Objective:To establish a diagnostic system for heat toxin syndrome of acute cerebral infarction.Based on this toxin syndrome diagnostic system,the general principles of heat toxin development will be uncovered,and the...Objective:To establish a diagnostic system for heat toxin syndrome of acute cerebral infarction.Based on this toxin syndrome diagnostic system,the general principles of heat toxin development will be uncovered,and the critical turning point at which the heat toxin syndrome occurs will also be explored.Methods:In this study,a total of 271 hypertension patients with cerebral infarction within 72 h were recruited from the Affiliated Dongfang Hospital of the Beijing University of Chinese Medicine,the Affiliated Dongzhimen Hospital of Beijing University of Chinese Medicine,the Affiliated Renmin Hospital of Peking University,the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,the Affiliated Hospital of Changchun University of Traditional Chinese Medicine,the Affiliated Hospital of Hebei University of Traditional Chinese Medicine and China Meitan General Hospital from August,2008,to December,2009.The patients’Chinese medical information was recorded on days 1,3,5,7,and 14 during their hospitalizations.The medical records were recorded according to traditional Chinese medicine(TCM)theory and included the serum marker levels at the beginning and at the end of the trial.The time line was also analyzed.Results:The level of Hs-CRP,PAG,NSE,OX-LDL,and MMP-9 were abnormal and,were higher in CI patients compared to hypertension patients.In the study of the heat toxin diagnosis system,according to the entropy clustering results,30 combinations of the medical information can be sorted into the traditional syndromes,but 13 combinations cannot be sorted.To obtain more precise symptoms related to the heat toxins,a logistic regression equation was set up with the variables from the unsorted medical information;the dependent variables were fever and BP fluctuation.Weighted variables were obtained.MLP analysis demonstrated that the diagnosis model was stable and precise.The accuracy reached 83.82%.The ROC test showed that seven points of the diagnosis system was the best cutting point,with a sensitivity of 0.857 and a specificity of 0.955.Progressing stroke was related to heat toxin syndrome.When the turning point appeared,the combination of symptoms,such as coma,aphasia,gummy eyes,and halitosis,predicted the deterioration or recovery of CI.The heat toxin syndrome existed in every subtype of CI;however,the observed heat toxin levels were highest in PACI and lowest in LACI.Meanwhile,blood and sputum stasis syndromes transformed into heat toxicity were one source of heat toxin syndrome.Conclusion:Heat toxin syndrome,as well as qi/blood/sputum stasis,co-existed in the CI patients,and the transformation frequently appeared during the process.Three to five days after the onset of CI was the turning point,at which time several combinations of medical indicators make it possible to predict the development of CI.展开更多
目的:评价一清胶囊治疗牙龈炎(热毒证)的经济性,以期为卫生医疗资源的合理配置提供参考依据。方法:从卫生体系角度出发,基于文献筛选后的有效性循证医学证据,运用TreeAge Pro 2018.2.1软件构建模型,对一清胶囊治疗牙龈炎(热毒证)进行成...目的:评价一清胶囊治疗牙龈炎(热毒证)的经济性,以期为卫生医疗资源的合理配置提供参考依据。方法:从卫生体系角度出发,基于文献筛选后的有效性循证医学证据,运用TreeAge Pro 2018.2.1软件构建模型,对一清胶囊治疗牙龈炎(热毒证)进行成本-效果分析和敏感性分析。模型的干预周期为7 d,成本参数源于药智网数据库和北京市医疗保障局官网,效果参数基于筛选出的1篇随机对照试验(RCT)报告的牙龈疼痛消失率。一清胶囊组的治疗方案为一清胶囊,对照组的治疗方案为牛黄解毒胶囊。结果:基础分析结果表明,以对照组方案为参照,一清胶囊组方案的增量成本为-119.70元,增量效果为15.10%,因此占有绝对优势。单因素敏感性分析显示,患者用药依从性对结果影响较大,除该因素外,一清胶囊组的效果参数对研究结果产生了重要影响。概率敏感性分析显示,基于该RCT研究的经济学中,一清胶囊组方案的经济性更高,并且与基础分析结果相一致。结论:与牛黄解毒胶囊比较,一清胶囊治疗牙龈炎(热毒证)患者更具经济性。展开更多
基金This work was supported by the National Basic Research Program of China(973 Program)under Grants No.2012CB518406 and 2006CB504805the National Science Foundation of China(Grant No.81173463).
文摘Objective:To establish a diagnostic system for heat toxin syndrome of acute cerebral infarction.Based on this toxin syndrome diagnostic system,the general principles of heat toxin development will be uncovered,and the critical turning point at which the heat toxin syndrome occurs will also be explored.Methods:In this study,a total of 271 hypertension patients with cerebral infarction within 72 h were recruited from the Affiliated Dongfang Hospital of the Beijing University of Chinese Medicine,the Affiliated Dongzhimen Hospital of Beijing University of Chinese Medicine,the Affiliated Renmin Hospital of Peking University,the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,the Affiliated Hospital of Changchun University of Traditional Chinese Medicine,the Affiliated Hospital of Hebei University of Traditional Chinese Medicine and China Meitan General Hospital from August,2008,to December,2009.The patients’Chinese medical information was recorded on days 1,3,5,7,and 14 during their hospitalizations.The medical records were recorded according to traditional Chinese medicine(TCM)theory and included the serum marker levels at the beginning and at the end of the trial.The time line was also analyzed.Results:The level of Hs-CRP,PAG,NSE,OX-LDL,and MMP-9 were abnormal and,were higher in CI patients compared to hypertension patients.In the study of the heat toxin diagnosis system,according to the entropy clustering results,30 combinations of the medical information can be sorted into the traditional syndromes,but 13 combinations cannot be sorted.To obtain more precise symptoms related to the heat toxins,a logistic regression equation was set up with the variables from the unsorted medical information;the dependent variables were fever and BP fluctuation.Weighted variables were obtained.MLP analysis demonstrated that the diagnosis model was stable and precise.The accuracy reached 83.82%.The ROC test showed that seven points of the diagnosis system was the best cutting point,with a sensitivity of 0.857 and a specificity of 0.955.Progressing stroke was related to heat toxin syndrome.When the turning point appeared,the combination of symptoms,such as coma,aphasia,gummy eyes,and halitosis,predicted the deterioration or recovery of CI.The heat toxin syndrome existed in every subtype of CI;however,the observed heat toxin levels were highest in PACI and lowest in LACI.Meanwhile,blood and sputum stasis syndromes transformed into heat toxicity were one source of heat toxin syndrome.Conclusion:Heat toxin syndrome,as well as qi/blood/sputum stasis,co-existed in the CI patients,and the transformation frequently appeared during the process.Three to five days after the onset of CI was the turning point,at which time several combinations of medical indicators make it possible to predict the development of CI.
文摘目的:评价一清胶囊治疗牙龈炎(热毒证)的经济性,以期为卫生医疗资源的合理配置提供参考依据。方法:从卫生体系角度出发,基于文献筛选后的有效性循证医学证据,运用TreeAge Pro 2018.2.1软件构建模型,对一清胶囊治疗牙龈炎(热毒证)进行成本-效果分析和敏感性分析。模型的干预周期为7 d,成本参数源于药智网数据库和北京市医疗保障局官网,效果参数基于筛选出的1篇随机对照试验(RCT)报告的牙龈疼痛消失率。一清胶囊组的治疗方案为一清胶囊,对照组的治疗方案为牛黄解毒胶囊。结果:基础分析结果表明,以对照组方案为参照,一清胶囊组方案的增量成本为-119.70元,增量效果为15.10%,因此占有绝对优势。单因素敏感性分析显示,患者用药依从性对结果影响较大,除该因素外,一清胶囊组的效果参数对研究结果产生了重要影响。概率敏感性分析显示,基于该RCT研究的经济学中,一清胶囊组方案的经济性更高,并且与基础分析结果相一致。结论:与牛黄解毒胶囊比较,一清胶囊治疗牙龈炎(热毒证)患者更具经济性。
