Aim: The majority of guidelines recommended the significance of home-based blood pressure (home-BP) measurement. The present study explored that to what extent, general practitioners (GPs) were aware of the importance...Aim: The majority of guidelines recommended the significance of home-based blood pressure (home-BP) measurement. The present study explored that to what extent, general practitioners (GPs) were aware of the importance of home-BP in the daily clinical practice. Method: We sent out questionnaires to GPs who had been specialized in nephrology and hypertension. The questions focused on the awareness of home-BP and the selections of antihypertensive agents for refractory hypertension in chronic kidney disease (CKD) patients. Results: 1) The majority (95.9%) of the responding GPs had utilized home-BP in their clinical practice. 2) When prescribing a single agent for hypertensive CKD patients, the majority of GPs (87.3%) chose ARB for the first line drug, and Ca channel blockers (CCB) were the second. 3) As an add-on drug to the pre-treatment with an angiotensin receptor blocker (ARB), the majority preferred CCB (82.7%) to diuretics (21.8%). In addition, a fixed combination formula of antihypertensive medication consisting of ARB plus diuretic was accepted by the majority of GPs (78.7%). 4) To improve morning hypertension in patients treated with two or more drugs, 87.8% of the doctors agreed that additional night-time dosing could be useful. The choices of the agents given at night-time varied, mainly with α1-blockers (40.6%), followed by α-blockers (30.5%) and α-methyldopa (19.8%). Conclusion: The majority of GPs in Japan are aware of the importance of the home-BP-based management of CKD. They mainly chose ARB as a first line drug, and ARB plus CCB as an add-on therapy.展开更多
目的:对家庭血压监测相关临床实践指南进行质量评价,整合现有指南的推荐意见,为规范家庭血压监测提供循证依据。方法:系统检索国内外临床实践指南网站、高血压专业学会网站及各数据库发布的家庭血压监测相关指南,采用临床指南研究与质...目的:对家庭血压监测相关临床实践指南进行质量评价,整合现有指南的推荐意见,为规范家庭血压监测提供循证依据。方法:系统检索国内外临床实践指南网站、高血压专业学会网站及各数据库发布的家庭血压监测相关指南,采用临床指南研究与质量评价工具Ⅱ(Appraisal of Guidelines for Research and EvaluationⅡ,AGREEⅡ)对纳入的指南进行质量评价并进行内容分析,梳理、整合家庭血压监测相关的推荐意见。结果:共纳入10篇临床实践指南,其中2篇为A级推荐,7篇为B级推荐,1篇为C级推荐。AGREEⅡ中6个领域平均标准化得分分别为范围和目的 77.59%、参与人员53.33%、严谨性63.57%、清晰性85.55%、应用性55.28%、独立性68.41%。经内容分析,最终汇总得到6个主题、27条推荐意见。结论:纳入的现有家庭血压监测临床实践指南推荐意见丰富、具体,临床可操作性强,但部分内容还需补充,建议国内学者在借鉴国外高质量证据的基础上结合我国国情制定本土化的临床实践方案。展开更多
目的探讨窄谱中波紫外线(NB-UVB)家庭光疗与院内光疗治疗小腿斑块状银屑病的疗效比较。方法选择2018年7月至2020年6月嘉兴市第一医院皮肤科门诊收治的58例小腿斑块状银屑病患者,随机分为对照组28例和观察组30例收治的对照组给予外用卡...目的探讨窄谱中波紫外线(NB-UVB)家庭光疗与院内光疗治疗小腿斑块状银屑病的疗效比较。方法选择2018年7月至2020年6月嘉兴市第一医院皮肤科门诊收治的58例小腿斑块状银屑病患者,随机分为对照组28例和观察组30例收治的对照组给予外用卡泊三醇倍他米松软膏联合院内照射NB-UVB,观察组给予外用卡泊三醇倍他米松软膏联合家中自行照射NB-UVB,两组疗程均为8周。通过治疗前后银屑病皮损面积与严重程度指数(psoriasis area and severity index,PASI)评分判定疗效,记录皮肤不良反应发生情况,以调查问卷形式评价便利性。结果治疗后两组的PASI评分均较治疗前下降,差异有统计学意义(P<0.05);治疗后两组的PASI评分比较,差异无统计学意义(P>0.05)。对照组的总有效率为82.14%,观察组为76.67%,两组比较,差异无统计学意义(P>0.05)。对照组的轻度皮肤不良反应发生率为17.86%,观察组为13.33%,两组比较,差异无统计学意义(P>0.05)。观察组的便利性优于对照组,差异有统计学意义(P<0.05)。结论NB-UVB家庭光疗对比院内光疗治疗小腿斑块状银屑病,疗效相当,安全性良好,便利程度高,值得临床推广。展开更多
文摘Aim: The majority of guidelines recommended the significance of home-based blood pressure (home-BP) measurement. The present study explored that to what extent, general practitioners (GPs) were aware of the importance of home-BP in the daily clinical practice. Method: We sent out questionnaires to GPs who had been specialized in nephrology and hypertension. The questions focused on the awareness of home-BP and the selections of antihypertensive agents for refractory hypertension in chronic kidney disease (CKD) patients. Results: 1) The majority (95.9%) of the responding GPs had utilized home-BP in their clinical practice. 2) When prescribing a single agent for hypertensive CKD patients, the majority of GPs (87.3%) chose ARB for the first line drug, and Ca channel blockers (CCB) were the second. 3) As an add-on drug to the pre-treatment with an angiotensin receptor blocker (ARB), the majority preferred CCB (82.7%) to diuretics (21.8%). In addition, a fixed combination formula of antihypertensive medication consisting of ARB plus diuretic was accepted by the majority of GPs (78.7%). 4) To improve morning hypertension in patients treated with two or more drugs, 87.8% of the doctors agreed that additional night-time dosing could be useful. The choices of the agents given at night-time varied, mainly with α1-blockers (40.6%), followed by α-blockers (30.5%) and α-methyldopa (19.8%). Conclusion: The majority of GPs in Japan are aware of the importance of the home-BP-based management of CKD. They mainly chose ARB as a first line drug, and ARB plus CCB as an add-on therapy.
文摘目的:对家庭血压监测相关临床实践指南进行质量评价,整合现有指南的推荐意见,为规范家庭血压监测提供循证依据。方法:系统检索国内外临床实践指南网站、高血压专业学会网站及各数据库发布的家庭血压监测相关指南,采用临床指南研究与质量评价工具Ⅱ(Appraisal of Guidelines for Research and EvaluationⅡ,AGREEⅡ)对纳入的指南进行质量评价并进行内容分析,梳理、整合家庭血压监测相关的推荐意见。结果:共纳入10篇临床实践指南,其中2篇为A级推荐,7篇为B级推荐,1篇为C级推荐。AGREEⅡ中6个领域平均标准化得分分别为范围和目的 77.59%、参与人员53.33%、严谨性63.57%、清晰性85.55%、应用性55.28%、独立性68.41%。经内容分析,最终汇总得到6个主题、27条推荐意见。结论:纳入的现有家庭血压监测临床实践指南推荐意见丰富、具体,临床可操作性强,但部分内容还需补充,建议国内学者在借鉴国外高质量证据的基础上结合我国国情制定本土化的临床实践方案。
文摘目的探讨窄谱中波紫外线(NB-UVB)家庭光疗与院内光疗治疗小腿斑块状银屑病的疗效比较。方法选择2018年7月至2020年6月嘉兴市第一医院皮肤科门诊收治的58例小腿斑块状银屑病患者,随机分为对照组28例和观察组30例收治的对照组给予外用卡泊三醇倍他米松软膏联合院内照射NB-UVB,观察组给予外用卡泊三醇倍他米松软膏联合家中自行照射NB-UVB,两组疗程均为8周。通过治疗前后银屑病皮损面积与严重程度指数(psoriasis area and severity index,PASI)评分判定疗效,记录皮肤不良反应发生情况,以调查问卷形式评价便利性。结果治疗后两组的PASI评分均较治疗前下降,差异有统计学意义(P<0.05);治疗后两组的PASI评分比较,差异无统计学意义(P>0.05)。对照组的总有效率为82.14%,观察组为76.67%,两组比较,差异无统计学意义(P>0.05)。对照组的轻度皮肤不良反应发生率为17.86%,观察组为13.33%,两组比较,差异无统计学意义(P>0.05)。观察组的便利性优于对照组,差异有统计学意义(P<0.05)。结论NB-UVB家庭光疗对比院内光疗治疗小腿斑块状银屑病,疗效相当,安全性良好,便利程度高,值得临床推广。
