Pharmacokinetics of nifedipine sustained-release tablets in healthy Chinese volunteers

Aim To establish a LC-MS method for determining the concentration of nifedipine in human plasma and to evaluate the pharmacokinetic characteristics of nifedipine sustained-release tablets. Methods A XB-C18 （5 μm, 4.6 mm ×150 mm） column and a mobile phase of methanol： 0.01 mol·L^-1ammonium acetate （60：40, V/V） were used to separate nifedipine, the detections was accuracy under atmosperic pressure electronic spray ionization （AP-ESI） mode and ion mass spectrum （m/z） of 314.9 [M＋H]^＋ for nifedipine, and 320.8 [M＋H]^＋ for lorazepam （Internal Standard, IS）. Results The linear range of nifedipine was 0.3 - 80 ng·mL^-1 （ r = 0.9997）, and the limit of quantitation （LOQ） was 0.3 ng·mL^-1. The nifedipine pharmacokinetic parameters after a single dose of 20 mg nifedipine sustained-release tablets test （T） or reference （R） were as the followings, t1/2 （6.73 ± 2.00） h and （7.04 ± 2.18） h, Tmax （4.28 ± 0.70） h and （4.48 ± 0.70） h, Cmax（39.66 ± 10.58） ng·mL^-1 and （40.19 ± 10.97） ng·mL^-1, AUC0-36 （391.63 ± 108.55） ng·mL^-1·h and （387.57 ± 121.51） ng·mL^-1·h, and AUC0-∞ （408.28 ± 121.16） ng·mL^-1·h and （406.15 ± 133.13） ng·mL^-1·h. The relative bioavailability of nifedipine sustained-release tablets （test） was （103.02 ± 13.93） %. Conclusion LC-MS method for the determination of concentrations of nifedipine in human plasma was sensitive and accurate, and could be used in nifedipine bioavailability and pharmacokinetic studies.

Pharmacokinetics of Controlled Release and Immediate Release Morphine Sulphate Tablets after a Single Dose and Multiple Doses in Chinese Volunteers

The pharmacokinetics of morphine sulphate was studied in 10 Chinese healthy volunteers after a single oral dose. Blood samples were collected before and after administration of controlled release tablets (CRMS, 30 mg) and immediate release tablets (IRMS, 20 mg). The plasma concentration of morphine was determined by GC MS. The pharmacokinetic parameters of controlled release tablets and immediate release tablets were calculated∶ C max was 19.38±3.80 and 21.27±6.21 ng/ml, t max was 2.36 ±0.37 h and 0.56±0.16 h, t 1/2β was 3.53±0.87 and 3.03±0.74 h, AUC was 145.15±17.65 and 93.08±16.65 ng/ml, respectively. The steady state plasma concentration of morphine sulphate in cancer patients after multiple doses was achieved, C max of CRMS and IRMS was 27.43±0.33 ng/ml and 22.68±0.16 ng/ml, C min of CRMS and IRMS was 19.45±1.44 ng/ml and 18.14±0.49 ng/ml, respectively.

The clinical observation of slow-released morphine tablets by rectum in the treatment of the patients with moderate to severe cancer pain

Objective: To observe the effect of slow-released morphine tablets by rectum in treating the patients of moderate to severe cancer pain with server nausea and vomiting or dysphagia. Methods: 54 cases of cancer patients with server nau- sea and vomiting symptoms or dysphagia were treated with slow-released morphine tablets by rectum, 30-90 mg/time, once every 12 hours. The drug dose was titrated by degree of pain, and the effects and adverse effects were observed. Results: The total effective rate was 81.48%, complete response rate was 51.85% (28/54), and the partial response rate was 29.63% (16/54); there were no obvious toxicities, and the common adverse symptoms included nausea (16.7%) and vomiting (9.3%). Conclusion: The treatment of slow-released morphine tablet by rectum could effectively control cancer pain, the adverse effects were slight than that by mouth. It is safe and effective to be worthy of the adhibition in clinic.

Preparation and <i>in Vitro</i>Drug Release Evaluation of Once-Daily Metformin Hydrochloride Sustained-Release Tablets

The objective of this study was to develop once-daily metformin hydrochloride sustained-release tablets (MHSRT) and evaluate their in vitro release behavior. MHSRT were prepared by the film coating method. The in vitro drug release rate of MHSRT and the commercial tablets Fortamet? made in the United States of America in water was fitted with zero order kinetic equation, and Ritger-Peppas kinetic equation in 0.1 M HCl and pH 6.8-phosphate buffer, respectively. The similarity factor f2 values of MHSRT in three different dissolution medium were 82, 80 and 74, respectively in comparison with imported Fortamet?, which were all greater than 50. The results of storage-stability showed that MHSRT were stable for at least 6 months under stress condition (40℃ ± 2℃, RH 75% ± 5%). Therefore, in this study, MHSRT were successfully prepared using optimized formulation technologies that meet mass produce. The in vitro release behavior of MHSRT was almost similar to that of imported Fortamet?.

Pharmacokinetic Study on Lovastatin Sustained-release Tablet and Sustained-release Capsule in Begal Dogs

This study pharmacokinetically examined the lovastatin sustained-release tablet and sustained-release capsule in Beagle dogs. An reversed-phase HPLC method was established for the determination of lovastatin in Beagle dog plasma. Pharmacokinetic findings were compared among three preparation(lovastatin sustained-release tablet,T p; sustained-release capsule,T J and conventional capsule). Our results showed that the pharmacokinetic parameters in 6 dogs after single-dose oral administration of three perparations were calculated. T max, C max and MRT revealed significant difference (P<0.05). Relative bioavailability was 111.5±16.9 % (T P) and 110.4%±9.6 % (T J). The pharmacokinetic parameters in the 6 dogs after multiple-dose oral administration of three perparations, T max, C max MRT and DF had significant difference (P<0.05); C av , C min and AUC 0-24 h displayed no significant difference (P>0.05). It is concluded that the lovastatin sustained-release tablet and sustained-release capsule are able to maintain a sustained-release for 24 h.

Preparation and evaluation of sustained-release azithromycin tablets in vitro and in vivo

The objective of this study was to prepare azithromycin(AZI)sustained-release products in order to allow for a high dose to be administered,reduce gastrointestinal side-effects and increase the compliance of patients.AZI sustained-release tablets with different release performance(F-I:T_(100%)=3 h and F-II:T_(100%)=8 h in pH 6.0 phosphate buffer)were successfully prepared by wet granulation.The in vitro release rate and drug release mechanism were studied.The release rate of F-Iwas affected by dissolutionmedia with different pH,but not for F-II.HixsoneCrowellmodel was the best regression fitting model for F-I and F-II.Additionally,F-I and F-II both belonged to non-Fick diffusion.Oral pharmacokinetics of the two tablets and one AZI dispersible tablet as reference were studied in six healthy beagle dogs after oral administration.Compared with the reference,the C_(max) of F-I and F-II were decreased,and the T_(max) were prolonged,in that case which meet the requirement of sustained-release tablets.The relative bioavailability of F-I and F-II were 79.12%and 64.09%.T-test ofAUC_(0-144),and AUC_(0-∞) for F-I and F-II indicated there was no significant difference between F-I and F-II.These mean that the extended release rate did not induce different pharmacokinetics in vivo.

Clinical observation of Baitou Weng Decoction combined with mesalazine sustained-release tablets in treating heat-toxic and smoldering ulcerative colitis

Objective:To observe the clinical efficacy of Baitou Weng Decoction combined with mesalazine sustained-release tablets in the treatment of ulcerative colitis with febrile heat and its effect on immune function and serum inflammatory factors.Methods: A total of 84 patients with ulcerative colitis were randomly divided into control group and treatment group, with 42 cases in each group. The control group was given mesalazine sustained-release tablets orally, while the treatment group was given Baitou Weng Decoction and mesalazine sustained-release tablets orally. The treatment period was 30 days and the patients were followed up for 3 months. After treatment, the clinical efficacy, quality of life, immune function and serum inflammatory factors of the two groups were observed.Results: The effective rate of treatment group (90.47%) was higher than that of control group (73.81%) (P<0.05);compared with before treatment, the scores of inflammatory bowel disease quality of life questionnaire scale in both groups were significantly improved (P<0.05), and the difference between the two groups was significant (P<0.05);after treatment, the plasma CD4+/CD8+ ratio and NK+ levels in both groups were significantly higher than those before treatment (P<0.05), and the treatment group was changed. The serum levels of tumor necrosis factor-α, interleukin-17 and interleukin-23 were significantly decreased in both groups after treatment (P<0.05), and the improvement was more significant in the treatment group (P<0.05). No significant adverse reactions were observed in the treatment group.Conclusions: Modified Baitou Weng Decoction combined with mesalazine in the treatment of heat-toxic and incandescent ulcerative colitis can significantly improve the clinical efficacy, improve the quality of life of patients, effectively regulate the expression level of serum inflammatory factors in ulcerative colitis patients, promote the recovery of patients' immune function, and have high drug safety.

Clinical observation on treatment of cancer pain with TCM oriented drugs combined with oxycodone sustained-release tablets and nimesulide sustained-release tablets

Objective： To study the effect of the transdermal preparation of traditional Chinese medicine in treating cancer pain. Methods： From October 2016 to January 2018, 126 patients with cancer pain were enrolled and divided into 4 groups, 39 patients in group A （directed TCM permeation）, 26 patients in group B （oxycodone sustained-release tablets）, 32 patients in group C （Chinese medicine directed drug penetration ＋ oxycodone sustained-release tablets）, and 29 patients group D （Chinese medicine directed drug penetration ＋ oxycodone sustained-release tablets ＋ nimesulide sustained release tablets）, according to KPS scores. Results： Transdermal preparations of traditional Chinese medicine can significantly alleviate cancer pain. For the treatment of moderate to severe cancer pain, the Chinese medicine transdermal preparation can reduce the dosage of oxycodone sustained-release tablets. At the same time, the patient＇s KPS and NRS scores were significantly reduced. Moreover, the transdermal preparation of traditional Chinese medicine has a better therapeutic effect on visceral pain. Conclusion： The traditional Chinese medicine tra_nsdermal preparation combined with western medicine for the treatment of cancer pain may be a new method for the treatment of cancer pain.

近红外光谱技术无损检测克咳片中麻黄类生物碱和吗啡含量研究

麻黄类生物碱以及吗啡含量对评价克咳片质量具有重要意义,该文基于近红外光谱(NIRS)技术建立了快速、无损、高效的克咳片质量评价方法,采用NIRS和偏最小二乘回归(PLSR)法建立了麻黄类生物碱以及吗啡的定量分析模型,并采用不同预处理方法和不同变量选择方法优化了模型性能。将校正集决定系数(R_(c)^(2))、验证集决定系数(R_(p)^(2))和相对分析误差(RPD)作为模型的评价指标。结果表明,标准正态变量变换(SNV)预处理方法结合竞争自适应重加权采样(CARS)变量选择方法所建立的模型性能最优。克咳片中麻黄类生物碱及吗啡近红外光谱模型的R_(c)^(2)、R_(p)^(2)及RPD分别为0.91、0.93、4.00和0.92、0.94、4.24,说明模型性能较好。该研究基于NIRS和CARS实现了克咳片指标成分的快速、无损分析,为克咳片的质量快检提供了参考。

超高效液相色谱法测定硫酸吗啡及硫酸吗啡缓释片的有关物质

目的:建立硫酸吗啡及其制剂杂质谱分析的超高效液相色谱法(UHPLC法)。方法:使用ACQUITY UPLC HSS C_(18)(100 mm×2.1 mm,1.8μm)色谱柱,以0.101%庚烷磺酸钠溶液(用50%磷酸溶液调节pH至2.6)和甲醇为流动相,梯度洗脱,柱温35℃,流速0.3 mL·min^(-1),检测波长230 nm。结果:本方法可实现磷酸可待因(杂质A)、伪吗啡(杂质B)、东罂粟碱(杂质C)、10-羟基吗啡(杂质D)、吗啡酮(杂质E)、吗啡氮氧化物(杂质F)和14-羟基吗啡酮(杂质G,基因毒性杂质)之间及其他相邻杂质之间的良好分离,UHPLC的使用,大大减少了分析时间和有机溶剂甲醇的消耗量,更为绿色环保。结论:该方法首次将硫酸吗啡各已知杂质和14-羟基吗啡酮在UHPLC条件下同时分离,专属性良好,并用校正因子法对原料药和制剂中的7个已知杂质进行准确定量,且可同时测定硫酸吗啡原料药及其制剂硫酸吗啡缓释片中的有关物质,为原料药的选择和制剂工艺的控制提供技术依据。

盐酸吗啡渗透泵片片芯促渗剂研究

目的探讨盐酸吗啡渗透泵片片芯促渗剂的选择。方法以体外释药行为为指标‚采用单因素考察法对渗透压活性物质、崩解剂、高分子聚合物的种类与用量进行考察,并根据优化结果进行验证试验。结果盐酸吗啡渗透泵片片芯处方中渗透压活性物质为60%乳糖,不加崩解剂,不加高分子聚合物,符合该品缓释规律。按处方工艺制备3批半透膜包衣片,其释放曲线良好,加速稳定性试验条件下体外累积释放度未发生显著变化。结论盐酸吗啡渗透泵片片芯促渗剂选择60%乳糖‚20 h时体外累积释放度达85%以上,产品质量稳定。

致孔剂及其用量对盐酸吗啡渗透泵片体外释放度的影响

目的比较不同致孔剂及其用量对盐酸吗啡渗透泵片体外释放度的影响。方法采用湿法制粒制备片芯,半透膜包衣,比较半透膜层中不同致孔剂及其用量对盐酸吗啡渗透泵片体外释放度的影响。结果不同致孔剂对盐酸吗啡渗透泵片的溶出均有促进作用,盐酸吗啡渗透泵片体外释放度随致孔剂用量的增加而增加,相同用量的致孔剂对盐酸吗啡渗透泵片体外释放度的影响从大至小依次为聚乙二醇6000>聚乙二醇4000>聚乙二醇400>聚乙烯吡咯烷酮K30>羟丙基纤维素。结论不同致孔剂及其用量对盐酸吗啡渗透泵片释放度的影响有较大差异。该研究中以聚乙二醇400为优选致孔剂,释放效果较好,重复性良好。

盐酸羟考酮缓释片与硫酸吗啡缓释片治疗中重度癌症疼痛患者的效果比较

目的探究盐酸羟考酮缓释片与硫酸吗啡缓释片治疗中重度癌症疼痛患者的临床效果。方法102例中重度癌症疼痛患者为研究对象,随机分为研究组和对照组,每组51例。对照组应用硫酸吗啡缓释片进行镇痛治疗,研究组患者则使用盐酸羟考酮缓释片进行镇痛治疗。对比两组患者的镇痛效果、治疗过程中不良反应发生情况以及镇痛前后生活质量评分。结果研究组患者镇痛总有效率为98.04%(50/51),显著高于对照组患者的82.35%(42/51)(P<0.05)。研究组患者不良反应发生率9.80%(5/51)显著低于对照组患者的45.10%(23/51)(P<0.05)。镇痛前两组患者生活质量评分组间差异无显著性(P>0.05);镇痛后两组患者生活质量评分较镇痛前明显降低,且研究组患者生活质量评分(12.23±5.13)分低于对照组的(16.59±4.81)分(P<0.05)。结论对中重度癌症疼痛患者使用盐酸羟考酮缓释片镇痛价值肯定,相较于硫酸吗啡缓释片镇痛效果更好,安全性更高,有助于提高患者的生活质量。

24 h盐酸吗啡缓释片与市售品在比格犬体内的药代动力学对比研究

目的建立测定比格犬血浆中盐酸吗啡浓度的液相色谱串联质谱(LC-MS/MS)法,比较自制24 h盐酸码啡缓释片与市售品的药代动力学行为和缓释特征。方法以磷酸可待因为内标,用乙腈沉淀分离蛋白;色谱柱为ACE Phenyl柱(100 mm×2.1 mm,5μm),流动相为0.1%甲酸水溶液-0.1%甲酸乙腈溶液(梯度洗脱),流速为500μL/min;采用电喷雾离子源、多反应监测模式,监测离子对分别为质荷比(m/z)286.1~165.3(吗啡)和m/z 300.2~165.1(可待因)。比格犬单剂量、三周期交叉口服方式给予24 h盐酸吗啡缓释片和2种盐酸吗啡市售品,采用LC-MS/MS法测定血药浓度,由Phoenix WinNonlin 7.0软件计算药代动力学参数。结果吗啡质量浓度在5~2000 ng/mL范围内与待测物和内标峰面积比值的线性关系良好(r=0.9984,n=8);准确度、精密度、稳定性试验结果的RSD和RE均低于20%。自制品与2种市售品的血药浓度时间曲线下面积(AUC_(0-t))、最大血药浓度(C_(max))无显著差异(P>0.05),达峰时间(t_(max))分别为市售品1的13.9倍、市售品2的7.1倍。结论自制24 h盐酸吗啡缓释片较2种市售品有明显的缓释特性。

中重度癌痛患者应用盐酸羟考酮缓释片联合硫酸吗啡片滴定治疗的临床效果及对睡眠质量的影响

目的 探讨联用盐酸羟考酮缓释片、硫酸吗啡片滴定在中重度癌痛患者中的效果。方法 便利选取2021年1月—2023年12月黔西南布依族苗族自治州人民医院收治的82例中重度癌痛患者为研究对象,根据不同镇痛方案将其分为对照组和观察组,各41例。对照组口服硫酸吗啡片滴定,观察组加用盐酸羟考酮缓释片。对比两组患者临床疗效、疼痛评分、血清疼痛介质、生活质量、睡眠质量及安全性。结果 观察组总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组疼痛数字评分、匹兹堡睡眠质量指数评分分别为(1.65±0.23)分、(5.53±1.04)分,低于对照组的(2.27±0.35)分、(7.09±1.12)分,差异有统计学意义(t=9.479、6.536,P均<0.05)。治疗后,观察组前列素E2、P物质、5-羟色胺水平低于对照组,且生活质量评分高于对照组,差异有统计学意义(P均<0.05)。两组患者不良反应总发生率对比,差异无统计学意义(P>0.05)。结论联用盐酸羟考酮及硫酸吗啡片滴定治疗中重度癌痛可有效抑制疼痛,减轻睡眠障碍,且安全性良好。

中西医结合对晚期恶性肿瘤患者癌性疼痛症状的改善评价

目的分析中西医结合治疗晚期恶性肿瘤癌性疼痛患者的疗效及对疼痛症状的改善。方法选取2021年1月—2023年5月辽源市第二人民医院收治的180例晚期恶性肿瘤癌性疼痛患者作为研究对象,按不同的治疗方法分为两组,各90例。对照组应用吗啡缓释片治疗,观察组在对照组基础上,结合中药汤剂治疗。比较两组不良反应发生率、镇痛效果、生活质量、睡眠质量评定、吗啡缓释片使用量。结果观察组镇痛总有效率为98.89%(89/90),高于对照组的92.22%(83/90),差异有统计学意义(χ^(2)=4.709,P=0.030)。两组不良反应发生率相比,差异无统计学意义(P>0.05)。观察组治疗后匹兹堡睡眠质量评分、吗啡缓释片使用量均少于对照组,差异有统计学意义(P均<0.05)。观察组生活质量评分均高于对照组,差异有统计学意义(P均<0.05)。结论中西医结合治疗对于晚期恶性肿瘤癌性疼痛患者有显著效果,可改善患者疼痛症状,减少吗啡缓释片使用量,具有临床应用价值。

鞘内泵入吗啡联合羟考酮缓释片口服治疗中重度癌痛的临床效果研究

目的分析中重度癌痛患者采用鞘内泵入吗啡结合羟考酮缓释片口服治疗的效果。方法选取2020年6月至2023年6月泉州市第一医院收治的70例中重度癌痛患者,采用随机数表法将其均分为两组,每组各35例。对照组采用羟考酮缓释片口服治疗,观察组在对照组基础上联合鞘内泵入吗啡治疗。比较疼痛评分、炎症指标、不良反应发生率及生活质量评分。结果治疗后观察组疼痛评分较对照组低,差异有统计学意义(P<0.05)。治疗后观察组红细胞沉降率、C反应蛋白、白细胞介素6水平均较对照组低,差异有统计学意义(P<0.05)。观察组不良反应总发生率较对照组低,差异无统计学意义(P>0.05)。观察组治疗后生活质量评分较对照组高,差异有统计学意义(P<0.05)。结论鞘内泵入吗啡联合羟考酮缓释片口服应用在中重度癌痛治疗中,可缓解患者疼痛感,降低其机体炎症水平,提升其生活质量,临床上可借鉴及推广。

Simultaneous Analysis of Indapamide and Related Impurities in Sustained-Release Tablets by a Single-Run HPLC-PDA Method

The contents of indapamide and related impurities in generic indapamide sustained-release tablets were simultaneously detected by a single-run high performance liquid chromatography equipped with photodiode array detector(HPLC-PDA)method for the quality control in this paper.The results showed the method had a good selectivity and was validated through linearity,limits of detection and quantification,recovery,and precision.The linear ranges of indapamide,2-methyl-1-nitroso-2,3-dihydro-1H-indole(impurity A,ImA),4-chloro-N-(2-methyl-1H-indol-1-yl)-3-sulphamoyl-benzamide(impurity B,ImB)and 4-chloro-3-sulfamoylbenzoic acid(impurity 1,Im1)were 0.028-1.80μg/mL(R=0.99995),0.060-1.20μg/mL(R=0.9996),0.0324-1.20μg/mL(R=0.99985)and 0.060-1.20μg/mL(R=0.9997)with detection limits of 0.0093,0.012,0.012 and 0.006μg/mL,respectively.ImA and Im1 were not detectable in the generic drug.The content of indapamide was 96.7%of the labeled amount with a relative standard deviation(RSD)of 1.30%,and the percentage of ImB relative to the labeled amounts of indapamide was 0.106%with an RSD of 1.82%.The content of other unspecified impurities all met the reference quality standards.The results provided references for the quality control and the quality standard study of generic indapamide sustained-release tablets.

Qualitative and quantitative analysis of HPLC fingerprint of Wuji gastric floating sustained-release tablets

A qualitative and quantitative test method of fingerprint of Wuji gastric floating sustained-release tablets was established. High performance liquid chromatography （HPLC） was adopted, using Agilent ZORBAX SB-C18 column （250 mm×4.6 mm, 5 μm） as the chromatographic column, and acetonitrile-0.05 mol/L potassium dihydrogen phosphate solution as the mobile phase in a gradient elution with the flow rate of 1.0 mL/min. Sample solution （10 μL） was injected and was tested at the wavelength of 225 nm for 75 min at the column temperature of 30 ℃, Fingerprint similarity software （2004A version） was used to conduct data analysis. A total of 11 batches of Wuji gastric floating sustained-release tablets were tested and analyzed with HPLC fingerprint. Seventeen common peaks were found and the similarity of the 11 batches of agents was greater than 0.9, indicating that the production process of the agent is stable and feasible. The method is operable and could effectively control the quality of Wuji gastric floating sustained-release tablets.

盐酸吗啡缓释片联合复方苦参注射液治疗中重度癌痛患者临床观察

目的 研究盐酸吗啡缓释片联合复方苦参注射液治疗中重度癌痛患者的临床表现,为后续临床治疗提供思路。方法 选取医院2017年6月—2023年1月收治的121例中重度癌痛患者,将其按照电脑抽样随机分为治疗组(60例,口服盐酸吗啡缓释片+静滴复方苦参注射液)和对照组(61例,仅口服盐酸吗啡缓释片)。比较两组的临床疗效、疼痛程度数字评估量表(NRS)、Karnofsky评分(KPS)、匹兹堡睡眠质量指数(PSQI)和不良事件发生情况。结果 经治疗,对照组完全缓解(CR)30例,部分缓解(PR)17例,轻微缓解(PR)7例,无效(NR)7例,有效缓解率为77.05%(47/61),治疗组CR 42例,PR 15例,MR 3例,NR 0例,有效缓解率95.00%(57/60),差异具有统计学意义(χ^(2)=10.954,P=0.010);两组NRS评分均显著提高(P<0.01),两组差异无统计学意义(U=1516.000,Z=1.708,P=0.880),治疗后KPS评分均较治疗前差异有显著统计学意义(P<0.01),两组间治疗后差异具有显著统计学意义(U=489.00,Z=6.962,P=0.000);两组患者治疗前后PSQI评分比较,均差异有统计学意义(P<0.01),两组治疗后对比,差异有显著统计学意义(U=378.000,Z=7.675,P=0.000);治疗组不良反应发生率为18.33%(11/60),对照组不良反应发生率为39.34%(24/61),差异具有统计学意义(χ^(2)=6.495,P=0.011)。结论 中重度癌痛患者应用盐酸吗啡缓释片联合复方苦参注射液可以提高临床疗效,改善患者的生活质量,改善患者睡眠质量,减少药物不良事件的发生。