms/Kinds of lack of,And children's drug r&d market downturn tied up relationship.At present,Many Chinese pharmaceutical enterprise in producing adult medicine is given priority to,Most children with drug is by pharmaceutical companies to small batch production.With respiratory drugs as an example,The only Shanghai/shenyang/wuxi/Wenzhou, etc and some medical institutions to participate in test,Can children's respiratory diseases of various kinds,Drug update and elimination speed and too fast,Pharmaceutical factory is difficult to profit.

　　冀连梅回忆起在美国沃尔玛药房的工作经历。美国大部分药品不但有儿童剂型，还有给儿童辅助用药的糖浆。这种糖浆包括桔子味、水蜜桃味、草莓味等多种口味，可以让孩子按自己的喜好挑选。她记得，自己回国后在和睦家医院工作，一位外国人来买糖浆，却被告知没有。

Hebei even may recall in the United States wal-mart pharmacy work experience.Most American children not only drug dosage form,And to the children of adjuvants syrup.This kind of syrup including orange flavour/Peach flavor/Strawberry flavour and so on many kinds of taste,Can let the child choose according to oneself be fond of.She remembered,After his return in peace hospital work,A foreigner to buy syrup,Not only to be told.

　　“什么，”那位母亲大吃一惊，“那中国的孩子怎么办？”

"what,"The mother surprised,"The children in China?"

　

　把大人的药减量给孩子吃，是“用孩子做药物实验” The adult medicine decrement give children to eat,is"With the child to do drug tests"

　　由于缺乏儿童药剂，许多儿科医生不得不给孩子开一些成人药物，然后“儿童酌情减半或遵医嘱”。

Due to the lack of children's agent,Many pediatricians to give a child open some adult drug,then"Children's discretionary halve or as directed by a physician".

　　但这种做法并不正确，按照世界卫生组织的说法，是“用孩子做药物实验”。“孩子可不是缩小版的成人，”参加世界卫生组织儿童药物标准化研讨会的儿内科专家鲍一笑指出，“这正是儿童用药与成人用药必须不一样的一个原因”。

But this kind of practice is not correct,According to the world health organization said,is"With the child to do drug tests"."The child is not smaller versions of adult,"To the world health organization children drug standardization workshop son physicians bao is pointed out that a smile,"This is medicine for children and adults use must not the same one reason".

　　上海瑞金医院儿科医生肖园表示，儿童在体格和器官功能各方面都处于不断发育的时期，中枢神经系统、胃肠道功能、肝肾功能和内分泌系统发育都未健全，其药动学和药效学特征与成人的差异更为显著。

Shanghai ruijin hospital department of pediatrics medical Chinese zodiac garden said,Children in physique and organ function all aspects are in constant development period,Central nervous system/Gastrointestinal function/Liver and kidney function and endocrine system development are not perfect,The pharmacokinetics and pharmacodynamics characteristics and adults more significant differences.

　　以承担排毒、解毒功能的肝脏、肾脏为例，新生儿的状况，就跟6岁的儿童完全不一样，13～14岁的孩子又是一个模式。在新生儿当中，又可以划分成两组，一组是发育成熟后出生的婴儿，另一组是早产儿。

To undertake row poison/Jiedu function of the liver/Kidney as an example,Neonatal condition,With 6 years old of children completely different,13 ~ 14 years old children is a pattern.The baby of,And can be divided into two groups,A set of mature born after the baby,Another group is premature.

　　为此，世界卫生组织将儿童按生理特征划分为7个阶段，并建议不同时期儿童所适合药物的剂型。但在我国的《国家基本药物处方集(化学药品和生物制品)》中，只有个别药品是根据不同年龄段建议使用不同剂量的，大部分药品都没有依照儿童的年龄段进行分类。

therefore,The world health organization will according to the physiological characteristics of children is divided into seven stages,And Suggestions for children in different periods of drug dosage form.But in our country[The national essential medicine prescription set(Chemical and biological products)]in,Only individual drugs is according to different age paragraph suggest using different doses of,Most of the drugs are not according to the children's age classification.

　　在这样的情况下，家长有时候不得不求助于说明书。但翻翻国内的感冒药、抗生素等药品说明书，那张薄薄的小纸片儿上，大多简单地写着“儿童在成人监护下使用”、“或遵医嘱”，有的甚至是一句不良反应和禁忌“尚不明确”

In such cases,Parents sometimes have to turn to specification.But the flip domestic cold medicine/Antibiotic medicines, etc,That piece of thin small piece of paper on,Most simply write"Children in adult care use"/"Or as directed by a physician",Some even is an adverse reaction and taboo"Is not clear"

　　“国外的药品说明书有两类，一类是用通俗易懂的话给患者看的，一类是用专业的医学名词给医生看的。”冀连梅表示，“许多药品的说明书，往往真的是‘书’——厚得像本书。”

"Foreign drug instruction has two kinds,One kind is to use plain English patient to see,One kind is with professional medical nouns to see the doctor."Hebei even mei said,"Many drug instruction,Often is really‘The book’- thick like this book."

　

　不该给孩子用的药用在孩子身上，“真是匪夷所思” Shouldn't give children with medicinal in children,"Is really fantastic"

　　在这样的情况下，儿童乱用药，甚至医生乱开药的情况时有发生。

In such cases,Children disorderly use,Even the doctor to prescribe medicine disorderly situation happen from time to tome.

　　不久前，5个月大的果果得了支气管炎，医生给开了5种药。妈妈不放心，找了一位学中医的朋友咨询。对方告诉她，其中两种药根本不适合给5个月的宝宝吃，“可能会有严重的过敏反应”。果果妈妈当时就觉得“心都要碎了”，“真心后悔大学没修儿科或者药理什么的专业”。

Not long ago,5 months GuoGuo got bronchitis,The doctor gave away 5 kinds of medicine.Mother doesn't trust,To find a friend to learn Chinese medicine of consultation.Each other tell her,Two kinds of medicine doesn't suit for five months baby to eat,"There may be a severe allergic reaction".GuoGuo mother then feel"Heart was broken","Really regret university didn't repair pediatric or pharmacological what major".

　　不久前的12月3日，河北献县的一家妇幼保健医院突然在凌晨1时40分停电，直到早晨6时30分，医院才启动应急发电。一名保温箱里的新生儿，在寒冷中苦苦支撑了5个小时之后，出现了发烧、打喷嚏的症状，4日下午，孩子开始呼吸困难。

Not long ago December 3,,Hebei XianXian a maternity and child care hospital in the morning suddenly 1 and power points,Until the morning 6 30 points,The hospital to start the emergency power.A heat preservation box newborns,In the cold hard support for five hours later,Appeared a fever/Sneezing symptoms,4 in the afternoon,The children began to difficulty breathing.

　　父亲李大兵按照医生的嘱咐，买来两瓶滴鼻净。“用完滴鼻净孩子就吐了，但大夫说没事了，说孩子情况挺平稳。”第二天凌晨，孩子的姥姥发现，自己刚出生3天的小外孙，已经停止了呼吸。

Father LiDaBing according to the doctor's charge,Buy two bottles of intranasal net."Run out of intranasal net child is sick,But the doctor said it's all right,Said the child situation is stable."The second day morning,The child's grandmother found,He just was born three days little grandson,Has stopped breathing.

　　“先不说停电断氧的事，给新生儿用滴鼻净这个药？真是匪夷所思。”在舆论纷纷指责医院的基础设施建设问题的时候，翟医生对这起事故中滴鼻净的使用十分诧异。

"Do not say first power off the oxygen,To the newborn with intranasal net this medicine?Is really fantastic."In the opinion of complaints from the hospital infrastructure construction problems,Debugging the doctor to the accident of intranasal net use very surprised.

　　据他解释，鼻眼净的成分是奈甲唑啉，是一种拟肾上腺素药，目前，国内已经有多起婴幼儿应用滴鼻净引起中毒的报道，这种药品会导致婴幼儿出现嗜睡呕吐等症状，该药品是禁用于婴幼儿患者的。

According to his explanation,Nose eyes clean composition is endure a azole Lin,Is a kind of quasi adrenalin medicine,At present,Domestic has dozens of baby application intranasal net cause poisoning reports,This medicine will cause baby appear sleepiness symptoms such as vomiting,The drug is banned in infant patients.

　　另一种已经被淘汰的药物，却仍在中国不少地区使用。“退热针通常使用的是安乃近、复方氨基比林等含氨基比林的药物，这些药物早就被淘汰了。”冀连梅强调，“世界卫生组织早就向家长和儿科医生提出建议，宝宝发烧不要注射退热针！”

Another has been eliminated drugs,But is still in China many areas use."Defervescence needle usually use analgin/Compound aminopyrine and contain aminopyrine drugs,These drugs have been eliminated."Hebei even may emphasize,"The world health organization already offering Suggestions and pediatricians,The baby has a fever don't injection defervescence needle!"

　　“这类药物用在儿童身上，可能会导致(儿童罹患)致死率极高、极其痛苦的大疱性表皮松懈症。”她在微博里提到那个可怕的副作用时，甚至不忍心贴上图片。

"This kind of drug use in children's body,May lead to(Children suffering from)High fatality rate/Extremely painful bulla sex skin disease of slack."She in micro bo mentioned that terrible when side effects,Don't even have the heart to labeled images.

　　她自己的女儿最近也发烧了，“吃了3次泰诺林退烧，生理性海水盐喷雾器洗鼻子，生理盐水雾化排痰缓解咳嗽”，“小公主”坐在地毯上用积木搭建城堡，虽然生着病，照样“吃喝玩不误”。

Her own daughter recently had a fever,"Eat three tylenol fever down,Physiological sea salt spray washing nose,Physiological saline spray productive relieve a cough","The little princess"Sitting on the carpet with blocks build castle,Though born with disease,so"Playing solitaire and".

　　(文中患者皆为化名）

(The patients are alias)