Therapeutic efficacy of methylprednisolone sodium succinate via diverse administration routes for mid-to high-frequency sudden sensorineural hearing loss

BACKGROUND Sudden sensorineural hearing loss(SSNHL),characterized by a rapid and unexplained loss of hearing,particularly at moderate to high frequencies,presents a significant clinical challenge.The therapeutic use of methylprednisolone sodium succinate(MPSS)via different administration routes,in combination with conventional medications,remains a topic of interest.AIM To compare the therapeutic efficacy of MPSS administered via different routes in combination with conventional drugs for the treatment of mid-to high-frequency SSNHL.METHODS The medical records of 109 patients with mid-to high-frequency SSNHL were analyzed.The patients were divided into three groups based on the route of administration:Group A[intratympanic(IT)injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection],Group B(intravenous injection of MPSS combined with mecobalamin and Ginkgo biloba leaf extract injection),and Group C(single IT injection of MPSS).The intervention effects were compared and analyzed.RESULTS The posttreatment auditory thresholds in Group A(21.23±3.34)were significantly lower than those in Groups B(28.52±3.36)and C(30.23±4.21;P<0.05).Group A also exhibited a significantly greater speech recognition rate(92.23±5.34)than Groups B and C.The disappearance time of tinnitus,time to hearing recovery,and disappearance time of vertigo in Group A were significantly shorter than those in Groups B and C(P<0.05).The total effective rate in Group A(97.56%)was significantly greater than that in Groups B and C(77.14%and 78.79%,χ^(2)=7.898,P=0.019).Moreover,the incidence of adverse reactions in Groups A and C was significantly lower than that in Group B(4.88%,3.03%vs 2.57%,χ^(2)=11.443,P=0.003),and the recurrence rate in Group A was significantly lower than that in Groups B and C(2.44%vs 20.00%vs 21.21%,χ^(2)=7.120,P=0.028).CONCLUSION IT injection of MPSS combined with conventional treatment demonstrates superior efficacy and safety compared to systemic administration via intravenous infusion and a single IT injection of MPSS.This approach effectively improves patients'hearing and reduces the risk of disease recurrence.

Retinal Functional Changes Measured by Microperimetry after Intravitreal Ranibizumab Injection and Sulfotanshinone Sodium Injection for Macular Edema Secondary to Retinal Vein Occlusion

Objectives: To study the visual field changes after intravitreal ranibizumab (IVR) injection and sulfotanshinone sodium (SS) injection for macular edema (ME) secondary to retinal vein occlusion (RVO), and discuss the value of microperimetry as a routine diagnostic test in the follow-up of RVO patients. Methods: This was a retrospective, interventional, case-series study. Twelve eyes of 12 RVO patients, including 6 eyes with central RVO (CRVO) and 6 eyes with branch RVO (BRVO) were included. The eyes were treated with IVR (0.5 mg) injections and SS injections (20 mg per day, one week consecutively in one month). The outcomes measured included best corrected visual acuity (BCVA), central retinal thickness (CRT), mean defect (MD), pattern standard deviation (PSD), macular light sensitivity of the central 16 points in CRVO group and the central 8 points in BRVO group before and after the treatment. Statistical analyses were then performed on the main outcome measures. Results: An improvement of BCVA was found in all patients after treatment with significant difference (t = 7.74, p p p p > 0.05). All RVO patients had their macular light sensitivity of the involved part improved significantly (t = 5.03, p p p < 0.01). The Pearson’s correlation was calculated among BCVA, MD, macular light sensitivity and CRT. No obvious significance was found between CRT and BCVA outcomes, whereas MD and mean macular light sensitivity outcomes were closely related to BCVA results in the BRVO group and the latter showed a more intimate correlation. No similar correlation was found in RVO and CRVO group. Conclusion: IVR injection and SS injection together could effectively improve the therapeutic effect in RVO patients with ME. Microperimetry could be used as a routine diagnostic test and a possible valuable tool in the follow-up of patients with RVO, especially in BRVO.

Construction of universal quantitative models for the determination of cefoperazone sodium/sulbactam sodium for injection from different manufacturers using near-infrared reflectance spectroscopy

To develop near-infrared （NIR） reflectance spectroscopic methods for the quantitative analysis of cefoperazone sodium/ sulbactam sodium from different manufacturers for injection powder medicaments. Various powders of cefoperazone sodium/ sulbactam sodium were directly analyzed by non-destructive NIR reflectance spectroscopy using the spectrometer EQUINOX55. Two quantitative methods via integrating sphere （IS） and fiberoptic probe （FOP） models were explored from 6 batches of commercial samples and 42 batches of laboratory samples at a content ranging from 30% to 70% for cefoperazone and 60% to 20% for sulbactam. The root mean square errors of cross validation （RMSECV） and the root mean square errors of prediction （RMSEP） of IS were 1.79% and 2.85%, respectively, for cefoperazone sodium, and were 1.86% and 3.08%, respectively, for sulbactam sodium; and those of FOP were 2.93% and 2.92%, respectively, for cefoperazone sodium, and were 2.23% and 3.01%, respectively, for sulbactam sodium. Based on the ICH guidelines and Ref. 12, the quantitative models were then evaluated in terms of specificity, linearity, accuracy, precision, robustness and model transferability. The non-destructive quantitative NIR methods used in this study are applicable for rapid analysis of injectable powdered drugs from different manufacturers.

The effectiveness of local anesthetic and sodium hyaluronate injection for the posterior disc displacement: A case report

Posterior disc displacement of the temporomandibular joint is rare. We present a unique treatment method and magnetic resonance (MR) images of this condition. The patient was a 43-year-old male with a chief complaint of abnormal occlusion. Regarding the present status, there was no occlusion on the right side. No temporomandibular joint pain, myalgia, or clicking were observed while mouth opening. On MR images, the posterior disc displacement without reduction on the right was observed and it was assumed that occlusal abnormality was due to this condition. We treated him with the following methods. After injection into the superior articular cavity with 2% lidocaine, a sodium hyaluronate preparation was injected followed by intermaxillary traction applied using rubber. The recovery of occlusion was confirmed in follow-up at 5 days after treatment. In the 13th days, the intermaxillary traction was removed. On MR images, the right disc condition was changed to anterior disc displacement with reduction. We consider our treatment methods are effective for this clinical condition.

A clinical comparative study on effects of intracavernous injection of sodium nitroprusside and papaverine/phentolamine in erectile dysfunction patients

Aim: To study the effect of intracavemous sodium nitropmsside (SNP), a nitric oxide (NO) donor, on penile erec-tion. Methods: Forty-two patients with erectile dysfunction (ED) were randomly assigned to receive SNP 300μgor the control drags (papaverine 30 mg + phentolamine 1 mg) intracavemously crosswise one week apart. The penilelength, circumference and hardness after the administration of the experimental and control drags were assessed andcompared statistically. Results: (1) There was no significant difference between the changes in penile length andcircumference in the two occasions; (2) In 25 SNP and 28 control cases, the hardness of the penis was scored above100 as evaluated by the Vimg method (P > 0.05); (3) The duration of erection in the controls was longer than that inthe SNP, but there were three priapism in the controls and not a single one in the SNP; (4) there was no apparentchange in the heart rate and blood pressure in both occasions; other side effects were minimal except slight local pain ina few controls. Conclusion: SNP facilitates relaxation of the penile smooth muscle and penile erection without sig-nificant side effects. SNP may be used in ED patients that experience pain and priapism with papaverine/phentolamine.(Asian J Androl 2000 Dec; 2: 301-303)

Effect of sodium ferulate in combined with Huangqi injection on the coagulation and immunological function in patients with primary nephrotic syndrome

Objective:To explore the effect of sodium ferulate in combined with Huangqi injection on the coagulation and immunological function in patients with primary nephrotic syndrome (PNS).Methods: A total of 137 patients with PNS were included in the study and randomized into the observation group (n=69) and the control group (n=68). The patients in the treatment group were given routine treatment, anticoagulation, lipid regulation, and other symptomatic treatments. On this basis, the patients in the observation group were given sodium ferulate in combined with Huangqi injection. The coagulation, immunological function, and hemorrheology indicators before and after treatment in the two groups were compared.Results:Alb content after treatment in the two groups was significantly elevated when compared with before treatment (P<0.05), while ET, 24 h UPQ, Scr, and BUN levels were significantly reduced when compared with before treatment (P<0.05);moreover, the improvement degree of the above indicators in the observation group was significantly greater than that in the control group (P<0.05). PT and APTT after treatment in the two groups were significantly prolonged when compared with before treatment (P<0.05), while FIB, D-D content, whole blood high shear viscosity, low shear viscosity, blood viscosity, and ARBC were significantly reduced when compared with before treatment (P<0.05);moreover, the improvement degree of the above indicators in the observation group was significantly greater than that in the control group (P<0.05). CD3+, CD4+, and CD8+ after treatment in the two groups were significantly elevated when compared with before treatment (P<0.05). CD3+ and CD4+ after treatment in the observation group were significantly higher than those in the control group (P<0.05). CD4+/CD8+, IgG, and IgA after treatment in the observation group were significantly higher than those in the control group (P<0.05).Conclusions:Sodium ferulate in combined with Huangqi injection in the treatment of PNS can improve the coagulation function and hemorheology, alleviate the blood coagulation, enhance the immunological function, and recover the renal function.

Effect of danhong injection combined with sodium ozagrel on serum IL-8, TNF-α, VEGF, TBIL and NSE in old patients with acute cerebral infarction

Objective:To study the effect of danhong injection combined with sodium ozagrel on serum IL-8, TNF-α, VEGF, TBIL and NSE in old patients with acute cerebral infarction.Methods:A total of 100 old patients with acute cerebral infarction in our hospital from August 2014 to December 2016 were enrolled in this study. The subjects were divided into the control group (n=50) and the treatment group (n=50) randomly. The control group was treated with sodium ozagrel, the treatment group was treated with danhong injection combined with sodium ozagrel, and both the two groups were treated for 14 days. The serum IL-8, TNF-α, VEGF, TBIL and NSE of the two groups before and after treatment were compared.Results:There were no significantly differences of the serum IL-8, TNF-α, VEGF, TBIL and NSE of the two groups before treatment. The serum IL-8, TNF-α, NSE levels of the two groups after treatment were significantly lower than before treatment, the serum VEGF, TBIL levels of the two groups after treatment were significantly higher than before treatment, and that of the treatment group after treatment were significantly better than the control group.Conclusion:Danhong injection combined with sodium ozagrel can significantly reduce the serum IL-8, TNF-α, NSE levels, improve the serum VEGF, TBIL levels, and reduce inflammation, promote the nerve functional recovery of the old patients with acute cerebral infarction, and it was worthy clinical application.

Clinical Study of Sulfotanshinone Sodium Injection in Treating Non-Ischemic Retinal Vein Occlusion

Objectives: To study the effect of sulfotanshinone sodium (SS) injection in the treatment of non-ischemic retinal vein occlusion (RVO). Methods: Sixty-two RVO patients treated in our hospital between Jan. 2013 and Oct. 2014 were randomly divided into Control Group (30 patients;Bendazol tablets) and Treatment Group (32 patients, Bendazol tablets + SS injections), each with a follow-up period of 6 months. Statistical analysis was then performed on changes in visual acuity, central retinal thickness (CRT) and retinal circulation time (RCT) before and after the treatment. Results: After treatment, both Control Group and Treatment Group witnessed an improvement on visual acuity (Control Group: t = 2.103, p = 0.044;Treatment Group: t = 8.021, p = 0.000). Visual acuity could be greatly improved in Treatment Group when compared with Control Group, with significant differences (p < 0.01). Macular edema could be greatly relieved in Treatment Group measured by CRT (t = 2.571, p = 0.007) while the difference was of no statistical significance in Control Group (t = 1.016, p = 0.070). RCT were remarkably shortened in both groups (Control Group: t = 43.83, p = 0.000;Treatment Group: t = 27.34, p = 0.000), and when compared with Control group, the changes in Treatment Group were more significant (p < 0.05). Conclusion: SS injection could effectively improve the therapeutic effect in patients with non-ischemic retinal vein occlusion.

Clinical value of sodium ferulate + Shenmai injection in the adjuvant treatment of acute myocardial infarction

Objective: To explore the clinical value of sodium ferulate + Shenmai injection in the adjuvant treatment of acute myocardial infarction (AMI). Methods: A total of 119 patients with AMI who were treated in our hospital between December 2014 and December 2017 were reviewed and divided into the control group (n=60) who received conventional western medicine +Shenmai injection therapy and the sodium ferulate group (n=59) who received conventional western medicine + sodium ferulate + Shenmai injection therapy. The differences in serum levels of myocardial injury markers, inflammatory mediators and ventricular remodeling-related indexes were compared between the two groups before treatment and after 2 weeks of treatment. Results: Before treatment, serum levels of myocardial injury markers, inflammatory mediators and ventricular remodeling-related indexes were not significantly different between the two groups. After 2 weeks of treatment, serum myocardial injury markers GMP-140, cTnT, MYO, NT-proBNP and H-FABP levels of sodium ferulate group were lower than those of control group;serum inflammatory mediators MCP-1, IL-18 and hs-CRP levels were lower than those of control group;serum ventricular remodeling-related indexes GDF-15, MMP-10 and CgA levels were lower than those of control group whereas IGF-1 level was higher than that of control group. Conclusion: Western medicine combined with sodium ferulate+ Shenmai injection therapy can effectively protect the myocardial function and inhibit the systemic inflammatory response and ventricular remodeling in patients with AMI.

Intravitreal Ranibizumab Combined with Sulfotanshinone Sodium Injection in Treating Type II Optic Disc Vasculitis

Objectives: To present the effect of intravitreal ranibizumab (IVR) therapy combined with sulfotanshinone sodium (SS) injection in a patient suffering from type II optic disc vasculitis (ODV). Methods: A 26-year-old female patient was diagnosed with type II ODV with macular edema (ME). The information was obtained by complete medical and ophthalmic history taking and a detailed ophthalmic examination at the initial and follow-up visits. Functional and morphological outcomes at baseline, 1 week and 1 month following IVR+SS injections, are presented. Results: Best-corrected visual acuity (BCVA) improved from 78 letters (ETDRS) at baseline to 90 letters at 1-week follow-up and maintained stable through 1-month follow-up. Central retinal thickness (CRT) measured by optical coherence tomography (OCT) decreased from 465 μm at baseline to 240 μm at 1-week follow-up and to 226 μm at 1-month follow-up. Mean deviation (MD) measured by perimetry increased from ?5.17 dB to ?4.59 dB and to ?4.29 dB, respectively. Fluorescein angiography (FFA) showed that the initial macular edema at baseline disappeared while the arm-retina circulation time (ART) was also greatly shortened when compared to the baseline. Electroretinogram (ERG) measured at 1-month follow-up demonstrated an overall improvement of the retinal function after the injection. No ocular or systemic side effects were detected. Conclusions: IVR+SS injection may lead to resolution of the associated ME and improve the retina morphologically as well as functionally. To our knowledge, this is the first case of a type II ODV benefiting from treatment with IVR+SS injection. The observed results warrant further investigation.

Sodium Tanshinone Ⅱ A Sulfonate Injection as Adjuvant Treatment for Unstable Angina Pectoris: A Meta-Analysis of 17 Randomized Controlled Trials

Objective： To systematically evaluate the effectiveness and safety of Sodium Tanshinone ⅡA Sulfonate Injection（STS） as one adjuvant therapy for treating unstable angina pectoris（UAP）. Methods： Randomized controlled trials（RCTs） of UAP treated by STS were searched in the China National Knowledge Infrastructure Database（CNKI）, VIP Database for Chinese Technical Periodicals（VIP）, Wanfang Database, the Chinese Biomedical Literature Database（CBM）, Web of Science, the Cochrane Library, Embase, and Pub Med, which from inception to January, 2016. The Cochrane Risk Assessment Tool was used to evaluate the methodological quality of the RCTs. The Review Manager 5.3 software was used to conduct the metaanalysis. Results： The results showed that 17 RCTs involving 1,372 patients were included. The meta-analysis indicated that the combined use of STS and Western medicine（WM） in the treatment of UAP can obviously improve the total effective rate [risk ratio（RR）=1.31, 95% confidence interval（CI）（1.24,1.39）, P〈0.0001], and the total effective rate of electrocardiogram [RR=1.43, 95% CI（1.30,1.56）, P〈0.0001], decrease the level of CRP [mean difference（MD）=–3.06, 95%CI（–3.85, –2.27）, P〈0.00001], fibrinogen [MD=–1.03, 95% CI（–1.16, –0.89）, P〈0.00001], and whole blood high shear viscosity [MD=–0.70, 95% CI（–0.92, –0.49）, P〈0.00001]. Additionally, the occurrence of adverse drug reaction of the experimental group was significantly higher than that of the control group [RR=3.57, 95% CI（1.28, 9.94）, P〈0.05]. Conclusions： Compared with WM, the combined use of STS was more effective.

Determination of Trace Non Rare Earth Elements in High Purity Rare Earth Oxides by ICP－AES with Microcolumn Preconcentration in a Flow Injection System

A new method for the determination of trace non-rare earth elements in high purity rare earth oxides by ICP-AES with preconcentration on an active carbon-silica gel microcolumn in a flow injection system is described in this paper. Experimental parameters such as pH, flow rate,reagent concentration,length of reaction coil,eluent acidity,etc. were optimized. In the buffer solution of NH3. H2O/NH4Cl at pH 4. 6,Al,Cr,Cu,Fe, Pb, V and Zn can be preconcentrated and then eluted with 4. 5 mol/L nitric acid utilizing stop-flow technique. The enrichment factors were in range of 8. 1￣12. 6 with detection limits of μg/m level ,and the RSD with metals at μg/g level were 2. 3￣5. 0% (n= 7). The method proposed can reduce the matrix interference effectively , and has been applied to the determination of non-rare earth metals atμg/g level in high purity Eu2O3 with satisfactory results.

Flow Injection Determination of Tramadol Based on Its Sensitizing Effect on the Chemiluminescent Reaction of Permanganate-Sulfite

In this paper, a novel chemiluminescence (CL) method for the determination of tramadol has been developed by combining the flow injection technique and its sensitizing effect on the weak CL reaction between sulfite and acidic KMnO4. A mechanism for the CL reaction has been proposed on the basis of fluorescent and CL spectra. Under the optimized conditions, the proposed method allows the measurement of tramadol hydrochloride over the range of 0.04 - 4 ?g/mLwith a correlation coefficient of 0.9995 (n = 8) and a detection limit of 0.01 ?g/mL (3σ), and the relative standard deviation for 2.0 ?g/mL tramadol (n = 11) is 2.1%. The utility of this method was demonstrated by determining tramadol hydrochloride in tablets and injections.

注射用亚胺培南西司他丁钠质量分析

目的 对国内市场中不同企业的注射用亚胺培南西司他丁钠的质量状况进行评价,发现质量风险点,为仿制药一致性评价提供质量控制关键点。方法 采用法定检验结合探索性研究的方法对样品进行检验,统计分析注射用亚胺培南西司他丁钠的整体质量水平,分析不同企业产品的差异。结果 按法定标准检验,80批次抽验样品结果均符合规定。但发现原研产品的复溶时间更快;不同企业的产品有关物质和含量结果差异较大;现行质量标准差异较大亟待提高统一。探索性研究表明,样品复溶时间与制剂中亚胺培南晶癖及粒度相关;采用LC/MS等方法对本品有关物质的来源进行了归属,对部分杂质结构进行了推断;对本品的含量测定方法进行了优化。结论 国内市场中注射用亚胺培南西司他丁钠的质量总体较好;在开展仿制药一致性评价工作中,需关注亚胺培南的晶癖以及制剂的有关物质、含量、充氮工艺和异亚丙基丙酮等质量关键点;现行标准有待统一和提高。

国家集采左氧氟沙星氯化钠注射液仿制药疗效和安全性评价

目的:比较国家集中带量采购左氧氟沙星氯化钠注射液和原研药品治疗社区获得性肺炎的临床疗效与安全性。方法:回顾性收集福建省某大型三甲医院2020年10月20日至2022年10月20日诊断为CAP并使用左氧氟沙星氯化钠注射液的患者相关临床信息,采用倾向性评分匹配法调整组间差异,比较两组的有效性和安全性。结果:倾向评分匹配后,集采组纳入患者117例,原研组纳入患者117例。两组用药第七天临床治疗有效率、白细胞、中性粒细胞百分数、C反应蛋白、降钙素原、体温、给药疗程(天)比较,无统计学差异。两组用药后肝肾功能异常比较,无统计学差异。结论:国家集中带量采购左氧氟沙星氯化钠注射液与原研药品治疗CAP的效果与安全性相当。

依达拉奉右莰醇联合丁苯酞氯化钠注射液对急性脑梗死患者血清单核细胞趋化蛋白-1、内皮素-1表达的影响

目的探讨依达拉奉右莰醇联合丁苯酞氯化钠注射液对急性脑梗死患者血清单核细胞趋化蛋白-1(MCP-1)、内皮素-1(ET-1)表达及动脉粥样硬化斑块的影响。方法选取河北省邯郸市中医院2020年12月至2022年8月收治的急性脑梗死患者140例,按随机数字表法分为联合组和对照组,各70例。两组患者均予丁苯酞氯化钠注射液,联合组患者加用依达拉奉右莰醇注射液,均治疗14 d。结果联合组总有效率为91.43%,显著高于对照组的68.57%(P<0.05)。治疗后,两组患者的颈动脉内中膜厚度、斑块面积、美国国立卫生研究院卒中量表(NIHSS)评分、改良Rankin量表(MRS)评分及血清MCP-1、ET-1、丙二醛、超氧化物歧化酶水平均显著降低(P<0.05),且联合组均显著低于对照组(P<0.05);联合组和对照组患者治疗期间不良反应发生率相当(12.86%比14.29%,P>0.05)。结论依达拉奉右莰醇联合丁苯酞氯化钠注射液治疗急性脑梗死的临床疗效良好,可有效改善患者的神经功能缺损情况、颈动脉粥样硬化斑块稳定性及内皮功能,降低氧化应激水平,提高生活质量,且安全性良好。

肝素钠注射液皮下注射知信行现状调查研究

目的 调查肝素钠注射液皮下注射护理操作规范的知信行现状及其影响因素,为临床护士的培训及管理提供参考依据。方法 使用方便抽样法选取2022年4-5月西安交通大学第一附属医院、西北妇女儿童医院和深圳市人民医院临床护士720人为研究对象,采用临床护士肝素钠注射液皮下注射护理操作规范的知信行调查问卷,进行问卷调查并寻找其影响因素。结果 临床护士肝素钠注射液皮下注射知信行得分(145.33±19.94)分,知识、态度、行为三维度分别是(19.23±4.48)分、(44.33±6.82)分、(81.73±15.05)分;多元线性回归结果显示临床护士对肝素钠注射液皮下注射操作知识的显著影响因素是工作时长、有无接受肝素钠注射液皮下注射操作培训;态度的显著影响因素是工作时长;行为的显著影响因素是知识、态度及有无接受肝素钠注射液皮下注射培训等。结论 临床护士关于肝素钠注射液皮下注射操作护理态度积极程度较好,但知识水平和行为执行情况有待进一步促进和提高。管理者只有采取多样化形式培训,做好肝素钠注射液皮下注射的质控管理,才能确保病人的用药安全。

基于Raman的复方柳安咖注射液主要成分分析

本文应用拉曼光谱技术对复方柳安咖注射液的主要成分及含量进行了分析。首先测试分析了62个复方柳安咖注射液样品的拉曼光谱,结果表明62个注射液样品的拉曼光谱主要由水杨酸钠、安替比林和咖啡因的水溶液拉曼谱带组成;进一步利用密度泛函理论(DFT)计算了其主要成分的理论拉曼光谱和红外光谱,与实验测定的固体粉末光谱和溶液光谱进行比较分析,进而对复方柳安咖注射液拉曼光谱谱峰的振动模式进行了归属;最后利用水杨酸钠和安替比林浓度梯度溶液拉曼光谱特征峰的峰高和峰面积,分别建立定量分析模型,对62个复方柳安咖注射液样品中主要成分水杨酸钠和安替比林的含量进行预测,并与液相色谱法测试值进行了对比,结果显示预测值与液相色谱法测试值相近,得到了较好的主要成分含量预测结果。研究结果可为复方柳安咖注射液药剂的生产、药品质量的监控、药品光谱分析研究等方面提供参考。

独活寄生汤联合几丁糖对寒湿痹阻型膝骨关节炎的临床疗效

目的 观察独活寄生汤联合几丁糖治疗寒湿痹阻型膝骨关节炎的临床效果。方法 选取2023年1月至8月黑龙江中医药大学附属第一医院门诊的60例膝骨关节炎患者,采用随机数字表法将其分为观察组和对照组,各30例。观察组采用独活寄生汤(加水煎煮,200 ml/剂,1剂/d,早晚两次温服,连续服用3周)联合几丁糖注射液(2 ml/次,1次/周,共3周)治疗,对照组口服洛索洛芬钠片(120 mg/次,3次/d)联合几丁糖注射液(2 ml/次,1次/周,共3周)治疗。评价两组临床疗效。比较两组治疗前后中医症状评分、西安大略和麦克马斯特大学骨关节炎指数评分(WOMAC评分)、视觉模拟评分法(VAS)评分,血清白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)的水平和血清环氧合酶(COX-2)和前列腺素(PGE2)的改善情况,并对两组患者于治疗后六周进行电话追踪和随访观察复发率。结果 观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗后,两组VAS评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组WOMAC评分较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组IL-1、TNF-α水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组血清COX-2、PGE2降低,且观察组低于对照组,差异有统计学意义(P<0.05)。两组复发率比较,差异无统计学意义(P>0.05)。结论 独活寄生汤联合几丁糖对寒湿痹阻型膝骨关节炎有显著疗效,并且能恢复膝关节功能,提高生活质量。

基于加权TOPSIS法的贝米肝素钠注射液药物利用评价

目的建立贝米肝素钠注射液药物利用评价(DUE)标准,并采用加权优劣解距离(TOPSIS)法对贝米肝素钠注射液的使用情况进行评价,为促进其合理使用提供参考。方法以药品说明书为基础,参考相关指南和文献,采用专家咨询法建立贝米肝素钠注射液的DUE标准细则,采用加权TOPSIS法对同济大学附属同济医院2021年6—7月使用贝米肝素钠注射液的住院患者病历进行合理性评价。结果在贝米肝素钠注射液DUE标准中,10个二级指标相对权重系数排名前2位的是禁忌证、不良反应处置,排名后2位的是给药方式、适应证。共纳入100份病历,用药方案与最优方案接近程度(C_(i))≥0.8(合理)的0例;0.6≤C_(i)<0.8(基本合理)的83例(83.00%);C_(i)<0.6(不合理)的17例(17.00%)。不合理用药主要表现在超适应证用药、超给药方式用药、存在潜在药物相互作用、给药剂量不适宜、违反用药禁忌证等方面。结论基于加权TOPSIS法的贝米肝素钠注射液DUE方法可综合多个评价指标,可操作性强,评价结果客观可信。该院贝米肝素钠注射液临床应用基本合理,需加快超说明书用药循证评价流程,加强管理力度,以保证临床合理用药。