基于数据挖掘与网络药理学探讨新型冠状病毒肺炎恢复期中医药用药规律及机制

目的基于数据挖掘分析新型冠状病毒肺炎(Corona virus disease 2019,COVID-19)恢复期临床研究、名医经验及官方公布恢复期方药组方规律,应用网络药理学研究核心药物及其化合物在COVID-19恢复期的作用机制,为新冠肺炎恢复期的防治提供指导。方法通过检索中国知网等数据库以构建新冠肺炎恢复期中医处方数据库,采用数据挖掘和关联规则分析等方法,研究新冠肺炎恢复期方药组方规律,筛选核心药组;进一步采用网络药理学方法,通过GO分析和KEGG通路富集分析,研究核心药物的生物信号通路,阐明其作用机制。结果筛选官方公布的新冠肺炎恢复期处方86套,发现13味高频中药,进一步关联分析得到14个高频药组,结合复杂网络分析及聚类分析确定新冠肺炎恢复期核心药组。采用网络药理学方法,研究核心药组作用机制,筛选得到疾病核心作用靶点与主要化合物成分靶点交集34个,GO富集分析367条,KEGG分析108条。结论新冠肺炎恢复期用药规律以补脾益肺,益气养阴为主,祛湿利痰、解毒化瘀为辅,病机以正虚邪恋为特点,“茯苓-半夏-党参-陈皮”为新冠肺炎恢复期处方中的核心药组。网络药理学分析进一步分析发现核心药组的关键成分木犀草素、黄芩素、柚皮素等可调控LI6、TNF、AKT等关键靶点发挥作用,松弛素信号通路、糖尿病并发症AGE-RAG等信号通路可能为其关键通路。

2005年城市样本医院用药及部分抗感染药物趋势分析

受药品降价、药品招标等宏观调控的影响,2005年我国城市样本医药用药增幅下降,其中全身用抗感染类药物的变化影响最大。

调整医院用药品种原则的探讨

调整医院用药品种原则的探讨邓丽云（北京市宣武中医医院１０００５０）一个医院的医疗质量如何，不仅取决于医疗技术水平，护理技术水平，而且在很大程度上取决于合理用药水平，对于不同规模、不同特色的医院，根据各自的特点来确定本院用药品种显得尤为重要。我院是以中...

中医药治疗肝病的临证体会

本文结合临床治疗乙肝的相关肝病,提出中医药运用时应以中医理论为指导,采取辨证立法,标本兼顾,确定病位,以提高治疗效果。

我院国家基本药物使用情况调研

国家基本药物是我国一项新的药品政策。我国卫生部已组织专家按照临床必需、安全有效、价格合理、使用方便的原则，筛选出１６９９种中药，６９９种西药作为国家基本药物。为更好地贯彻执行国家基本药物政策，我们对浙江医科大学附属第一医院使用国家基本药物的情况进行了...

基于数据挖掘探讨中医药治疗稳定型心绞痛证治规律

目的利用数据挖掘技术总结中医药辨证治疗稳定型心绞痛(SAP)的组方思路及配伍规律。方法检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(重庆维普)、中国生物医学文献服务系统(SinoMed)建库至2022年2月28日有关中医药治疗SAP的临床研究文献, 采用Clementine 12.0、Excel 2016、SPSS Statistics 22.0软件对中药数据进行频次统计、聚类分析及关联规则分析, 总结核心处方。结果纳入处方289首, 涉及中药185味, 包含中医证型38种。基于SAP"病"的整体研究发现, 临床治疗SAP以活血化瘀药、补虚扶正药、理气化痰药为主, 使用频次较高的中药包括川芎、丹参、甘草、黄芪、当归等;常用药对包括川芎-当归、川芎-红花、川芎-枳实等。药物复杂网络图及聚类分析显示, 补阳还五汤化裁方是治疗SAP的基本方;基于SAP"证"的研究发现, 气虚血瘀证、痰瘀互结证、气滞血瘀证是SAP较为常见的中医证型, 三者用药均以温、平为主;药味均以甘、辛、苦为主, 多归肝、脾、肺、心经。其中, 气虚血瘀证以黄芪、川芎、丹参等高频药物组成的补阳还五汤为基本方;痰瘀互结证常以制半夏、川芎、薤白等高频药物组成的瓜蒌薤白半夏汤合桃红四物汤为基本方;气滞血瘀证以川芎、当归、枳壳等高频药物组成的血府逐瘀汤为基本方。药物聚类分析气虚血瘀证与气滞血瘀证可分为3类, 痰瘀互结证可分为4类。结论虚、瘀、痰、滞是SAP的重要病理因素, 其中气虚为发病基础, 血瘀贯穿本病始终, 或兼痰浊及气滞之证。围绕着本虚标实的病机, 临床多治以补虚药和活血化瘀药, 辨证选方。

Application of Microcalorimetric Technique for the Screening and Examination of Medicines

According to the heating effect caused by interaction between matters,a series of experiments on the interaction between drugs and cells from human bodies,DNA and physiological saline have been carried out with a MS-80 standard Calvet microcalorimeter.The experiments include: (1) Thermokinetic studies of the effect of anticancer drugs [sodium norcantharidate (ASN),the bioac- tire materials (Sp.P and Sp.S) from algae etc.]on the cancer cells [Hela,human breast carcinoma (Bcap-37),human adenocarcinoma gastric cells (SGc-7901 and MCF-7) etc.] and the normal cells from human bodies [diploid fibroblasts from human fetal lung (2BS) etc.] at 310.15 K:(2) Studies of the in- tercalation binding of some alkaloidal drugs with the bioactivity to inhibit monoamine oxidase (harmalinc and harmine etc.) to call thymus DNA in neutral aqueous solution at 298.15 K:(3) Studies of the interaction between long acting drugs (long acting oral contraceptive-norgestrel etc.) and slow- releasing drug (Contac) and aqueous solution of 0.9% NaCI at 310.15 K.All the experimental results have given their characteristic thermograms and the interaction enthalpy changes.On the analysis of all the results,the authors put forward a method on application of microcalorimetric technique for screen- ing and examination of medicines.The principle of application and the experimental operation of this method have been expounded,and some results of the above experiments have been discussed.As one of the methods for screening and examining medicines,the microcalorimctric method has some distin- guished features and advantages over other methods.

A Comparative Analysis of the Administration of Oral Hypoglycemic Drugs in Second Affiliated Hospital of Guiyang Medical College during 2012-2014

[Objective] This study aimed to analyze the application and administration of oral hypoglycemic drugs in Second Affiliated Hospital of Guiyang Medical College,aiming at providing guidance and reference for clinical medication for treatment of diabetes.[Method] The main types,dosages and prices of oral hypoglycemic drugs in Second Affiliated Hospital of Guiyang Medical College during 2012-2014 were compared and analyzed using the computer network system.[Result] During 2012-2014,sales quantity and sales amount of oral hypoglycemic drugs in Second Affiliated Hospital of Guiyang Medical College demonstrated an upward trend.[Conclusion] Integrative medicine can significantly improve symptoms of diabetes complications.Certain achievements have been made in diabetes treatment by Second Affiliated Hospital of Guiyang Medical College.

Recent advances in network pharmacology applications in Chinese herbal medicine

Network pharmacology is a new discipline based on the theory of systems biology and network analysis of biological systems to design the drugs.It comprehensively observes the intervention and influence of drugs on the disease network,and reveals the mystery of multi-molecular drugs synergistically acting on disease.These concepts reflect the ideas of multi-component,multi-target and system regulation,and have many similarities with the research ideas of traditional Chinese medicine,which focuses on syndrome differentiation and treatment,emphasizes the overall understanding of the etiology and pathogenesis.Network pharmacology can be used to predict and identify the target and active component of traditional herbal medicine,to clarify the mechanism of action,to scientifically explain the rules of the prescription,to explore the rules of real-world prescription,to discover new indications and new active compounds,and to study drug relocation,etc.The applications of network pharmacology in traditional herbal medicine were systematically summarized to demonstrate the significant value in these areas.

Effects of Huo Nao Fang in 60 Cases of Ischemic Apoplexy

To observe the therapeutic effects of the prescription of Huo Nao Fang (活脑方) on ischemic apoplexy,120 patients were divided into a treatment group and a control group, with 60 in each group, the formertreated with Huo Nao Fang while the latter with western medicine. The nervous function and bloodrheology were tested before and after treatment for both groups, and the effects of Huo Nao Fang wereevaluated. The results showed that the total effective rate was 91.7% in the treatment group and 61.6% inthe control group, with a significant difference (P＜0.01) between the two groups. The treatment group wassuperior to the control group in improving blood rheology, reducing blood lipid and restoring the nervousfunction (P＜0.05).

Clinical Observation in 31 Cases of Chronic Bronchitis at Remission Stage Treated with Bufei Keli

To observe the therapeutic effects of a Chinese drug Bufei Keli (补肺颗粒 granules for invigorating the lung) in the treatment of chronic bronchitis at remission stage, 62 cases were randomly divided into a treatment group (treated with Bufei Keli) and a control group (treated with Yupingfeng Keli 玉屏风颗粒). The results turned out to be that the short-term clinically controlled and markedly effective rate was 77.42% and the long-term relapse-resisting markedly effective rate was 74.2% in the treatment group, which were obviously higher than 45.16% and 38.71% respectively in the control group (P<0.05). And the increase in contents of SOD and CD_3 and the decrease in LPO content in the treatment group were also bigger than that in the control group (P<0.01). It is therefore concluded that Bufei Keli can improve qi deficiency syndrome and raise the immunity of patients with chronic bronchitis, hence its effect of resisting relapse of chronic bronchitis.

Jamu-A Healthy Drink of Indonesia

Jamu is traditional herbal medicine and a healthy drink considered by some Indonesians to be a primary element in their lives. The term ofjamu may be derived from ancient Javanese language ＂Djampi＂ that means a healing method using herb during the era of Ancient Java emerged since the 9th century AD. Jamu is consume either in fresh or in processed one. Some jamu sellers still found carrying their wares, in a basket fastened to their torsos using a sling made of fabric, and visit door to door in local neighborhoods. The name is Jamu gendong. The use of the j amu remains the same as the ancestors did. The visible proof is the use of traditional herbal medicine of various type of ＂medical plants＂, either from the leaves, the fruits, the roots, the flowers or the barks, etc. It is truly back to nature. These herbal medicine had been used since the ancient time up to now, it is largely consumed by people of different levels： lower, middle and upper, in the villages and in the big cities. Jamu as a cultural heritage has a big potential asset of Indonesia and is also one of Indonsia＇s cultural products based on local resources and the creativity of the nation. Indonesia has natural resourses of plants totaling about 30,000 species of flowering plants, which is the third largest in the world after Brazil and Zaire, including 7,000 species of medicinal plants, 940 species one could buy easily readymade jamu packed modernly in the form of powder, pills, capsules, drinking liquid and ointments. Of course there are still jamu shops, which only sell for those have been identified, 283 species are listed as raw materials that are used routinely in the medicine industry. Jamu from time to time has been widely accepted in almost every country in the world. It is not only as a preventive maintenance, but also as a curative treatment for acute and chronic treatment. At present ingredients ofjamu and its preparation spot as required by buyers. Some women are roaming the street to sell jamu, which is a common view across the country. At present time, jamu has also been produced in mass by manufacturers for export, and mostly concerns on quality, consistency, and cleanliness either locally or internationally distributed.

某三级医院中医药联合西医用药管理措施探讨

目的:为加强联合用药的合理性,探究某三级医院中医药联合西医用药管理措施。方法:随机选择医院急诊科2020年3月~2021年3月收治的120例患者为研究对象,随机均分为对照组和观察组各60例,两组患者均执行中医药联合西医用药方案,观察组在此基础上实施加强药物管理,比较两组患者的管理效果。结果:观察组患者用药总合理率,显著高于对照组(P<0.05)。观察组患者管理效果的各方面评分,均显著高于对照组(P<0.05)。结论:在医院急诊科应用综合性管控,可有效提高处方质量,确保了用药安全性。

Biomechanopharmacology in Evaluation of Herbs of Activating Blood Circulation to Remove Blood Stasis

Herbs of activating blood circulation to remove blood stasis (ABCRBS) are a category of over 10% in the modern Chinese Pharmacopoeia. A new borderline discipline, biomechanopharmacology, is shaping by the efforts of applying biomechanics in pharmacological studies of ABCRBS herbs. Biomechanics is involved in modeling of blood stasis syndrome (BSS) with mechanical force induced injury and model evaluation by shear stress monitoring for blood coagulation. Investigations showed that tetramethylpyrazine (TMP) contained in Ligusticum chuanxiong Hort and diallyl trisulfide (DT) extracted from garlic demonstrated inhibiting characteristics on vWF mediated platelet activation and thrombus formation occurring under high shear rates. The effect of TMP on shear-induced platelet aggregation might be due to inhibition of calcium channel activity since it showed significant inhibition on intracellular level of calcium demonstrated by laser confocal microscope. The combined effects of TMP and shear stress on rat cerebral microvascular endothelial cell (rCMEC) were investigated by various doses of TMP incorporated with different levels of shear stress generated by a rotational cone-plate rheometer. The results indicated that apoptosis of rCMECs could be restrained by a combination of medial level of shear stress with a suitable dose of TMP. To study the influences of shear stress, pressure and TMP on angiogenesis of vascular endothelial cell, cultured rCMEC was pretreated in a flow chamber with independent adjustment for levels of shear stress and pressure, and then 3D cultured on Matrigel. The results indicate that combined effects of shear stress, pressure and TMP may influence angiogenesis significantly. We believe that research on interactions among blood shear stress, secretion of endothelial cell, and pharmacodynamics will be an interesting area of biomechanopharmacology. Herbs of ABCRBS and their extracts for protecting endothelial cells to maintain their normal functions are expected.

THE CLINICAL ANALYSIS OF HYPNOTICS AND SEDATIVES USED IN OUTPATIENT CLINICS IN GENERAL HOSPITAL

Aim. To statistic the usage of hypnotics and sedatives in outpatient and emergency clinics prescriptions in one day. Method. Check all prescriptions on April 29, 1987 and November 13, 1995 in order to know the quantity, kind and distribution of hypnotics and sedatives in different outpatient departments. Result. There were 1 319 prescriptions on April 29, 1987. Among them, hypnotics and sedatives were 122(9. 24%); in comparing with 2 065 prescriptions on November 13, 1995, hypnotics and sedatives were 141 (6. 82%). Benzodiazepine used more than 80% in all prescriptions. Conclusion. The possibility of long-term low-dosage using benzodiazepine is present. It must strengthen the control and education to avoid the drug-abuse.

Impacts of National Basic Medical Insurance Drug List adjustment on drug utilization in China: an interrupted time series study

Under Chinese medicine and health care system, Medicine Catalogue for National Basic Medical Insurance（2009） was issued in 2009 in China to fulfill the basic drug demands of the insured Chinese and to control the medical expenses. In this study, the influence of the list adjustment on drug utilization was investigated. With the comparison between inpatients＇ use of drugs before and after adjustment of Basic Medical Insurance Drug List, we classified the drugs adjusted in national list into six categories： class A to class B, class B to class A, class A to class C, class B to class C, class C to class A, and class C to class B（class A referring to overall insured drugs, class B referring to partial reimbursement drugs, class C referring to self-funded drugs in China）, and drug utilization and expenditure were analyzed with time series model. We analyzed the overall expenditure and average expenditure per 10 000 people based on the comparison before and after the adjustment of 2009 Basic Medical Insurance Drug List. The drug expenditure from class A to class B was decreased by 13.87% of overall expenditure and 16.37% of average expenditure per 10 000 people, and it was decreased by 38.74% and 48.03% from class A to class C; respectively, the drug expenditure from class B to class A was increased by 74.12% and 94.52%, while it was reduced by 19.79% and 14.52% from class B to class C; expenditure declined by 31.77% and 36.22% from class C to class A, and expenditure was increased by 12.42% and 22.05% from class C to class B, respectively, both were lower than before. The adjustment of National Basic Medical Insurance Drug List reduced the overall drug expenditure.

Trends on medicine use in county public hospitals in Sanming,China from 2011 to 2017

Sanming model in healthcare reform has attracted much attention due to its comprehensive and efficient exploration,while its impact on physicians’prescribing behavior remains unknown.In the present study,we aimed to evaluate the impact of Sanming reform on physicians’medicine use in county-level public hospitals.We collected outpatient prescriptions in the internal medicine and pediatric departments from nine county public hospitals in Sanming from January 2011 to December 2017.We used six prescribing indicators to analyze physicians’medicine use.The Mann-Kendall test was used to examine trends in the study outcomes.A total of 1577904 outpatient prescriptions were included in this study.The average prescription rate of antibiotics and combined antibiotics were 57.5%and 12.2%in 2011,respectively,which were declined to 28.2%(P=0.007)and 2.9%(P=0.003)in 2017,respectively.The average prescription rate of injection was 30.2%in 2011 and declined to 5.3%(P=0.003)in 2017.As for the subgroup analysis of the internal medicine and pediatric departments,the average prescription rate of antibiotics was 39.3%and 71.4%in 2011,respectively,which was declined to 10.2%(P=0.003)and 47.3%(P=0.035)in 2017,respectively.The average prescription rate of combined antibiotics was 15.9%and 9.4%in 2011,respectively,which was declined to 2.9%(P=0.003)and 2.9%(P=0.016),respectively.The average prescription rate of injection was 17.8%and 39.6%in 2011,respectively,which was declined to 1.9%(P=0.003)and 9.0%(P=0.003),respectively.Our study showed a significant decreasing trend in antibiotic use in county-level public hospitals after the Sanming healthcare reform,indicating that the reform successfully promoted the appropriate use of medicine to some extent.

The impacts of national essential medicine policies on the rational use of medicines in China: A cross-sectional study in primary health care institution

Irrational use of medicines is a major problem worldwide, and it is believed there would be positive correlation between the National Essential Medicines Policies(NEMPs) and the level of rational use of medicines(RUMs). Though there is some early evidence on the NEMPs’ effects on RUMs in China, the evidence is scarce, and conclusions vary. In the present study, we aimed to evaluate the impacts of the NEMPs of China on the RUMs in the primary health care institutions(PHCs). A cross-sectional survey was conducted in 2010. A total of 201 PHCs from six provinces of China were selected, and 39 181 prescriptions were extracted from January to June, 2010. Six indicators were used and tested by independent-samples T test. We found that the average number of drugs per prescription in PHCs with NEMP implementation(the treatment group) was significantly higher than that of the group without NEMP implementation(the control group)(3.37 vs. 2.83, P<0.01). There was no significant difference in the average cost per prescription(81.43 vs. 75.02). The percentage of prescriptions, including an antibiotic(53.40% vs. 36.48%, P<0.01) or an injection(40.54% vs. 27.94%, P<0.01), was higher in the treatment group, and the percentage of drugs prescribed by general name was significantly lower(83.71% vs. 93.11%, P<0.01). For the percentage of drugs prescribed from essential medicines list, the treatment group exhibited the higher ratio(76.12% vs. 53.45%, P<0.01). From this study, the NEMPs were not likely to have a positive impact on RUMs. China still needed efforts to improve the selection, the absence of physicians’ active involvement, and the patients’ habits of irrational medication use.

Research ideas and strategies on the dose-effect relationship of traditional Chinese medicine prescriptions and herbs

We discuss here the complexity of the doses of traditional Chinese medicine(TCM) prescriptions and herbs from different viewpoints,including the heterogeneity of drug quality,the flexibility of prescriptions,and the diversity of drug effects.Then,the corresponding research ideas and strategies are proposed.We can reveal the actual situation of clinical doses based on in-depth "real-world study" of the safety and effectiveness of TCM prescriptions,create an analytical method for dose-effect relationships in accordance with the features of TCM,and reveal the correlated regular nature of the effectiveness and dosage of TCM prescriptions and herbs.