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Effect of Jianpi Shengxue Tablet on Iron Metabolism and Nutritional Status in Patients with Renal Anemia:A Prospective,Randomized,Open,Parallel Controlled and Multicenter Clinical Study
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作者 Juan YANG Meng-yuan LIANG +15 位作者 Yu LI Hao ZHANG Wei LI Jing LV Li-ping DONG Jing-song JIN Cheng YANG Qing-hong ZHANG Li LONG Rong ZOU Yi GAO Dan SONG Chun-qin PAN Ying YAO Xiao-lin ZHAN Xiao-hui WANG 《Current Medical Science》 SCIE CAS 2024年第3期603-610,共8页
Objective This study aimed to analyze the clinical efficacy of the Jianpi Shengxue tablet for treating renal anemia.Methods A total of 200 patients with renal anemia from December 2020 to December 2022 were enrolled a... Objective This study aimed to analyze the clinical efficacy of the Jianpi Shengxue tablet for treating renal anemia.Methods A total of 200 patients with renal anemia from December 2020 to December 2022 were enrolled and randomly divided into two groups.Patients in the control group were treated with polysaccharide-iron complex,and those in the experimental group were administered Jianpi Shengxue tablet.After 8 weeks of continuous treatment,the therapeutic outcomes regarding anemia were compared between the two groups.Results After treatment,the red blood cell(RBC)count,hematocrit(HCT),reticulocyte percentage(RET),ferritin(SF),serum iron(SI),transferrin saturation(TSAT),and serum albumin(ALB)all increased(P<0.01),and the clinical symptom score and total iron binding capacity decreased(P<0.01)in the experimental group.Moreover,the improvements in RBC,HCT,RET,SF,SI,TAST,ALB,and clinical symptoms(fatigue,anorexia,dull skin complexion,numbness of hands and feet)in the experimental group were significantly greater than those in the control group(P<0.05).The total effective rate for treating renal anemia was significantly higher in the experimental group than in the control group(P<0.01).Conclusion The Jianpi Shengxue tablet demonstrates efficacy in treating renal anemia,leading to significant improvements in the laboratory examination results and clinical symptoms of patients with renal anemia. 展开更多
关键词 Jianpi Shengxue tablet renal anemia RANDOMIZED OPEN parallel control multicenter clinical study
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Human umbilical cord mesenchymal stem cells to treat spinal cord injury in the early chronic phase: study protocol for a prospective, multicenter, randomized, placebo-controlled, single-blinded clinical trial 被引量:9
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作者 Yang Yang Mao Pang +5 位作者 Yu-Yong Chen Liang-Ming Zhang Hao Liu Jun Tan Bin Liu Li-Min Rong 《Neural Regeneration Research》 SCIE CAS CSCD 2020年第8期1532-1538,共7页
Human umbilical cord mesenchymal stem cells(hUC-MSCs)support revascularization,inhibition of inflammation,regulation of apoptosis,and promotion of the release of beneficial factors.Thus,they are regarded as a promisin... Human umbilical cord mesenchymal stem cells(hUC-MSCs)support revascularization,inhibition of inflammation,regulation of apoptosis,and promotion of the release of beneficial factors.Thus,they are regarded as a promising candidate for the treatment of intractable spinal cord injury(SCI).Clinical studies on patients with early chronic SCI(from 2 months to 1 year post-injury),which is clinically common,are rare;therefore,we will conduct a prospective,multicenter,randomized,placebo-controlled,single-blinded clinical trial at the Third Affiliated Hospital of Sun Yat-sen University,West China Hospital of Sichuan University,and Shanghai East Hospital,Tongji University School of Medicine,China.The trial plans to recruit 66 early chronic SCI patients.Eligible patients will undergo randomization at a 2:1 ratio to two arms:the observation group and the control group.Subjects in the observation group will receive four intrathecal transplantations of stem cells,with a dosage of 1×106/kg,at one calendar month intervals.Subjects in the control group will receive intrathecal administrations of 10 mL sterile normal saline in place of the stem cell transplantations.Clinical safety will be assessed by the analysis of adverse events and laboratory tests.The American Spinal Injury Association(ASIA)total score will be the primary efficacy endpoint,and the secondary efficacy outcomes will be the following:ASIA impairment scale,International Association of Neural Restoration-Spinal Cord Injury Functional Rating Scale,muscle tension,electromyogram,cortical motor and cortical sensory evoked potentials,residual urine volume,magnetic resonance imaging–diffusion tensor imaging,T cell subtypes in serum,neurotrophic factors and inflammatory factors in both serum and cerebrospinal fluid.All evaluations will be performed at 1,3,6,and 12 months following the final intrathecal administration.During the entire study procedure,all adverse events will be reported as soon as they are noted.This trial is designed to evaluate the clinical safety and efficacy of subarachnoid transplantation of hUC-MSCs to treat early chronic SCI.Moreover,it will establish whether cytotherapy can ameliorate local hostile microenvironments,promote tracking fiber regeneration,and strengthen spinal conduction ability,thus improving overall motor,sensory,and micturition/defecation function in patients with early chronic SCI.This study was approved by the Stem Cell Research Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University,China(approval No.[2018]-02)on March 30,2018,and was registered with ClinicalTrials.gov(registration No.NCT03521323)on April 12,2018.The revised trial protocol(protocol version 4.0)was approved by the Stem Cell Research Ethics Committee of the Third Affiliated Hospital of Sun Yat-sen University,China(approval No.[2019]-10)on February 25,2019,and released on ClinicalTrials.gov on April 29,2019. 展开更多
关键词 clinical study early chronic phase efficacy human umbilical cord mesenchymal stem cell multicenter trial prospective study randomized controlled trial safety spinal cord injury study protocol
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Effect of Xingnao-Jianshen granules in treating AIS patients:study protocol for a non-randomized controlled intervention trial
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作者 Chun-Yu Ma Miao Liu +3 位作者 Hao-Yu Zhang Min Yang Xin-Na Wang De-Xi Zhao 《Clinical Research Communications》 2022年第4期17-22,共6页
Objective:Acute ischemic stroke(AIS)is characterized by high morbidity and high mortality.In recent years,complementary and alternative medicine has gradually been widely accepted and applied.At present,traditional Ch... Objective:Acute ischemic stroke(AIS)is characterized by high morbidity and high mortality.In recent years,complementary and alternative medicine has gradually been widely accepted and applied.At present,traditional Chinese medicine therapy and standard treatments are used for the treatment of AIS.Xingnao-Jianshen prescriptions(XNJS)is an effective prescription for the clinical treatment of AIS,but there is a lack of large-scale clinical evidence to confirm its clinical efficacy.Therefore,our team designed this protocol to evaluate the initial therapeutic effect of XNJS.Methods:The protocol for a non-randomized controlled trial is designed in which 72 eligible patients will be allocated to one of two groups.The control group(n=36)will receive standard treatment for AIS,the test group(n=36)will receive XNJS and standard treatment.Patients will be recruited after stroke onset and will receive the intervention continuously over 10±1 days,with a follow-up period of 90 days.The primary outcome will be the change in the NIHSS,BI,mRS scores.All outcome measures will be assessed at inception,after the intervention(10±1 days),and at the follow-up(90 days).The results will be disseminated to the public through peerreviewed journals and academic conferences.Discussion:The study will provide evidence of the preliminary effects. 展开更多
关键词 Xingnao-Jianshen prescriptions AIS non-randomized controlled intervention trials study protocol
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Bias-Variation Dilemma Challenges Clinical Trials: Inherent Limitations of Randomized Controlled Trials and Meta-Analyses Comparing Hernia Therapies
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作者 U. Klinge Andreas Koch +3 位作者 D. Weyhe Enrico Nicolo R. Bendavid Anette Fiebeler 《International Journal of Clinical Medicine》 2014年第13期778-789,共12页
Purpose:Evaluation of hernia therapies according to the current rules of Evidence Based Medicine is widely reduced to results of RCTs or meta-analyses. RCTs have been accepted as a most important tool to confirm a sup... Purpose:Evaluation of hernia therapies according to the current rules of Evidence Based Medicine is widely reduced to results of RCTs or meta-analyses. RCTs have been accepted as a most important tool to confirm a superior effect of an intervention. Unfortunately, in hernia surgery, comparisons of RCTs and correspondingly their use in meta-analyses, are not, surprisingly often, able to confirm any significant impact of a specific procedure due to intrinsic restrictions in a multi-causal setting with its web of influences. Methods:Based on our own experiences of clinical studies in surgery, the present article outlines several situations, with their respective reasons, which argue the severe limitations of RCTs and meta-analysis to define an optimum treatment. Results:Meta-analyses accumulate the variations of each trial, which then may cover any clear causal relationship. RCTs usually are dealing with subgroups of standard patients thus excluding the majority of our patients. Low statistical power of current cohort sizes restricts the analysis of subgroups or of effects with low incidences. Simple comparisons of means frequently are hampered by nonlinear relationships to outcome. The relevance of a specific variable is difficult to separate from other influences. The limited surveillance period of studies ignores a delayed change in outcome. Randomization cannot guarantee a standardized patient’s condition. All the arguments have to be considered as a crucial and fundamental consequence of the bias-variance dilemma or principle of uncertainty in medicine, and underline the many limitations of RCTs to evaluate any specific impact of hernia therapies on e.g. infection, pain or recurrence. Conclusions: Many surgical issues cannot be and should not be investigated by RCTs, in particular, if a marked patients’ heterogeneity has to be considered or the low incidences of the outcome readout cannot be addressed with sufficient statistical power without getting lost in the variation mire. Registries with their non-restricted data-acquisition should be regarded as reliable alternatives for postoperative outcome quality surveillance studies. 展开更多
关键词 Randomized controlled Trial HERNIA Surgery REGISTRY Meta-Analysis clinical study
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Study design in evidence-based surgery:What is the role of case-control studies?
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作者 Amy M Cao Michael R Cox Guy D Eslick 《World Journal of Methodology》 2016年第1期101-104,共4页
Randomized controlled trials(RCTs) are the gold standard in terms of study design, however, in the surgical setting conducting RCTs can often be unethical or logistically impossible. Case-control studies should become... Randomized controlled trials(RCTs) are the gold standard in terms of study design, however, in the surgical setting conducting RCTs can often be unethical or logistically impossible. Case-control studies should become the major study design used in surgical research when RCTs are unable to be conducted and definitely replacing case series which offer little insight into surgical outcomes and disease processes. 展开更多
关键词 Research STUDIES CASE-control STUDIES RANDOMIZED clinical trials BIAS SAMPLE size
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Differences in clinical and genetic characteristics between early-and late-onset narcolepsy in a Han Chinese cohort
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作者 Hui Ouyang Fang Han +1 位作者 Ze-Chen Zhou Jun Zhang 《Neural Regeneration Research》 SCIE CAS CSCD 2020年第10期1887-1893,共7页
Early-and late-onset narcolepsy constitutes two distinct diagnostic subgroups.However,it is not clear whether symptomology and genetic risk factors differ between early-and late-onset narcoleptics.This study compared ... Early-and late-onset narcolepsy constitutes two distinct diagnostic subgroups.However,it is not clear whether symptomology and genetic risk factors differ between early-and late-onset narcoleptics.This study compared clinical data and single-nucleotide polymorphisms(SNPs)between early-and late-onset patients in a large cohort of 899 Han Chinese narcolepsy patients.Blood,cerebrospinal fluid,and clinical data were prospectively collected from patients,and patients were genotyped for 40 previously reported narcolepsy risk-conferring SNPs.Genetic risk scores(GRSs),associations of five different sets of SNPs(GRS1–GRS5)with early-and late-onset narcolepsy,were evaluated using logistic regression and receiver operating characteristic curves.Mean sleep latency was significantly shorter in early-onset cases than in late-onset cases.Symptom severity was greater among late-onset patients,with higher rates of sleep paralysis,hypnagogic hallucinations,health-related quality of life impairment,and concurrent presentation with four or more symptoms.Hypocretin levels did not differ significantly between early-and late-onset cases.Only rs3181077(CCR1/CCR3)and rs9274477(HLA-DQB1)were more prevalent among early-onset cases.Only GRS1(26 SNPs;OR=1.513,95%CI:0.893–2.585;P<0.05)and GRS5(6 SNPs;OR=1.893,95%CI:1.204–2.993;P<0.05)were associated with early-onset narcolepsy,with areas under the receiver operating characteristic curves of 0.731 and 0.732,respectively.Neither GRS1 nor GRS5 included SNPs in HLA regions.Our results indicate that symptomology and genetic risk factors differ between early-and late-onset narcolepsy.This protocol was approved by the Institutional Review Board(IRB)Panels on Medical Human Subjects at Peking University People’s Hospital,China(approval No.Yuanlunshenlinyi 86)in October 2011. 展开更多
关键词 case-control studies clinical features genetic association studies genetic load genetic loci genetic phenomena hypothalamic diseases precision medicine risk assessment single nucleotide polymorphism
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针灸真实世界研究的质量影响因素及其控制措施
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作者 张琪 盛煜栋 +3 位作者 卢恩仕 赵天易 吕晓颖 李洪皎 《世界中医药》 CAS 北大核心 2024年第7期922-926,共5页
与传统随机对照试验(RCT)相比,真实世界研究(RWS)以真实的临床研究环境为基础,基于临床真实数据,围绕“效果”研究开展,与针灸学的理论体系和临床实践特点表现出较好的相适性。赫尔辛基宣言、国家药监局发布的药物临床试验质量管理规范(... 与传统随机对照试验(RCT)相比,真实世界研究(RWS)以真实的临床研究环境为基础,基于临床真实数据,围绕“效果”研究开展,与针灸学的理论体系和临床实践特点表现出较好的相适性。赫尔辛基宣言、国家药监局发布的药物临床试验质量管理规范(GCP)、国际人用药品注册技术协调会发布的药物临床试验管理规范(ICH E6)等为临床研究质量控制提供了指导法则,RCT可通过对人群、干预、对照、结局的严格控制产生高质量临床研究证据,而RWS由于开放、非盲的研究设计,在研究过程中容易产生偏倚,为提升真实世界数据(RWD)质量,故从研究设计角度分析RWS质量影响因素,并从研究者操作标准质量控制、基于受试者相关风险的质量控制、结局指标质量控制等3个方面探讨RWS质量控制措施;从原始数据采集管理规范、原始数据预处理及质量控制、科学数据质量评估、RWD核查等4个方面探讨RWD质量控制措施,以提升RWD质量,产出高可信度的真实世界证据,推动RWS在针灸领域的应用与发展。 展开更多
关键词 针灸 真实世界研究 质量影响因素 质量控制内容 研究设计类型 临床研究 质量管理 偏倚
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益肾祛浊方对比二甲双胍治疗多囊卵巢综合征合并胰岛素抵抗的随机对照研究
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作者 李梦元 高征 +3 位作者 梁婧翘 张雅冬 李博 许昕 《中国全科医学》 CAS 北大核心 2024年第27期3411-3417,3427,共8页
背景多囊卵巢综合征合并胰岛素抵抗(PCOS-IR)是PCOS中治愈难度最大的亚型,病机复杂,个体差异性大。二甲双胍作为一线用药,虽然能够降低血糖和改善胰岛素敏感性,但是对于调节激素失衡、改善卵巢功能等PCOS核心病理作用有限,且胃肠道反应... 背景多囊卵巢综合征合并胰岛素抵抗(PCOS-IR)是PCOS中治愈难度最大的亚型,病机复杂,个体差异性大。二甲双胍作为一线用药,虽然能够降低血糖和改善胰岛素敏感性,但是对于调节激素失衡、改善卵巢功能等PCOS核心病理作用有限,且胃肠道反应大,患者难以坚持服用。目的评价益肾祛浊方对比二甲双胍治疗PCOS-IR的有效性与安全性。方法前瞻性选取2022年6月—2023年10月首都医科大学附属北京中医医院妇科门诊的102例PCOS-IR患者为研究对象,按照2∶1比例随机分为试验组(n=68)、对照组(n=34)。试验组以益肾祛浊方治疗,对照组以二甲双胍治疗,比较两组患者的排卵率、妊娠率、性激素[卵泡刺激素、促黄体生成素、LH/FSH、睾酮、抗苗勒管激素];糖脂代谢指标;BMI、腰臀比及不良反应发生率。结果治疗后试验组基础体温排卵率较治疗前升高(P<0.05)。试验组有生育需求患者13例,妊娠5例,对照组有生育需求患者5例,妊娠1例。治疗后两组妊娠率比较,差异无统计学意义(χ^(2)=1.154,P>0.05)。治疗后两组患者LH/FSH均较治疗前降低(P<0.05)。治疗后两组患者空腹血糖、空腹胰岛素、胰岛素抵抗指数、总胆固醇、三酰甘油均较治疗前降低(P<0.05)。治疗后两组患者低密度脂蛋白胆固醇、高密度脂蛋白胆固醇与治疗前比较,差异均无统计学意义(P>0.05)。治疗后对照组腰围少于试验组(P<0.05)。治疗后两组患者BMI、腰围、臀围、腰臀比均较治疗前降低(P<0.05)。治疗后试验组患者ALT、尿酸较治疗前降低,对照组UA较治疗前升高(P<0.05)。治疗后两组患者其他指标与治疗前比较,差异均无统计学意义(P>0.05)。治疗期间,患者出现低血糖、乏力、胃脘不适及腹泻等不良反应,试验组不良反应发生率(5/68,7.35%)低于对照组(15/31,48.39%)(χ^(2)=20.404,P<0.001)。结论益肾祛浊方调节激素失衡、改善糖脂代谢异常,治疗PCOS-IR的有效性与二甲双胍相当,对肝肾功能有保护作用,且在减少不良反应方面优于二甲双胍,鉴于二甲双胍的胃肠道反应,患者对益肾祛浊方有更好的耐受度和接受度,值得临床推广应用。 展开更多
关键词 多囊卵巢综合征 胰岛素抵抗 益肾祛浊方 排卵 葡萄糖代谢障碍 脂代谢障碍 临床研究 随机对照试验
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Low-dose and high-dose ^(131)I therapy for low and intermediate risk differentiated thyroid cancer: a randomized controlled clinical study
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作者 瞿源 《China Medical Abstracts(Internal Medicine)》 2017年第1期20-21,共2页
Objective To compare the ablation efficacy and therapy response with low-dose(1.1 GBq)and high-dose(3.7 GBq) 131I in postoperative patients with low and in-termediate risk DTC.Methods A total of 140 patients(37 m... Objective To compare the ablation efficacy and therapy response with low-dose(1.1 GBq)and high-dose(3.7 GBq) 131I in postoperative patients with low and in-termediate risk DTC.Methods A total of 140 patients(37 males,103 females,age range:18-75 years)were enrolled from October 2014 to June 2015,and 展开更多
关键词 HIGH a randomized controlled clinical study Low-dose and high-dose I therapy for low and intermediate risk differentiated thyroid cancer
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大黄■虫丸治疗非酒精性脂肪性肝炎痰瘀互结证的临床疗效与安全性
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作者 刘晓隽 费小凡 +1 位作者 贺雷 朱林 《世界中医药》 CAS 北大核心 2024年第15期2323-2328,共6页
目的:观察大黄■虫丸治疗非酒精性脂肪性肝炎(NASH)痰瘀互结证的临床疗效与安全性。方法:选取2020年5月11日至2022年1月20日四川大学华西医院收治的NASH患者,均辨证为痰瘀互结证的患者216例作为研究对象,采用区组随机化方法分为对照组... 目的:观察大黄■虫丸治疗非酒精性脂肪性肝炎(NASH)痰瘀互结证的临床疗效与安全性。方法:选取2020年5月11日至2022年1月20日四川大学华西医院收治的NASH患者,均辨证为痰瘀互结证的患者216例作为研究对象,采用区组随机化方法分为对照组和观察组,每组108例,观察组脱失10例,对照组脱失9例。对照组接受健康宣教,根据病情给予降压、降糖、调脂、保肝降酶等标准化基础治疗;观察组在对照组治疗方法基础上,联用大黄■虫丸。治疗前及治疗后(治疗1年)对比2组肝活检缓解率、肝纤维化扫描仪(FibroScan)测定的肝纤维化评级缓解率、中医证候积分、体质量指数及肝功能指标[血清谷丙转氨酶(GPT)、血清总胆红素(TB)、血清谷草转氨酶(GOT)]、血脂指标[总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)]、临床疗效及安全性。结果:观察组患者肝活检缓解率高于对照组(χ^(2)=14.512,P=0.002),肝纤维化评级改善率高于对照组(χ^(2)=15.550,P=0.001)。观察组临床中医证候总有效率高于对照组(χ^(2)=21.438,P<0.05)。治疗后,2组患者体质量指数及肝功能、血脂指标均较治疗前改善(P<0.05);治疗后,2组体质量指数及血脂指标比较差异无统计学意义(P>0.05),观察组肝功能指标(GPT、GOT、TB)低于对照组(P<0.05)。共发生不良事件37例次,均为轻微不良反应,未经处理或对症治疗后缓解,2组不良事件发生率比较差异无统计学意义(P>0.05)。结论:大黄■虫丸可改善NASH痰瘀互结证患者的肝纤维化、中医证候与肝功能,安全性良好。 展开更多
关键词 大黄■虫丸 非酒精性脂肪性肝炎 痰瘀互结证 肝纤维化 瞬时弹性成像技术 随机对照研究 临床疗效 安全性
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蒿秦化斑优化方治疗多形性日光疹的临床研究
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作者 侯雨彤 李冠汝 +6 位作者 张艺 王思艺 许艺川 李怡 郑倞 杨功瑞 孙丽蕴 《中国中西医结合皮肤性病学杂志》 CAS 2024年第2期122-127,共6页
目的应用多中心、双盲、安慰剂随机的研究方法对蒿秦化斑优化方治疗多形性日光疹(PLE)的临床疗效及安全性进行评价。方法依据诊断、纳入及排除标准,将126例于首都医科大学附属北京中医医院、北京中医医院顺义医院、北京回民医院皮肤科... 目的应用多中心、双盲、安慰剂随机的研究方法对蒿秦化斑优化方治疗多形性日光疹(PLE)的临床疗效及安全性进行评价。方法依据诊断、纳入及排除标准,将126例于首都医科大学附属北京中医医院、北京中医医院顺义医院、北京回民医院皮肤科门诊就诊的多形性日光疹患者,采用2∶1比例随机分为治疗组与对照组,治疗组84例口服蒿秦化斑优化方颗粒,对照组42例口服安慰剂。每周观察1次,连续观察4周后进行疗效评价。比较2组治疗前后湿疹面积及严重程度指数(EASI)评分(红斑、丘疹、表皮剥脱、渗出/结痂、苔藓化和受累面积);中医主要临床证候评分(瘙痒、心烦、口渴、小便黄和大便干);皮肤病生活质量指数(DLQI)量表、健康状况调查问卷(SF-36)及安全性指标进行疗效判定。结果治疗4周后,治疗组愈显率(76.92%)及总有效率(94.87%)均较对照组提高(P<0.001);EASI评分较对照组明显下降(P<0.001),其中红斑、丘疹、受累面积均较对照组明显改善(P<0.05)。治疗组治疗4周后中医证候评分总分较对照组明显下降(P<0.05)。治疗4周后治疗组患者生理机能、生理职能、躯体疼痛、社会功能、情感职能评分较对照组提高(P<0.05),DLQI评分较对照组明显降低(P<0.05)。2组患者治疗前后安全性指标未出现异常,无不良事件发生。结论口服蒿秦化斑优化方可有效改善PLE患者临床症状和体征及生活质量,且无明显不良反应。 展开更多
关键词 蒿秦化斑优化方 多形性日光疹 多中心临床观察 随机对照试验 双盲 安慰剂对照
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真实世界研究用于医疗器械临床评价的探讨
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作者 樊晓婷 《中国药事》 CAS 2024年第7期738-744,共7页
目的:探究真实世界研究(RWS)如何在遵循伦理和法规的基础上,形成支持医疗器械上市监管决策的真实世界证据。方法:基于国内外关于RWS在医疗器械临床研究的相关政策、指导原则和研究现状,从研究方案设计要点、真实世界数据质量控制、数据... 目的:探究真实世界研究(RWS)如何在遵循伦理和法规的基础上,形成支持医疗器械上市监管决策的真实世界证据。方法:基于国内外关于RWS在医疗器械临床研究的相关政策、指导原则和研究现状,从研究方案设计要点、真实世界数据质量控制、数据统计分析以及实例分析等方面,分析RWS在医疗器械临床评价中的要求。结果与结论:RWS因其宽松的患者入组标准、广泛的覆盖人群以及庞大的样本量等特点,为医疗器械上市提供了有力的支持。科学、合理地设计临床试验方案,确保临床试验实施过程的可追溯性和质量可控,合理运用统计分析方法,是将真实世界数据转化为真实世界证据的关键。推动RWS在医疗器械临床试验中的应用,将加快医疗器械上市,促进整个医疗器械行业的健康快速发展。 展开更多
关键词 真实世界研究 医疗器械 临床试验 质量控制 科学监管
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药物涂层球囊处理冠状动脉小血管狭窄病变的临床对照研究
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作者 韦文财 韦碧妙 +2 位作者 谭宗良 杨智全 吴建福 《现代医药卫生》 2024年第11期1900-1905,共6页
目的分析药物涂层球囊(DCB)处理冠状动脉小血管狭窄病变的疗效和发生再狭窄的危险因素。方法回顾性分析该院2021年12月至2023年6月收治的160例存在冠状动脉小血管狭窄病变,行DCB经皮腔内冠状动脉成形术(PTCA)介入治疗患者的临床资料,术... 目的分析药物涂层球囊(DCB)处理冠状动脉小血管狭窄病变的疗效和发生再狭窄的危险因素。方法回顾性分析该院2021年12月至2023年6月收治的160例存在冠状动脉小血管狭窄病变,行DCB经皮腔内冠状动脉成形术(PTCA)介入治疗患者的临床资料,术后6~12个月返院复查患者共90例。对比分析其中44例治疗后再狭窄患者(研究组)与46例治疗后未发生狭窄患者(对照组)的基本临床资料、血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)]水平及手术资料。结果2组患者在性别、年龄、吸烟史、肥胖、既往经皮冠状动脉介入手术(PCI)病史、高血压、糖尿病、慢性肾功能衰竭、甲状腺功能亢进、甲状腺功能减退方面比较,差异均无统计学意义(P>0.05);2组患者的TC、TG、HDL-C、LDL-C、Hcy、hs-CRP水平比较,差异均无统计学意义(P>0.05);2组患者DCB管径比较,差异有统计学意义(P<0.05),而DCB长度、释放压力、释放持续时间、狭窄段是否有支架、术前狭窄程度、PTCA部位、分叉病变比较,差异均无统计学意义(P>0.05)。研究组患者冠心病家族史、未规范服药比例明显高于对照组,差异均有统计学意义(P<0.05)。经多因素logistic回归分析结果显示,DCB管径、冠心病家族史、未规范服药是DCB处理冠状动脉小血管狭窄病变发生再狭窄的独立危险因素(P<0.05)。结论DCB处理冠状动脉小血管狭窄病变时,DCB管径小(2.00~2.25 mm)则再狭窄率相对高。DCB管径小、冠心病家族史、未规范服药是DCB处理冠状动脉小血管狭窄病变发生再狭窄的独立危险因素。 展开更多
关键词 药物涂层球囊 冠状动脉小血管狭窄病变 临床对照研究 再狭窄 多因素分析
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基于LSPI质量改进框架的压力性损伤临床防治国际指南的应用与评价
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作者 王凡凡 庄敏 +2 位作者 胡三莲 马俊 苏怡芳 《现代临床护理》 2024年第4期60-66,共7页
目的分析基于LSPI[领导力(Leadership)、护士培训(Staff)、临床实践优化(Performance Improvement)和信息技术(Information Technology)]质量改进框架的压力性损伤临床防治国际指南的应用效果,以期为促进相关防治实践指南向临床转化提... 目的分析基于LSPI[领导力(Leadership)、护士培训(Staff)、临床实践优化(Performance Improvement)和信息技术(Information Technology)]质量改进框架的压力性损伤临床防治国际指南的应用效果,以期为促进相关防治实践指南向临床转化提供新方法。方法应用前-后对照研究方法,选择2019年7月—2020年6月就诊于本院的住院患者101005例设为对照组,选择2020年7月—2021年6月就诊于本院的住院患者110824例设为试验组。比较实施前后院内压力性损伤首次风险评估及时率、首次风险评估准确率、高危患者预防措施落实率与压力性损伤发生率。结果首次风险评估及时率从干预前86.73%上升至干预后96.25%,首次风险评估准确率从干预前93.46%上升至干预后98.69%,高危患者预防措施落实率从干预前94.21%上升至干预后98.15%,院内压力性损伤发生率从干预前0.77‰下降至干预后0.29‰,前后比较,差异均具有统计学意义(均P<0.05)。结论基于LSPI质量改进框架的压力性损伤临床防治国际指南的应用可提高压力性损伤过程管理质量,从而降低院内压力性损伤的发生率,促进实施以指南为依据的实践规范。 展开更多
关键词 压力性损伤 领导力-护士培训-临床实践优化-信息技术质量改进 压力性损伤临床防治国际指南 护理管理 前-后对照研究
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近5年中医药治疗肩周炎临床研究结局指标的现状分析 被引量:4
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作者 毛泽芳 王海腾 +5 位作者 王晓宇 范顺 王乙焜 吴秋君 张海宁 王金贵 《天津中医药》 CAS 2023年第8期1029-1034,共6页
[目的]评价近5年中医药治疗肩周炎临床研究随机对照试验(RCT)结局指标的选择应用情况,为建立能够体现中医药辨证论治效果的证候疗效特色结局指标集提供基础。[方法]系统检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献... [目的]评价近5年中医药治疗肩周炎临床研究随机对照试验(RCT)结局指标的选择应用情况,为建立能够体现中医药辨证论治效果的证候疗效特色结局指标集提供基础。[方法]系统检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统、PubMed和Cochrane Library等数据库,通过筛选文献、提取资料、评价偏倚风险,采用定性分析的方法描述纳入研究的RCTs的结局指标的应用情况。[结果]共纳入108篇RCTs,将其结局指标按照功能属性分为症状体征、生活质量、中医证候、理化检查、安全性、远期预后6类,其中应用频数较高的为总有效率86项(79.62%)、疼痛程度96项(88.69%)、视觉模拟评分法(VAS评分)63项(58.33%)以及简易McGill疼痛问卷(SF-MPQ评分)26项(24.07%)、肩关节功能81项(75.00%)[Constant-Murley肩关节评估量表45项(41.67%)以及肩关节活动度ROM评分13项(12.04%)]以及实验室指标30项(27.78%)等,这些会影响临床研究结果的应用价值。[结论]临床研究中,中医药对肩周炎的治疗有着重要的作用,但在疗效评定时,结局指标选择的多样化会影响研究结果的应用价值,应当构建必须报告的、统一的、标准化的以及体现辨证论治干预效果的证候疗效特色结局指标集。在开展该领域的研究设计前,应当加强研究的方法学质量,纳入疾病时充分考虑中医证候相关因素,设计更加具有中医特色的实用性RCT。在中医临床疗效评价体系中,应在中医基础理论的指导下,合理选择结局指标,完善相应的评价方法,提高中医药临床研究的研究效率。 展开更多
关键词 中医药 肩周炎 临床研究 随机对照研究 结局指标
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子宫内膜异位症痛经的临床特点及相关因素分析 被引量:6
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作者 赵婷玉 杨新春 +1 位作者 鲍美如 赵瑞华 《世界中医药》 CAS 2023年第8期1192-1197,共6页
目的:探讨子宫内膜异位症(Endometriosis,EM)痛经的临床特点及影响痛经发生的相关因素。方法:选取2019年1月至2021年12月来自全国42家医院收治的EM患者2056例作为研究对象,通过问卷调查收集研究对象的病历资料。采用病例对照研究,根据... 目的:探讨子宫内膜异位症(Endometriosis,EM)痛经的临床特点及影响痛经发生的相关因素。方法:选取2019年1月至2021年12月来自全国42家医院收治的EM患者2056例作为研究对象,通过问卷调查收集研究对象的病历资料。采用病例对照研究,根据患者是否痛经将其分为痛经1097例和无痛经959例。应用单因素与多因素Logistic回归分析方法,比较痛经或无痛经不同的临床特征,分析EM痛经的临床特点及影响痛经发生的相关因素。结果:1)EM患者痛经的发生率为53.4%。痛经在怕冷、头晕、食欲不佳、肛门坠胀、性交痛5个伴随症状的发生率均高于无痛经,差异有统计学意义(P<0.05)。2)单因素分析结果显示:痛经或无痛经患者在年龄、是否进行过EM手术、有无西药治疗、有无性生活、合并子宫腺肌病方面差异有统计学意义(P<0.05)。3)多因素Logistic回归分析结果显示:EM痛经与年龄、是否进行过EM手术治疗、有无性生活相关(P<0.05)。结论:痛经是EM患者常见的症状。EM痛经患者常伴随怕冷、头晕、食欲不佳、肛门坠胀、性交痛等症状。年龄≤25岁为EM痛经发生的危险因素;而年龄>35岁、进行EM手术、性生活为EM痛经发生的保护因素。临床应综合考虑以上相关因素,早诊断、早治疗,有助于减灭和消除病灶,缓解疼痛。 展开更多
关键词 子宫内膜异位症 痛经 临床特点 相关因素 病例对照研究 问卷调查 LOGISTIC回归分析 流行病学
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解郁天香丹对冠心病伴抑郁焦虑障碍患者IL-6表达及生活质量影响的临床研究 被引量:1
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作者 谢林园 赵明芬 倪昀 《辽宁中医杂志》 CAS 2023年第9期102-107,共6页
目的观察解郁天香丹对冠心病伴抑郁焦虑障碍患者白细胞介素-6(IL-6)及超敏C反应蛋白(hs-CRR)的表达及生活质量的影响。方法选择就诊新疆医科大学附属中医医院且符合标准的患者60例,随机分为观察组和对照组,每组30例,两组均用阿司匹林肠... 目的观察解郁天香丹对冠心病伴抑郁焦虑障碍患者白细胞介素-6(IL-6)及超敏C反应蛋白(hs-CRR)的表达及生活质量的影响。方法选择就诊新疆医科大学附属中医医院且符合标准的患者60例,随机分为观察组和对照组,每组30例,两组均用阿司匹林肠溶片及阿托伐他汀基础治疗,对照组加用黛力新治疗,观察组加用中药解郁天香丹治疗,疗程均为4周。比较两组治疗前后炎症指标IL-6、hs-CRR变化情况以及综合医院焦虑抑郁评分量表(HAD)、中医证候积分、生活质量评定量表简表(WHOQOL-BREF)变化。并收集两组患者在观察时间内的不良反应进行比较。结果两组患者在治疗后,两组患者经治疗后IL-6较治疗前明显改善(P<0.05);观察组患者IL-6较对照组降低明显(P<0.05);观察组患者经治疗后hs-CRP较治疗前明显改善(P<0.05),两组hs-CRP差异无统计学意义(P>0.05)。焦虑、抑郁均有所改善,观察组优于对照组(P<0.05)。在中医证候方面,观察组的有效率为86.7%(26/30),高于对照组有效率为70.0%(21/30)。在中医症状方面,两组患者在胸痛、胸闷、失眠多梦均有所改善,且观察组优于对照组(P<0.05)。两组患者治疗后生活质量均有所改善,且观察组在生理、心理方面优于对照组(P<0.05)。观察组心电图有效率86.7%(26/30),高于对照组66.7%(20/30)。两组患者在治疗前后的不良反应对比,观察组0例,小于对照组7例。两组的安全指标,差异不具有统计学意义(P>0.05)。结论解郁天香丹治疗冠心病伴抑郁焦虑障碍在改善患者焦虑、抑郁、中医临床证候、生活质量疗效显著,能明显降低炎症指标IL-6。用药安全且药物无不良反应,具有较高临床价值,值得推广应用。 展开更多
关键词 解郁天香丹 冠心病 抑郁焦虑 临床对照研究
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A Randomized Double-blind Placebo-controlled Study of Pu'er Tea(普洱茶) Extract on the Regulation of Metabolic Syndrome 被引量:13
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作者 褚松龄 富宏 +5 位作者 杨金霞 刘庚信 窦攀 张良 屠鹏飞 王学美 《Chinese Journal of Integrative Medicine》 SCIE CAS 2011年第7期492-498,共7页
Objective:To explore the regulative efficacy of Pu'er tea(普洱茶)extract on metabolic syndrome. Methods:Ninety patients with metabolic syndrome were randomly divided into two groups,the intervention group adminis... Objective:To explore the regulative efficacy of Pu'er tea(普洱茶)extract on metabolic syndrome. Methods:Ninety patients with metabolic syndrome were randomly divided into two groups,the intervention group administered with Pu'er tea extract,and the placebo group with placebo capsules.After 3 months' treatment, body mass index,waist hip ratio,blood lipids,blood sugar,immune and inflammatory index,and oxidation index of the patients with metabolic syndrome were tested and analyzed.Results:In the intervention group,the body mass index,waist-hip ratio,fasting and 2 h postprandial blood glucose,serum total cholesterol,triglycerides, low density lipoprotein and apolipoprotein B-100 all decreased in the patients with metabolic syndrome,and also the high-density lipoprotein level increased and apolipoprotein A-1 showed the tendency to increase. Serum C-reactive protein,tumor necrosis factor-α,and interleukin-6 were decreased in the intervention group. lnterleukin-10 level was increased,MDA was decreased and superoxide dismutase was increased.Compared with before treatment and the placebo group,there were significant differences(P0.05,P0.01).Conclusions: Pu'er tea demonstrated excellent potential in improving central obesity,adjusting blood lipid,lowering blood sugar,regulating immunity and resisting oxidation.It can adjust the metabolic syndrome of different clinical phenotypes to different degrees,and is ideally fit for early prevention of metabolic syndrome. 展开更多
关键词 TEA metabolic syndrome randomized controlled clinical study
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中药复方治疗腰椎间盘突出症的临床随机对照试验证据图
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作者 肖想玉 秦晓宽 +3 位作者 杨克新 魏戌 孙凯 朱立国 《世界中医药》 CAS 2023年第21期3018-3025,共8页
目的:通过系统检索并梳理中药复方治疗腰椎间盘突出症(LDH)临床随机对照试验(RCT),了解该领域的证据分布。方法:检索国家知识基础设施数据库(CNKI)、中文科技期刊数据库(CCD)、中文科技期刊数据库(CCD)、中国生物医学文献数据库(CBM)、P... 目的:通过系统检索并梳理中药复方治疗腰椎间盘突出症(LDH)临床随机对照试验(RCT),了解该领域的证据分布。方法:检索国家知识基础设施数据库(CNKI)、中文科技期刊数据库(CCD)、中文科技期刊数据库(CCD)、中国生物医学文献数据库(CBM)、PubMed、Embase、Cochrane图书馆、Web of Science数据库中的文献,检索时间限定为2013年1月至2023年2月,纳入相关中药复方治疗LDH的RCT,以文字和图表相结合的方式呈现证据的分布情况。结果:共纳入102项临床研究,文献发表数量总体呈逐渐上升的趋势;疗程多为1~4周;方法学质量评价结果显示目前中药复方治疗LDH的临床研究质量较低;中药治疗LDH对疼痛类指标、功能障碍指标、临床疗效、安全性指标等方面关注较多,而对于中医证候评分/中医症状积分、影像学指标、血液检测指标、生命质量指标、经济学指标及复发率方面关注较少。结论:中药复方在治疗LDH上具有独特优势,但是也存在局限性,中药复方治疗LDH临床研究质量较低,未来需进一步提高临床随机对照试验研究质量,为中药复方防治LDH的有效性及安全性提供更充分的证据支持。 展开更多
关键词 腰椎间盘突出症 中药复方 临床研究 随机对照试验 证据图 研究现状 方法学 质量评价
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Clinical data quality problems and countermeasure for real world study 被引量:6
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作者 Runshun Zhang Yinghui Wang +4 位作者 Baoyan Liu Guangli Song Xuezhong Zhou Shizhen Fan Xishui Pan 《Frontiers of Medicine》 SCIE CAS CSCD 2014年第3期352-357,共6页
Real world study (RWS) has become a hotspot for clinical research. Data quality plays a vital role in research achievement and other clinical research fields. In this paper, the common quality problems in the RWS of... Real world study (RWS) has become a hotspot for clinical research. Data quality plays a vital role in research achievement and other clinical research fields. In this paper, the common quality problems in the RWS of traditional Chinese medicine are discussed, and a countermeasure is proposed. 展开更多
关键词 real world study traditional Chinese medicine clinical and research information sharing system data quality problem data quality control
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