Professor Liu Guobin used traditional Chinese medicine to cure a case of primary erythema limb pain

Primary erythema limb pain is a very rare disease,and its pathogenesis is not clear.Usually,the pain symptoms of patients exist for a long time,which seriously affect the daily life of patients and increase the economic burden of patients.Professor Liu Guobin,who has been engaged in the diagnosis and treatment of peripheral vascular diseases for nearly 30 years,believes that heat-toxin and blood stasis collaterals are closely related to the disease,and emphasizes the principle of heat-toxin and evil qi causing the disease.It is emphasized that clearing heat and detoxification,promoting blood circulation and dispersing blood stasis are the main treatment principles.This paper selects a typical case to describe Professor Liu's clinical experience in the treatment of primary erythema limb pain by oral and external use of traditional Chinese medicine,so as to provide an effective method of traditional Chinese medicine for the treatment of primary erythema limb pain.

Traditional Chinese Medicine Is Widely Used for Cardiovascular Disease

A review article by Hao et al.(J Am Coll Cardiol 2017;69(24):2952– 66)has had huge repercussions among those familiar with traditional Chinese medicine(TCM)in the international academic community.It evaluated the effi cacy and safety of TCM for cardiovascular disease and the pharmacological effect of active TCM ingredients on the cardiovascular system and potential mechanisms.We have several comments:Firstly,we give a brief summary addressing nonpharmacotherapy in TCM,including acupuncture,moxibustion,Qigong,and Tai Chi.Secondly,we have added traditional antiarrhythmic drug– related randomized controlled trials to make the coverage more comprehensive.Lastly,we support the concept that research into,development of,and application of active ingredients is part of modern TCM.

Published papers about Salvia miltiorrhiza Bunge used in traditional Chinese medicine

Chu Kedan, Ji Guolu, Shi Hong, Xie Weirong, Zhang Yuqin, Zhang Xiaoqin. Study of the alcohol extraction process of Shenhu granules. Strait Pharmaceutical Journal, 2011, 23（03）： 21-24. Email： chukd5917@ 163.com

Analogous Systems Principles and Concepts of Traditional Chinese Medicine and Congruence Couple Therapy

This article explicates the analogous principles and concepts between traditional Chinese medicine(TCM)and congruence couple therapy(CCT).Although originating out of vastly different times and places,TCM and CCT share a view of health based on systems understanding to facilitate the interconnections of the parts of an organism rather than focusing on eliminating symptoms.Both approaches aim to release Qi(气)and vitality by removing blockages through adjusting the interactions,adaptation,and balance of multiple elements and Yin‑Yang energies.The goal is to liberate the Qi or life force through improved holistic balance and cooperation.While TCM focuses on interventions at the level of the body,CCT focuses on the attention,awareness,acknowledgement,and alignment of the four human dimensions consisting of the intrapsychic,interpersonal,intergenerational,and universal‑spiritual.In light of the current trend toward increasing mental,substance use,and neurological disorders,in particular among countries of middle and low income,dialogue to explore these compatibilities between TCM and CCT is conducive to the continuous evolution of TCM and Western therapies to address not only physical health but also the exigencies of contemporary addiction and mental health care within a mind–body relationship matrix.

Professor Jia Li-qun’s experience in external treatment of tumor complications based on the theory of“use communication as a complement”

The external treatment of Traditional Chinese Medicine has a long history of external treatment,with the characteristics of simplicity,convenience,cheapness,and effectiveness.It also plays an important role in the treatment of malignant tumor complications.The academic idea of“Use communication as a complement”has existed since ancient times,and it still has great significance in guiding clinical treatment.Based on the theory of“Use communication as a complement”,Professor JIA Liqun used Tongluo powder to treat chemotherapy-induced peripheral neuropathy,Wentong acupoint sticking for external treatment of cancer pain,and digestive tract reaction after chemotherapy,and achieved good clinical effects.An inspection case is attached to prove it.

THE USE OF TRADITIONAL CHINESE MEDICINE FOR IN VITRO FERTILIZATION IN CHINA: CLINICAL EVIDENCE

In vitro fertilization(IVF),as an important assisted reproductive technology(ART),is chosen by over l,000,000infertile couples each year,which is linked to over 3,000,000babies bom worldwide.However,an IVF cycle may be unsuccessful.The success of IVF is not guaranteed,and patients often have to undergo more than one cycle of treatment before they are successful.IVF treatment

Comparative Evaluation of Antitumor Chinese Patent Medicine Injections Based on Evidence-Based Medicine and Markov Model

Objective: The objective of this study was to explore the safety, efficacy, economy, and other aspects of frequently-used antitumor Chinese patent medicine injections through a comprehensive evaluation of evidence-based medical research to provide scientific information and decision-making basis for drug selection, rational drug use, public awareness of safe drug use, and medical insurance. Materials and Methods: The names of five frequently used antitumor Chinese patent medicine injections were used as search terms, including the compound Sophora flavescens injection, Kangai injection, Aidi injection, Kanglaite injection, and Brucea javanica oil emulsion injection. Relevant evidence-based medical research was extracted from the databases. A descriptive evaluation was conducted, and the Markov model was used for the cost-benefit analysis. Finally, the above injections are ranked by comprehensive scores using the multi-criteria decision analysis and Delphi method. Results: The five injections had their own advantages in enhancing the effectiveness of anti-tumor treatments, improving the quality of life for cancer patients, and reducing the incidence of adverse reactions. From the perspective of economy and other attributes, compound S. flavescens was superior to B. javanica oil, Aidi, Kangai, and Kanglaite. After a comprehensive evaluation of the above five injections, the compound S. flavescens injection received the highest score. Conclusions: Compound S. flavescens, Kangai, Aidi, B. javanica oil, and Kanglaite have their own advantages in effectiveness and no significant difference in safety. Compound S. flavescens injection has the highest comprehensive score. Clinical attention should be paid to monitoring the initial stage of medication and special groups.

Treating Biliary System Postoperational Complications by Syndrome Differentiation Using Traditional Chinese Medicine

The operation of the biliary system is usually employed for liver, gallbladder or pancreatic diseases. Most benign cases are cholelithiasisinduced cholecystitis and choledochitis, while malignant ones mainly include gallbladder cancers, cholangiocarcinoma orcarcinoma of the head of the pancreas.

基于多学科协作管理模式结合PDCA质量管理工具对中药注射剂的管控效果分析

目的:探讨多学科协作管理模式结合PDCA质量管理工具用于医院中药注射剂管理的成效,为促进中药注射剂的合理应用提供参考。方法:成立多学科协作管理小组,运用PDCA质量管理工具,采取综合干预措施管控河北省中医院(以下简称“该院”)中药注射剂的临床应用。以2020年为干预前、2021年为第1阶段干预后、2022年为第2阶段干预后,对比干预效果。结果:干预前,该院中药注射剂合理使用率为92.38%(3 008/3 256),第1阶段干预后、第2阶段干预后分别升高至94.64%(3 740/3 952)、97.34%(3 766/3 869),与干预前的差异有统计学意义(P<0.001),中药注射剂不合理使用情况得到明显改善。第2阶段干预后,在超疗程、未冲管方面较第1阶段干预后明显改善,差异均有统计学意义(P<0.001),且未发现中西药混合输注、溶剂剂量不适宜、给药途径不适宜、溶剂种类选择不当等问题。干预后,中药注射剂相关不良反应占药品总不良反应的比例呈逐年降低趋势,尤其是第2阶段干预后较干预前明显降低,差异有统计学意义(P=0.013)。结论:在医院中药注射剂管理中运用多学科协作管理模式结合PDCA质量管理工具,可使管理质量显著提高,该方法值得在医院药事管理中推广。

2018年至2022年某中医院第二类精神药品使用情况分析

目的促进中医院第二类精神药品的合理使用。方法利用医院信息系统收集安徽省芜湖市中医医院2018年至2022年第二类精神药品的销售数据,分析用药频度(DDDs)、限定日费用(DDC)、排序比(B/A);按第二类精神药品门急诊处方150张/年和病历医嘱50份/年,根据药品说明书、相关指南及专家共识进行处方点评。结果2020年,第二类精神药品销售金额最大,占全院药品销售总金额的1.86%;地佐辛注射液、盐酸曲马多缓释片、咪达唑仑注射液销售金额排名前3;阿普唑仑片、艾司唑仑片、地佐辛注射液的DDDs排名前3;阿普唑仑片的DDC最低;地佐辛注射液的B/A在0.33~1.00之间。共收集1000张处方/医嘱,其中合理处方709张,合理医嘱228条,合理率为93.70%;不合理类型包括用药不规范、不适宜。结论该院2018年至2022年第二类精神药品的使用存在不合理现象,应继续加强对其的管理和监控,确保临床用药安全、合理。

SHANGHAI WARD FOR WEIGHT LOSS USES TRADITIONAL CHINESE MEDICINE

A weight-loss clinic which uses traditional Chinese medicine was set up at the Xiangshan Hospital of Traditional Chinese Medicine in Shanghai. In addition to doing exercises, patients receive a treatment of rhubarb that is applied externally or taken orally to lose weight.

精细化管理法减少中药注射剂不合理配伍的效果分析

目的:评价精细化管理法减少中药注射剂不合理配伍的效果。方法:通过鱼骨图分析可能影响中药注射剂不合理配伍的因素,针对关键问题实施精细化管理,调查精细化管理干预前(2021年7—12月)、干预后(2022年7—12月)该院中药注射剂医嘱,对不合理配伍医嘱进行统计分析,对比干预前后中药注射剂医嘱配伍不合理率,探讨干预措施的有效性。结果:干预前,25453组中药注射剂医嘱中,不合理配伍医嘱2366组,中药注射剂医嘱配伍不合理率为9.30%;干预后,28466组中药注射剂医嘱中,不合理配伍医嘱855组,中药注射剂医嘱配伍不合理率为3.00%,不合理率较干预前降低67.74%。干预后,中药注射剂医嘱中溶剂剂量不适宜、违反“十九畏”原则和溶剂种类选择不当问题大幅减少,未冲管和中西药混合输注问题已基本不存在。表明精细化管理模式能够有效改善中药注射剂医嘱不合理配伍情况。结论:通过鱼骨图分析可能影响中药注射剂不合理配伍的因素,针对关键问题实施精细化管理,可有效减少中药注射剂的不合理配伍现象,为其他医院中药注射剂的合理应用提供了参考。

理性情绪疗法联合中医情志干预对血管性痴呆患者焦虑抑郁症状的影响

目的观察理性情绪疗法联合中医情志干预对血管性痴呆患者焦虑抑郁症状的影响。方法将80例血管性痴呆患者按照随机数字表法分为2组,对照组40例予常规基础干预,观察组40例在对照组干预基础上采用理性情绪疗法联合中医情志干预,2组均干预4周。比较2组干预前后简易智能状态检查表(MMSE)、日常生活能力量表(ADL)、老年痴呆患者生活质量量表(QOL-AD)评分、汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分变化;比较2组干预满意度。结果2组干预后MMSE评分均较本组干预前升高(P<0.05),干预后观察组高于对照组(P<0.05)。2组干预后ADL评分均较本组干预前降低(P<0.05),QOL-AD评分均较本组干预前升高(P<0.05);干预后观察组ADL评分低于对照组(P<0.05),QOL-AD评分高于对照组(P<0.05)。2组干预后HAMD评分、HAMA评分均较本组干预前降低(P<0.05),干预后观察组HAMD评分、HAMA评分均低于对照组(P<0.05)。观察组各项满意度均高于对照组(P<0.05)。结论理性情绪疗法联合中医情志干预,能有效改善血管性痴呆患者心理状态和认知功能,提高其日常生活能力、生活质量和干预满意度。

某院门诊中药饮片处方合理用药分析

目的探讨PDCA循环管理方法在中药饮片处方点评中的应用,分析其对提高处方合格率和促进合理用药的作用。方法对照组选取2023年10~12月期间院内门诊的645张中药饮片处方,研究组为2024年1~3月(612张)和2024年4~6月(615张),分别为第一阶段和第二阶段PDCA循环管理的处方。通过比较开展PDCA循环管理前后的处方点评结果,评价该方法在提高中药饮片处方合格率及减少不合理处方产生的效果。结果经过2个PDCA循环管理,中药饮片的处方合格率得到了显著提升。研究第一阶段组,门诊中药饮片处方的合格率明显提高,从70.54%提高至81.69%(P<0.01),并未达到预期效果;第二轮循环后,研究第二阶段组合格率达91.87%,与对照组和研究第一阶段组相比明显改善(P<0.01)。在诊断缺失、无中医辨证、特殊煎法未标注及毒性饮片合理使用等方面,亦有明显改善(P<0.01)。结论PDCA循环管理策略显著优化了中药饮片处方的质量,可推动医院合理用药水平提升。

“有毒中药”的医疗机构应用现状及警戒思考

目的:通过调研中医药专业人员,了解“有毒中药”的临床应用现状,提出有针对性的药物警戒思考。方法:围绕“有毒中药”设计调研问卷,对19个省/自治区/直辖市的136名中医师、中药师进行调研,并对调研结果进行分析。结果:发放调研问卷136张,回收136张。调研对象对于“有毒中药”的认知存在一定的局限性,关注重视程度不足,临床使用行为存在不规范现象,相关法律法规等方面的学习相对片面。结论:医疗机构医师、药师应以本院的“有毒中药”为基础,提升对“有毒中药”整体的认知水平;以不良反应为切入点,加强对“有毒中药”的重视程度;将科研成果与临床实际相结合,规范“有毒中药”的临床使用。

中药饮片处方的临床不合理用药情况分析

目的分析中药处方的临床不合理应用情况,并进行中药处方点评,以探讨中药处方点评对中药饮片使用合理性的影响。方法将开展中药处方点评前(2019年1~12月)的650张处方作为对照组,开展中药处方点评后(2020年1~12月)的710张处方作为研究组。对照组未开展中药处方点评,研究组开展中药处方点评。比较两组不合理处方发生情况及医患纠纷发生情况。结果研究组的不规范处方、不适宜处方、大处方发生率分别为21.97%、30.42%、0.99%,均明显低于对照组的73.69%、69.08%、5.08%,差异有统计学意义(P<0.05)。研究组医患纠纷发生率为1.27%(9/710),低于对照组的6.77%(44/650),差异有统计学意义(P<0.05)。结论中药饮片临床应用存在较多不合理用药情况,通过中药处方点评可有效的促进中药饮片的合理应用水平,并能监测中药饮片的用药质量,加强中药饮片处方的监管,从而保障患者的用药安全,改善医患关系。

何首乌安全用药指南

何首乌为常用中药,在临床治疗和日常保健中使用广泛,但近年来屡见有肝损伤报道,引起国内外广泛关注,部分含何首乌和首乌藤制剂肝损伤风险已被国家食品药品监督管理局多次通报。近年来相关研究已取得实质性进展,揭示了其特异质肝损伤的基本属性、主要成因、物质基础和分子机制,发现其易感人群的基本特征和生物标志物,表明何首乌仅对极少数特定人群有肝损伤风险,对绝大多数人群是安全的。研究成果为正确客观地认识何首乌致肝损伤、合理制定何首乌及相关制剂安全用药措施提供了科学依据。为此,中华中医药学会组织全国相关领域专家,起草制定了《何首乌安全用药指南》,旨在帮助国内外公众和相关机构,科学认识、评估和规避何首乌肝损伤风险,指导何首乌及相关制剂的合理使用,保障广大消费者的健康权益,同时促进何首乌及相关产业的健康持续发展。该指南已通过中华中医药学会的审核,并进行了发布,编号T/CACM 1328-2019。

临床药学干预对中药注射剂使用合理性影响研究

目的:对中药注射剂使用过程中的临床药学干预效果进行探析。方法:选取2022年12月—2023年12月无锡市江南大学附属医院收治的104例行中药注射剂治疗的患者,采用随机数字表法将其分为对照组和研究组,每组各52例。对照组实行常规干预,研究组实行临床药学干预。对两组患者临床治疗效果、不合理用药情况、不良反应发生情况进行比较与分析。结果:研究组临床有效率为96.15%,高于对照组(76.92%),差异有统计学意义(χ^(2)=4.308,P=0.038);研究组不合理用药率为9.62%,低于对照组(25.00%),差异有统计学意义(χ^(2)=4.300,P=0.038);研究组不良反应发生率为5.77%,低于对照组(21.15%),差异有统计学意义(χ^(2)=5.283,P=0.022)。结论:临床药学干预能够显著降低用药不合理性风险,降低药物不良反应的发生率。

门诊中药饮片处方点评及合理用药对策研究

目的对目前门诊的处方(中药饮片)执行的具体情况进行总结、分析,为安全合理用药提供参考。方法抽取2021年1—12月常熟市中医院门诊就诊的3600例患者作为研究对象,开具3600张中药饮片处方。归纳患者疾病类型、就诊科室,计算各季度不合理处方发生率,分析不合理处方的具体状况,探讨中药饮片配伍禁忌及应用频次等。结果纳入本次研究的3600例患者中,疾病类型占比前3位的分别为消化系统疾病、妇科病、呼吸系统疾病,占比依次为30.73%、23.75%、15.78%。处方由中医内科、中医外科、妇科、皮肤科、儿科、骨科门诊抽取,分别为1223张、463张、727张、304张、562张、321张。不合理处方有532张,占比14.78%(532/3600),其中包括不适宜处方87张,不规范处方143张、超常处方302张。单药处方>10~15种占比最高,为40.78%,其次为>15~20种,占比38.11%。第一、二、三、四季度不合理处方数占比分别为5.44%、4.53%、2.97%、1.83%。饮片配伍禁忌以半夏-附子、浙贝母-附子等为主。结论常熟市中医院的门诊中药饮片处方基本合理,但依然存在着一些问题,在临床工作中,中药师自先需加强与医师间的交流。指导其开展合理与科学的正确处方。这样所开具的中药饮片能确保患者的用药安全,改善疾病预后。

深圳市某三级甲等医院中药饮片处方药味调查及影响因素分析

目的:探讨该院中药饮片处方药味数及其影响因素,寻找改进措施,促进中药饮片的合理应用。方法:抽取2023年该院门诊中药饮片处方2880张,通过Excel软件录入患者性别、年龄、药味数、科室、医师职称等信息,重点分析上述因素与处方药味数的关联性。采用SPSS 27.0软件对数据进行统计学分析。结果:抽取的2880张中药饮片处方中,平均药味数为13.99味,药味频率主要集中在11~20味,16味药的处方最多(465张,占16.15%);不同性别患者的处方药味数比较,差异无统计学意义(P>0.05);不同年龄段患者的处方药味数比较,差异有统计学意义(P<0.01),其中>50岁的患者处方药味数较其他年龄段多;随着医师职称的升高,处方的药味数亦呈升高趋势,且不同医师职称的处方药味数的差异有统计学意义(P<0.01);平均药味数排序居前列的科室主要有名中医馆、脾胃病科、老年病科、肾病科、肝病科;>18味药的处方有280张(占9.72%),主要集中于脾胃病科、名中医馆、流派工作室等;针对280张大处方进行处方点评,不合理率高达31.43%(88张)。结论:该院中药饮片处方药味数偏高,处方药味数受患者年龄、医师职称、就诊科室的影响;大处方中的不合理率亦较高,不合理之处主要体现在药味机械相加、主辅不明等。