Clinical efficacy and safety of TCM prescriptions combined with nucleoside(acid)analogues in treating chronic hepatitis B:a meta-analysis

Objective There are many clinical reports on traditional Chinese medicine(TCM)combined with nucleoside(acid)analogues(NAs)for the treatment of chronic hepatitis B(CHB),but its efficacy and safety are not completely clear.This meta-analysis aims to evaluate the clinical efficacy and safety thus providing evidence for clinical applications.Methods We searched Chinese databases the China National Knowledge Infrastructure(CNKI),Wanfang Data,and China Science and Technology Journal Database(VIP),as well as English databases Pub Med and Cochrane Library,from time of establishment to April 14,2021.Literature quality was evaluated according to the bias risk assessment criteria of Cochrane Collaboration network.Rev Man 5.3 and Stata 12.0 software were used to perform this research.Results A total of 23 articles,3282 patients,and 25 TCM prescriptions were included in this study.NAs plus TCM remarkably improved the clinical total effective rate[Odds ratio(OR)=3.92,P<0.00001],TCM syndrome score(Mean difference=-3.73,P<0.00001),hepatitis B virus(HBV)DNA negative conversion rate(OR=1.49,P=0.0001),hepatitis Be antigen(HBe Ag)negative conversion rate(OR=2.03,P<0.00001),alanine aminotransferase levels[Std mean difference(SMD)=-0.95,P<0.00001],and aspartate aminotransferase levels(SMD=-0.70,P=0.0004).Adverse reaction rates did not increase in the combined treatment group(OR=0.97,P=0.84).A comprehensive analysis of the 25 TCM prescriptions suggested that the combination of spleen-strengthening prescriptions with NAs showed better effects than other prescriptions.Conclusion TCM in combination with NAs,demonstrated better clinical efficacy against CHB than NAs alone.In addition,the combination of spleen-strengthening prescriptions and NAs was identified as the best therapeutic strategy.However,more randomized controlled trials of high quality are needed to provide more reliable clinical basis for the application of TCM.

Integrated data mining and network pharmacology to discover a novel traditional Chinese medicine prescription against diabetic retinopathy and reveal its mechanism

Background:Diabetic retinopathy(DR)is currently the leading cause of blindness in elderly individuals with diabetes.Traditional Chinese medicine(TCM)prescriptions have shown remarkable effectiveness for treating DR.This study aimed to screen a novel TCM prescription against DR from patents and elucidate its medication rule and molecular mechanism using data mining,network pharmacology,molecular docking and molecular dynamics(MD)simulation.Method:TCM prescriptions for treating DR was collected from patents and a novel TCM prescription was identified using data mining.Subsequently,the mechanism of the novel TCM prescription against DR was explored by constructing a network of core TCMs-core active ingredients-core targets-core pathways.Finally,molecular docking and MD simulation were employed to validate the findings from network pharmacology.Result:The TCMs of the collected prescriptions primarily possessed bitter and cold properties with heat-clearing and supplementing effects,attributed to the liver,lung and kidney channels.Notably,a novel TCM prescription for treating DR was identified,composed of Lycii Fructus,Chrysanthemi Flos,Astragali Radix and Angelicae Sinensis Radix.Twenty core active ingredients and ten core targets of the novel TCM prescription for treating DR were screened.Moreover,the novel TCM prescription played a crucial role for treating DR by inhibiting inflammatory response,oxidative stress,retinal pigment epithelium cell apoptosis and retinal neovascularization through various pathways,such as the AGE-RAGE signaling pathway in diabetic complications and the MAPK signaling pathway.Finally,molecular docking and MD simulation demonstrated that almost all core active ingredients exhibited satisfactory binding energies to core targets.Conclusions:This study identified a novel TCM prescription and unveiled its multi-component,multi-target and multi-pathway characteristics for treating DR.These findings provide a scientific basis and novel insights into the development of drugs for DR prevention and treatment.

Research on the Progress of Treating Gastroesophageal Reflux Disease with Modified Classic Traditional Chinese Medicine Prescription

Gastroesophageal reflux disease (GERD) is a high-incidence digestive system disease. Western medicine mainly uses drugs such as proton pump inhibitors to inhibit gastric acid secretion, but some patients are accompanied by symptoms such as non-acid reflux and gas reflux, which cannot effectively treat the disease. It is necessary to actively explore other treatment schemes. Traditional Chinese medicine (TCM) has a long history of research on gastroesophageal reflux disease, which emphasizes the treatment based on syndrome differentiation as a whole. Through the treatment of various and multi-component TCM prescriptions, the patient’s body condition can be adjusted, and the treatment effect on gastroesophageal reflux disease is reliable, which has obvious therapeutic advantages. To further clarify the treatment of gastroesophageal reflux disease, this study reviewed and analyzed the research progress of the treatment of liver disease with modified prescriptions, and the report is as follows.

China Association of Chinese Medicine Paper notice for seminar on clinical application of TCM classic prescriptions and herbs in the treatment of emotional diseases

Hosted by ChinaAssociation of Chinese Medicine,and organized by World Journal of Integrated traditional and western Medicine,seminar on clinical application of TCM classic prescriptions and herbs in the treatment of emotional diseaseis planned to be held in Yichang,Hubei province from June 22nd to 24th.

Analysis on the Pharmacists Intervention Results of the Problems from 2000 Prescriptions of Chinese Herbal Pieces

OBJECTIVE: To interfere with the improper prescriptions of Chinese herbal pieces issued by the outpatient doctors so as to reduce the doctor's prescription error rate and ensure the safety of medication for patients. METHODS:Based on Prescription Administrative Policy, Management Standard of Chinese Herbal Pieces in Hospital, and Beijing Chinese Herbal Pieces Dispensing Regulation, 2000 prescriptions were collected and analyzed according to the different intervention, and solutions were put forward for a variety of reasons. RESULTS: In 2000 prescriptions, there were 932 prescriptions containing toxic drug overdose without double signature, 577 prescriptions of dose error, 282 prescriptions of ingredients error, 85 prescriptions with wrong route of administration, 73 prescriptions of herb incompatibility without double signature, and 51 prescriptions with repeat herbs, accounting for 46.5%, 28.85%, 14.1%, 4.25%, 3.65% and2.55% of the total number of prescriptions respectively. After the intervention of pharmacists, 2000 prescriptions were all successfully intervened to protect the safety of medication. CONCLUSIONS: TCM pharmacist should double check prescriptions with errors issued by doctors, so as to reduce the prescription error rate, and ensure the safety of medication and rehabilitation of patients, and then improve values of pharmacists.

Analysis on the Medication Law of Drug Pair Acorus Tatarinowii-Polygala Tenuifolia Based on the Dictionary of Traditional Chinese Medicine Prescriptions

Objective:Using data mining method to dig and sort out the prescriptions with Acorus tatarinowiiPolygala tenuifolia drug pair,and summarize the medication characteristics and compatibility of their prescriptions after preliminary screening.Methods:By searching the Dictionary of Traditional Chinese Medicine Prescriptions,a standardized database of prescriptions was established,and the properties,tastes and meridian tropism of prescriptions were classified,and the indications of prescriptions and core combinations of traditional Chinese medicines were analyzed.Results:178 prescriptions were collected,of which 210 were related.Most of the drugs were warm in nature and sweet in taste,and mainly return to the heart and kidney meridians.Under the same confidence and different support,the core drug combination for treating brain diseases was Acorus tatarinowiiPolygala tenuifolia-Ginseng,and the core drug combination for treating asthenia was Acorus tatarinowii-Poria cocos-Rehmannia glutinosa-Polygala tenuifolia.Conclusion:The compatibility characteristics of the prescriptions containing Acorus Tatarinowii and Polygala tenuifolia in the Dictionary of Traditional Chinese Medicine Prescriptions are remarkable,which provides reference for scientific guidance of clinical rational drug use and basic research of prescriptions containing Acorus tatarinowii and Polygala tenuifolia.

基于数据挖掘的痛经用药规律研究

目的:基于数据挖掘技术分析《中医方剂大辞典》中治疗痛经方剂的用药规律。方法:根据纳入与排除标准筛选出《中医方剂大辞典》中治疗痛经的方剂,对其进行方药名称规范,运用Excel、IBM SPSS Modeler 18.0、IBM SPSS Statistics 26.0等进行频数统计、关联规则分析、聚类分析及因子分析。结果:共纳入151首治疗痛经的方剂,涉及中药191味;其中出现频次≥10的中药为当归、川芎、延胡索、白芍、香附、甘草等共36味,药效以补虚药、活血化瘀药、理气药为主,药性偏温、寒、平,药味则偏辛、苦、甘,多入肝、脾、心经。选取出现频次≥25的13味高频药物进行关联规则分析,得到“当归-川芎“”当归-香附-川芎“”当归-熟地黄-白芍-川芎”等常用药对21组,并通过提升关联规则的支持度得到“当归-川芎-白芍”核心组合。进行高频药物聚类分析得出4类药物组合,C1:白芍、熟地黄、川芎、当归;C2:牡丹皮、茯苓;C3:香附、甘草;C4:桃仁、红花,因子分析得到5个公因子。结论《:中医方剂大辞典》中治疗痛经以补血活血、化瘀散结、疏肝理气为主。

补肾健脾通络方治疗老年衰弱综合征临床疗效观察

目的观察补肾健脾通络方治疗老年衰弱综合征临床疗效及安全性。方法研究纳入2021年1月—2022年6月收治的老年衰弱综合征患者共计102例,以随机数字表法将患者分为对照组与观察组,每组51例,对照组患者采取临床常规治疗,观察组患者采取常规治疗结合补肾健脾通络方治疗。观察各组数据:治疗总有效率、治疗前后患者中医证候总积分变化及Fried表型衰弱量表(frailty phenotype,FP)评分变化及白介素-6(interleukin 6,IL-6)、超敏C反应蛋白(C-ReactiveProtein,hs-CRP)水平变化、握力变化及起立-行走计时测试(Timed Up and Go test,TUG)变化、5次坐立试验(five-times-sit-to-stand test,FTSST)变化、步速变化、体质指数(Body Mass Index,BMI)变化及四肢骨骼肌质量指数(appendicular skeletal muscle mass index,ASMI)变化、简易精神状态评分(Mini-mental State Examination,MMSE)变化、匹兹堡睡眠指数(Pittsburgh sleep quality index,PSQI)评分变化、日常生活能力(Activity of Daily Living,ADL)评分变化、微型营养评估(mini nutritionaal assessment,MNA)评分变化、患者治疗满意度、不良反应。结果观察组患者治疗总有效率比对照组高[96.08%(49/51)vs84.31%(43/51)],P<0.05;治疗前,各组患者中医证候总积分、FP评分、IL-6、hs-CRP水平、握力、TUG测试结果及FTSST测试结果、步速、BMI、ASMI、MMSE评分、PSQI评分、ADL评分、MNA评分比较,P>0.05,治疗后各组患者中医证候总积分、FP评分、IL-6、hs-CRP水平、握力、TUG测试结果及FTSST测试结果、步速、BMI、ASMI、MMSE评分、PSQI评分、ADL评分、MNA评分均改善,观察组患者治疗后中医证候总积分、FP评分、IL-6、hs-CRP水平、握力、TUG测试结果及FTSST测试结果、步速、BMI、ASMI、MMSE评分、PSQI评分、ADL评分、MNA评分均优于对照组患者,P<0.05;观察组患者治疗满意度高于对照组[98.04%(50/51)vs84.31%(43/51)],P<0.05;观察组与对照组不良反应率均较低,且可自行缓解,P>0.05。结论补肾健脾通络方治疗老年衰弱综合征临床疗效显著,能缓解衰弱综合征患者的临床症状,抑制患者机体炎性反应,增加肌肉质量,改善睡眠,提高生活质量,且无不良反应,较为安全可靠,值得应用。

基于大语言预训练模型的中医个性化处方推荐研究

目的针对中医个性化处方推荐问题,研究自动化处方推荐任务,为中医临床辅助决策提供参考。方法基于大语言预训练文本生成模型设计一种中医个性化处方推荐算法。将中医处方推荐任务转化为端到端(seq2seq)的文本生成任务,即将临床症状描述文本通过模型转化为处方文本,以实现处方推荐任务的需求,并利用基于大语言预训练的BART(Bidirectional and Auto-Regressive Transformers)模型的预训练参数来提升模型对通用语义信息的理解,通过对训练集处方内中药排序提升模型的处方推荐性能。结果实验证明通过大语言预训练模型以及端到端的文本生成架构可有效提升模型的生成性能,同时对处方内中药依次排序可以获取更高准确率,并且通过中药的排列获取更多值得参考的有价值信息。中医个性化处方推荐模型在处方排序后分别在前5、10、15味生成的处方分别取得了58.60、53.79和49.67的准确率。结论中医个性化处方推荐模型取得了更优的处方推荐效果,表明其可为中医临床治疗疾病进行参考,达到辅助临床决策支持的效果。

基于网络药理学的中药组方治疗骨质疏松症的用药规律研究

目的 分析国家专利中药组方治疗骨质疏松症的用药规律并进行网络药理学分析。方法 在国家知识产权局网站中检索治疗慢骨质疏松的中药组方,规范药名后进行中药频数分析、性味归经分析,组方规律分析,药物靶点频数分析,k-means降维PPI分析、GO-BP生物学功能富集分析和KEGGPathway分析。结果 共纳入112项专利中药组方,涉及156味中药,其中淫羊藿的使用频次最高。药性以温性、平性、寒常见;五味多为甘、苦、辛;归经多归属肝经、肾经、脾经。关联规则分析提示常用的药对组合为牡蛎—淫羊藿,三七—当归,黄芪—淫羊藿等。核心靶点主要是AR、ESR1、ESR2、NR1I2、SHBG、VDR、NR3C1,GABRA家族和GABRG家族等。k-mean聚类分析PPI互作网络可降维成4类,与临床分型密切相关。GO和KEGG-Pathway分析表明中药复方主要通过神经活性配体-受体相互作用,氯化物跨膜转运,类固醇激素生物合成,碳水化合物的消化和多种物质成瘾的信号通路,通过消化吸收,神经信号和递质传递,类固醇的代谢,氯离子的转运等功能发挥防治骨质疏松症的作用。结论 结果表明中药治疗原发性骨质疏松症有规律可循,为中药治疗骨质疏松提供了理论依据,为中药的临床研究和基础研究提供了新的思路。

补虚化瘀组方治疗原发性胆汁性胆管炎的效果

目的探究补虚化瘀组方对原发性胆汁性胆管炎(primary biliary cholangitis,PBC)中医临床症状及免疫功能的影响。方法选取80例PBC患者作为研究对象,用单双球法随机分为对照组和治疗组,每组40例。对照组给予基础治疗,治疗组在基础治疗的基础上予以补虚化瘀组方治疗。比较治疗前和治疗6个月后,2组患者中医症候积分(腹胀、胁肋疼痛、乏力、皮肤瘙痒及大便不调)、肝功能指标[天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、谷氨酰转肽酶(glutamyl transpeptidase,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)及总胆红素(total bilirubin,TB)]、免疫功能[免疫细胞(CD4^(+)、CD8^(+))、免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)及免疫球蛋白M(immunoglobulin M,IgM)],记录2组患者不良反应(头晕、恶心呕吐、腹泻及皮疹)的发生情况。结果治疗6个月后,2组患者的中医症候积分、肝功能指标及免疫功能均降低,且治疗组低于对照组(均P<0.05);6个月内,治疗组熊去氧胆酸(ursodeoxycholic acid,UDCA)应答率高于对照组(P<0.05),2组患者总不良反应发生率比较差异无统计学意义(P>0.05)。结论补虚化瘀组方可以改善PBC患者中医临床症状及肝功能,增强患者免疫力,减少不良反应的发生。

基于《中医方剂大辞典》的雷丸组方用药规律分析

目的 基于数据挖掘方法探究《中医方剂大辞典》中雷丸的组方用药规律。方法 以《中医方剂大辞典》为信息源,梳理含雷丸的方剂,构建雷丸方药数据库;采用文献分析和数据挖掘方法,探讨雷丸的增效减毒及其方剂主治病症类型、药物配伍情况;利用关联规则分析探寻其在常见病中的配伍特点;使用皮尔逊相关性分析发掘药-证的相关性,总结其用药规律。结果 含有雷丸方剂的剂型主要为丸剂和散剂,高频用药为槟榔、大黄、木香等,与雷丸配伍的主要为驱虫药、泻下药及理气药等,且味多为苦、辛,归胃经、脾经。其中“槟榔-雷丸”出现的药对配伍频数最高,其次是“大黄-雷丸”“木香-雷丸”;雷丸方剂的主治病症为虫积的频数最高,其次为疳证、积滞等。皮尔逊相关性分析结果表明,治疗虫积配伍槟榔、木香、使君子、芜荑、鹤虱等;治疗疳证配伍胡黄连、黄连、青皮等;治疗积滞配伍神曲、陈皮、牵牛子、三棱等。结论 雷丸与槟榔等配伍可加强杀虫消积的功效;与胡黄连、大黄等配伍可增加泻下攻积的作用,以上可能会引起轻微的胃肠道不良反应;与陈皮、神曲等配伍可保护胃黏膜,减轻胃肠不良反应。但雷丸毒性物质基础研究等未见报道,仍需深入研究,为雷丸临床应用提供更确切的基础。

常克教授基于痰、湿、瘀理论以经方论治儿童腺样体肥大经验

仲景经典医著《伤寒论》和《金匮要略》在儿科有着广泛的应用与实践,通过总结常克教授的临床经验,探索仲景经方治疗儿童腺样体肥大的治疗思路,系统整理儿童腺样体肥大的证治规律,开拓儿童腺样体肥大的治疗。

从《伤寒论》少阴篇讨论阳虚阴盛证辨治规律

[目的]讨论《伤寒论》中阳虚阴盛证的病势、层次、治法及用药规律,探究并扩充阳虚阴盛证的辨治规律及临床意义。[方法]结合后世医家的医论,明确阳虚阴盛证的病机及证候;从病理生理学角度,阐释阳虚阴盛证的机制;分析少阴篇中各版本条文的差异,论述病位、邪气性质、胃气、津液的不同,治法、主方、配伍的变化,归纳在少阴篇中隐含的辨治规律。[结果]阳虚阴盛证的辨治原则是“保胃气、存津液”,可将其细分为太阴湿土病、少阴君火病、厥阴风木病。细致的望闻问切,并结合现代医学的病理生理基础能精确辨阳虚阴盛证。少阴为三阴枢机,少阴篇结构完整,能动态反映少阴发病、两阴合病或并病、三阴合病的相互变化过程。由条文可发现,病位由表入里,治法有灸焫、温经、温阳、通阳之别;病情由轻而重、痰饮有无,治法有散寒、散饮、利水之别;津液损伤程度不同,治法有救逆、救阴之别。[结论]从病理生理角度,能阐释中医主症的变化机制。辨治阳虚阴盛证时,应根据病位、邪气性质、胃气、津液择取方药,阳虚阴盛证的辨治规律对于其他证候的辨治同样具有指导意义。

基于数据挖掘的中医药治疗颈性眩晕证治方药规律研究

目的基于数据挖掘方法探讨中医药治疗颈性眩晕的证治方药规律。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(VIP)2013年1月1日-2023年1月1日中医药治疗颈性眩晕研究文献,运用WPS Office 11.1.0.14036软件统计方剂、疗法、证型、药物及药物性味归经的频次、频率;运用SPSS Statistics 25.0、SPSS Modeler 18.0软件对方药进行聚类分析和关联规则分析。结果纳入研究文献155篇,包含中医证型24种,方剂162首,中药119味。证型以痰湿中阻证、气血亏虚证为主,常用方剂类别为祛痰剂、补益剂,其中半夏白术天麻汤、益气聪明汤使用频次最高;常用药物类别为补虚药、解表药、活血化瘀药、平肝息风药、化痰药;药性以温性为主,药味以甘味为主,归经以脾经为主。聚类分析得出4个聚类方,关联规则分析得出11组药物组合。结论颈性眩晕主要证型为痰湿中阻证、气血亏虚证,治以化痰祛湿、益气升阳,方剂多选用半夏白术天麻汤、益气聪明汤;用药多性温味甘,以白术、半夏、天麻、葛根、茯苓为主。

中医药治疗肺癌的用药规律

目的:探究中医药治疗肺癌的用药规律。方法:检索《肿瘤良方大全》《肿瘤方剂大辞典》《卫生部药品标准中药成方制剂》以及《国家药品监督管理局总局国家药品标准(修订)颁布件》中中医治疗肺癌的处方,将数据录入Excel进行数据处理,使用Lantern 5.0、SPSS Modeler 18.0及SPSS Statistics 25.0对肺癌方剂频次统计、系统聚类分析及关联规则分析。结果:共纳入650个处方,572种药,6 120次。药性以寒、温、平为主,药味以苦、甘、辛为主,归经使用最多为胃、脾、肾、肝、肺。使用频次最多的药物为黄芪、白花蛇舌草、甘草、茯苓、沙参、麦冬等。高频药物以清热解毒药和益气养阴药及活血化瘀药主;关联规则分析得到药对关联16条,三联24条,因子内得到13个公因子,系统聚类分析得出7个关联紧密的药组。隐结构得到14个隐变量,每个隐变量有2个隐类,共28个隐类。结论:补气养阴药和清热抗癌解毒、活血化瘀药、健脾利湿药、清热化痰治则,为中医药治疗肺癌提供借鉴,有待进一步结合临床及实验给予验证。

基于方剂计量学对全国名中医周铭心教授治疗湿疹用药规律的数据挖掘

目的:运用周铭心教授所创“方剂计量学”研究方法对周师诊治湿疹的医案处方进行研究,挖掘其用药范围、药性构成和制方规律,总结方剂组成配伍法则和临床运用规律。方法:筛选2018年1月-2021年6月周铭心教授治疗湿疹有效病案50例,对所用药物名称、性味、归经和类别进行统计分析,并采用统计软件SPSS 26.0对数据进行系统聚类分析。结果:周铭心教授治疗湿疹用药总数96味,用药频数592次;用药药性以寒、温、平、微寒性为主,药味以苦、辛、甘味为主;用药归经以归肝经为主,次归肺、胃、脾、心经;用药以清热燥湿药、发散风寒药、祛风寒湿药、利尿通淋药、养心安神药、化湿药、发散风热药、息风止痉药为主;常用药物为白鲜皮、乌梢蛇、地肤子、荆芥、天麻、浮萍、酸枣仁、苍术、防风、白芷、苦参、蝉蜕、栀子、重楼、合欢皮、龙骨、牡蛎、砂仁、白芍、白术、黄柏、黄连、黄芩、茯苓、土茯苓、当归、黄芪、芥子、羌活、首乌藤、西洋参等;本证用药为白鲜皮、乌梢蛇、地肤子、荆芥、天麻等;单元药组:4组对药,2组角药。结论:周铭心教授以“风湿伏郁肌卫”为湿疹“本病病机”,以“祛风燥湿宣卫”为法治疗湿疹的学术经验特色突出,疗效确切,值得借鉴推广。

基于“治未病”理论挖掘中药复方治疗支气管扩张症的用药规律

目的:基于“治未病”理论分析国家专利数据库中治疗支气管扩张症的用药规律,为临床治疗提供新思路。方法:检索国家知识产权局公开专利公布公告,检索建库至2023年3月1日专治支气管扩张症的国家中药复方专利,进行中药复方药物筛选后导入Microsoft Excel 2021,建立数据库,对数据予以规范后进行频次、功效、四气五味、归经处理分析,用IBM SPSS Modeler 18.0、IBM SPSS Statistics 26.0软件进行关联规则和聚类分析,同时用Cytoscape 3.8.0进行核心中药可视化,挖掘核心药物及潜在组方规律。结果:共筛选出中药复方96首,共涉及中药342味,出现频次1402次,出现频次较高的中药为甘草、黄芩、桑白皮、生地黄、苦杏仁,中药出现频次≥10者占总频次的51.28%;归经以肺经、肝经、胃经为主,四气五味以甘、苦、寒、平为主;药物关联规则分析得出二项关联药对3组、三项关联药对15组;聚类分析发现8组潜在组方。结论:在“治未病”理论指导下,清热化痰、止血、补虚、化瘀的中药及其组合无疑是治疗支气管扩张症的首选,为日后新药的研发提供支撑。

强化用药管理联合精益管理对中药饮片处方合理性及用药安全性的影响

目的:分析强化用药管理联合精益管理对中药饮片处方合理性及用药安全性的影响。方法:抽取2018年7月—2019年11月期间我院中药房的中药饮片处方共240份,其中,2018年7月—12月服用中药饮片治疗的患者120例实施传统管理,纳入实施前,2019年6月—11月服用中药饮片治疗的患者120例实施强化用药管理联合精益管理,并纳入实施后。评价及对比实施前后处方用药不良情况、服药不良反应发生率、处方调剂质量、患者治疗满意度。结果:实施后的处方用药不良情况发生率低于实施前(P<0.05);实施后患者的服药不良反应率低于实施前患者(P<0.05);实施后的处方调剂差错率低于实施前(P<0.05);实施后患者的治疗满意度高于实施前(P<0.05)。结论:对中药饮片处方实施强化用药管理联合精益管理,可确保处方用药合理性,提高处方调剂质量,减少服药后不良反应,患者治疗满意度高,具有借鉴应用价值。

滋阴化痰方治疗阴虚痰凝型良性甲状腺结节的临床疗效

【目的】探讨滋阴化痰方(由消瘰丸加味组方而成)治疗阴虚痰凝型良性甲状腺结节的临床疗效。【方法】将62例阴虚痰凝型良性甲状腺结节患者随机分为试验组和对照组,每组各31例。2组患者均给予清淡饮食、少食辛辣刺激食物、适当运动和保持心情舒畅等基础治疗,在此基础上,试验组给予滋阴化痰方治疗,对照组给予左甲状腺素钠片治疗,疗程为3个月。观察2组患者治疗前后中医证候积分、甲状腺结节最大直径及甲状腺功能指标的变化情况,并评价2组患者的临床疾病疗效和中医证候疗效。【结果】(1)疾病疗效方面,治疗3个月后,试验组的总有效率为90.32%(28/31),对照组为48.39%(15/31),组间比较,试验组的临床疾病疗效明显优于对照组(P<0.05)。(2)中医证候疗效方面,治疗3个月后,试验组的总有效率为77.42%(24/31),对照组为38.71%(12/31),组间比较,试验组的中医证候疗效明显优于对照组(P<0.01)。(3)中医证候积分方面,治疗后,试验组的中医证候积分较治疗前明显降低(P<0.01),而对照组无明显降低(P>0.05);组间比较,试验组对中医证候积分的降低作用明显优于对照组(P<0.05)。(4)结节最大直径方面,治疗后,2组患者的甲状腺结节最大直径均较治疗前缩小(P<0.05或P<0.01),且试验组对甲状腺结节最大直径的缩小作用优于对照组(P<0.05)。(5)甲状腺功能指标方面,2组患者在治疗前后的各项甲状腺功能指标均无明显变化,差异均无统计学意义(P>0.05)。【结论】滋阴化痰方在改善良性甲状腺结节患者临床症状、缩小甲状腺结节方面疗效显著,且无明显不良反应,具有较高的安全性。