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为评价糖皮质激素治疗突发性聋的疗效及安全性。通过循证医学评价数据库、PubMed等数据库机检和检索中文耳鼻咽喉杂志,对突聋的文献进行分析。对于轻度、低频听力损失的突聋,激素并不优于其他治疗;抗病毒加激素治疗不能提高激素的有限疗效,无循证医学依据证明某一种激素的疗效更佳;激素与抗凝、神经营养类药治疗缺乏随机对照研究,临床报道的疗效相互矛盾;局部应用激素的疗效需多中心的随机对照研究,才能评价其真正作用。 相似文献
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目的:通过对针灸治疗肿瘤化疗后消化道反应的临床证据的整理评价,为临床决策提供参考依据。方法:全面广泛收集相关文献,按照循证医学的原则,采用统一编制的“针灸治疗肿瘤化疗后消化道反应文献质量评价信息采集表”,对1979—2014年发表的临床随机对照试验进行质量评价。结果:检索共获得中文临床文献60篇,随机对照试验文献30篇;英文临床文献10篇,其中随机对照试验文献5篇,符合纳入标准的只有中文随机对照试验文献17篇。经过分析研究发现,针灸治疗肿瘤化疗后消化道反应的症状(恶心呕吐)改善有效率与常规药物治疗相比,治疗优势明显。结论:循证医学的方法有利于高质量证据的提炼,为针灸治疗肿瘤病症提供临床依据。 相似文献
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《吉林医学》2015,(17)
目的:探讨高压氧在循证治疗中的临床应用状况。方法:使用计算机检索中国生物医学文献数据库(CBM,2001~2014)、中文期刊全文数据库(2001~2014)和Cochranc图书馆(2014年第2期),从中查找相关的Meta分析、随机对照试验和系统评价,并对它们的纳入文献进行分析、总结和评价。结果:共检索到7篇高质量的高压氧治疗疾病疗效的系统评价,其中有6篇Cochrance系统评价。研究结果显示高压氧对缺血性脑卒中、多发性硬化、急性冠状动脉综合征、突发性感觉神经性耳鸣、耳聋等多种疾病均具有一定程度的治疗效果,并且还可以加快患者慢性伤口的愈合速度,降低放射性损伤。讨论:高压氧在多种疾病的治疗中均有一定程度的治疗效果,不过目前相关的随机对照试验中的样本量都比较少,因此高压氧在多种疾病中的确切疗效和安全性等还需要更多大样本量的、设计严格的随机对照试验来进一步证明。 相似文献
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目的运用循证医学的方法评价盐酸米诺环素治疗种植体周围炎的疗效及其研究质量。方法计算机检索中国知网、万方数据库、维普数据库、Web of Science、MEDLINE、Science Direct和Springer Link中有关盐酸米诺环素局部应用治疗种植体周围炎的文献。按纳入和排除标准筛选文献,进行方法学评价并整理文献,按照循证医学的方法进行分析。结果共检索到文献13篇,符合随机对照试验标准的文献有2篇,文献的数量较少,无法进行Meta分析。据纳入的文献分析结果得知,局部应用盐酸米诺环素在治疗种植体周围炎症时,有很好的疗效。结论目前,盐酸米诺环素治疗种植体周围炎症疗效的研究文献数量和质量不能满足临床需求,需要更多更科学的随机对照试验研究文献,指导盐酸米诺环素对种植体周围炎症的治疗。 相似文献
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银屑病性关节炎的循证治疗 总被引:1,自引:0,他引:1
目的为1例银屑病性关节炎患者制定循证治疗方案。方法充分评估患者情况后.提出临床问题,计算机检索Guideline美国国立指南库、Cochrane图书馆(2007年第3期)、MEDLINE数据库(PubMed网站1980年1月至2007年7月)。结果共检索到与不同问题相关的文献11篇,其中美国国立指南2篇.Cochrane图书馆系统评价1篇,PubMed荟萃分析1篇和随机对照试验文献7篇。通过对检索结果进行分析,为患者制定了合理的治疗方案。经6个月的治疗随访,证实该方案适合患者。结论采用循证医学的方法,为银屑病性关节炎患者制定合理的治疗方案,可提高治疗效果。 相似文献
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目的 评价半夏泻心汤治疗慢性胃炎的疗效与安全性。方法 采用Cochrane循证医学系统评价方法,检索Cochrane图书馆、Cochrane另证医学领域试验注册数据库,MEDLINE、EMBASE、中国生物医学文献数据库以及BIOSIS等数据库。收集比较半夏泻心汤与安慰剂、非特异性治疗、其它中药治疗或西药治疗的随机与半随机对照试验。数据采用Cochrane协作网专用软件RevMan4.1进行统计分析。结果 共有18篇随机对照试验1886名病人满足纳入标准。所有试验普遍质量不高,未发现双盲试验。“倒漏斗”图显示不对称,提示存在发表偏倚。与得乐冲剂、非特异性疗法比较,半夏泻心汤在症状和体征改善及抗幽门螺杆菌方面有效,与雷尼替丁、三九胃泰比较,半夏泻心汤对症状和体征改善有效。试验未发现严重的副作用。结论 由于存在发表偏倚且文献质量普遍低,尚不能提供半夏泻心汤治疗慢性胃炎疗效的循证医学证据。 相似文献
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【目的】系统评价靳三针治疗中风后痉挛性偏瘫的临床疗效,为临床治疗中风后痉挛性偏瘫提供循证医学依据。【方法】计算机检索中国知网期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、美国生物医学信息检索系统(PubMed)、荷兰医学文摘(Embase)、国际循证医学图书馆(Cochrane Library)等各大数据库中所有关于靳三针治疗中风后痉挛性偏瘫的随机对照临床试验(RCTs)文献。检索语言为中文和英文;检索时间为各数据库自建库以来至2022年5月。由2名研究员独立筛选文献、提取资料并采用Cochrane偏倚风险评估工具评价纳入研究的偏倚风险后,采用RevMan 5.4.1进行Meta分析。【结果】最终共纳入12篇文献,共1 200例患者。Meta分析结果显示,与康复组相比,靳三针组改善临床神经功能缺损程度(NDS)评分[MD=-1.55,95%CI(-2.09,-1.00),P<0.000 01]、四肢简化Fugl-Meyer评分(FMA)[MD=4.02,95%CI(2.71,5.32),P... 相似文献
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[目的]对针灸治疗颈椎病临床随机对照文献进行方法学质量评价,为临床研究提供循证医学证据.[方法]通过检索PubMed数据库、中国期刊全文数据库(CNKI)、中文科技期刊数据库(VIP)、万方中华医学会期刊数据库,在排除重复、无关及非随机对照研究后,筛选出符合纳入标准的针灸治疗颈椎病临床随机对照文献,并采用Jadad评分... 相似文献
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Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD. 相似文献
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Jiageng Zhu Jun Li Ruipeng Ji Jianghao Su Mingshun Shen Zhigang Cao 《南京医科大学学报(自然科学版)》2007,21(2):125-128
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment. 相似文献
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Xi-zhao Sun Zhi-wei Zhang 《中国医学科学杂志(英文版)》2005,20(3):221-221
Shock wave lithotripsy (SWL) is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it's difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath. 相似文献
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Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction. 相似文献
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INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5 相似文献
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Tao Ye * Zhi-quan Liu Jian-jun Mu Xi-han Fu Jun Yang Bao-lin Gao and Xiao-hong Zhang Department of Cardiology First Hospital of Xi'an Jiaotong University Xi'an Hanzhong Cardiovascular Institute Hanzhong 《中国医学科学杂志(英文版)》2004,19(4):248-251
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure. 相似文献
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People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia its metabolic origin in Tibetan population.…… 《中国医学科学杂志(英文版)》2007,22(2):F0003-F0003
People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population. 相似文献
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APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES 总被引:13,自引:0,他引:13
Hong Zhao Tie-hu Ye* Zhi-yi Gong Yang Xue Zhang-gang Xue and Wen-qi HuangDepartment of Anesthesiology Peking Union Medical College Hospital Chinese Academy of Medical Sciences & Peking Union Medical College Beijing Department of Anesthesiology Zhongshan Hospital Fudan University Shanghai Department of Anesthesiology the First Affiliated Hospital Zhongshan University Guangzhou 《中国医学科学杂志(英文版)》2005,20(1):59-62
FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle… 相似文献
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Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and > 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability. 相似文献
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Changjun Bao Dr. Dworkin Daxin Ni Renjie Jiang Xian Li Zhongze Wang Zhiyang Shi Liang Li Hua Wang 《南京医科大学学报(自然科学版)》2007,21(5):324-332
Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission. 相似文献