乌拉地尔对急性脑出血患者高血压的疗效观察

目的　探讨新型α 受体阻滞剂乌拉地尔 (压宁定 )治疗急性脑出血患者高血压的疗效及作用特点。方法　对 2 5例急性脑出血伴血压明显增高者用乌拉地尔前后的血压和心率进行了观察和比较。结果　用乌拉地尔后 5、16、2 0、30、6 0、12 0min的收缩压及舒张压与用药前相比 ,有显著的降低 (P<0 .0 1) ,而心率与用药前相比差异无显著 (P >0 .0 5 )。用药后 5min收缩压、舒张压下降幅度分别达14 .3 %、10 .4% ,用药后 30min分别达 2 7.3%、2 5 .4% ,30min以后下降速度缓慢 ,出现相对稳定 ,无 1例出现血压过低现象。结论　乌拉地尔治疗急性脑出血患者的高血压 ,降压迅速、安全、副作用小 ,不引起反射性心动过速。     

乌拉地尔与硝酸甘油治疗高血压急症的随机对照研究

目的 :将乌拉地尔和硝酸甘油进行比较 ,探讨乌拉地尔治疗高血压急症的疗效。方法 :4 2例高血压急症患者随机接受乌拉地尔或硝酸甘油静脉治疗 ,其中乌拉地尔组 2 3例 ,硝酸甘油组 19例。两组均记录用药前及用药后 5min、 10min、 2 0min、 30min、 6 0min的血压和心率。结果 :两组血压自用药后 5min开始较用药前均明显下降 (P <0 0 5 )。但乌拉地尔组用药后各时间段心率无明显变化 (P >0 0 5 ) ,硝酸甘油组用药后各时间段心率均增快 (P <0 0 5 )。乌拉地尔组在 6 0min的降压幅度为收缩压下降了 2 4 6 % ,舒张压下降了 2 5 6 %。结论 :乌拉地尔治疗高血压急症的降压效果与硝酸甘油相似 ,但心率变化小 ,降压幅度较理想 ,可作为治疗高血压急症的首选药物之一。     

乌拉地尔与硝普钠治疗急性左心衰竭的疗效对比观察

目的观察乌拉地尔治疗急性左心衰竭的临床疗效。方法将50例急性左心衰竭患者随机分为观察组和对照组各25例。在常规治疗基础上,对照组予以硝普钠微量泵泵入,观察组予以乌拉地尔静脉滴注。观察并比较2组临床疗效。结果观察组治疗后总有效率为88%,高于对照组的60%,差异有统计学意义(P<0.05)。结论乌拉地尔治疗急性左心衰竭效果显著。     

国产和进口乌拉地尔治疗高血压的费用-效果分析

目的：比较国产乌拉地尔(利喜定)与进口乌拉地尔(压宁定)治疗外科手术时高血压的效益。方法：根据献选择60例重症高血压病人，将他们随机分为两组：国产乌拉地尔组(n＝30)，进口乌拉地尔组(n＝30)，应用药物经济学的费用—效果分析方法进行评价。结果：国产乌拉地尔用药后SBP平均下降42．70mmHg，降幅23％；进口乌拉地尔用药后SBP平均下降39．85mmHg，降幅22％。DBP两组下降分别为：国产乌拉地尔26．90mmHg(25％)，进口乌拉地尔26。70mmHg（25%）。治疗前后两组差别均无显性(P＞0．05)。但进口乌拉地尔价格较贵。结论：通过药物经济学的分析，国产乌拉地尔是治疗重症高血压的理想药物。     

静脉注射乌拉地尔治疗急性左心功能衰竭疗效观察

目的　观察乌拉地尔治疗急性左心功能衰竭的疗效。方法　急性左心功能衰竭 49例 ,随机分为治疗组 ( 32例 )和对照组 ( 17例 ) ,治疗组在常规治疗的基础上加用乌拉地尔 ,对照组在常规治疗的基础上加用硝酸甘油。结果　治疗组显效 2 2例 ,有效 8例 ,无效 2例 ,总有效率 93 75 %。对照组显效 4例 ,有效 7例 ,无效 6例 ,总有效率 6 4 71%。乌拉地尔治疗组与对照组对比P <0 0 1,具有显著性差异。结论　乌拉地尔治疗急性左心功能衰竭效果显著 ,安全。     

利喜定和优匹敌治疗重症高血压的费用-效果分析

目的 :探讨国产和进口乌拉地尔注射液对重症高血压的治疗效果和经济效果。方法 :重症高血压患者80例 ,随机分为Ⅰ组和Ⅱ组 ,Ⅰ组给予国产乌拉地尔 (利喜定 )注射液 ,Ⅱ组给予进口乌拉地尔 (优匹敌 )注射液 ,运用药物经济学中的费用 -效果分析方法进行比较。结果 :Ⅰ组治疗有效率为90 0 % ,Ⅱ组治疗有效率为92 5 % ,两组间无显著性差异 (P>0 05) ,但治疗费用上却有明显差异。结论 :药物经济学在指导临床合理用药、减轻患者经济负担方面具有重要意义。     

利喜定和优匹敌治疗重症高血压的费用-效果分析

目的 :探讨国产和进口乌拉地尔注射液对重症高血压的治疗效果和经济效果。方法 :重症高血压患者80例 ,随机分为Ⅰ组和Ⅱ组 ,Ⅰ组给予国产乌拉地尔 (利喜定 )注射液 ,Ⅱ组给予进口乌拉地尔 (优匹敌 )注射液 ,运用药物经济学中的费用 -效果分析方法进行比较。结果 :Ⅰ组治疗有效率为90 0 % ,Ⅱ组治疗有效率为92 5 % ,两组间无显著性差异 (P>0 05) ,但治疗费用上却有明显差异。结论 :药物经济学在指导临床合理用药、减轻患者经济负担方面具有重要意义     

国产乌拉地尔治疗终末期肾性高血压30例

目的 :比较国产乌拉地尔注射液与进口乌拉地尔注射液对终末期肾性高血压的临床疗效。方法 :治疗组3 0例 ,给予国产乌拉地尔注射液 12 .5mg ,iv ,qd ,继以 15 0 μg·min 1 静脉点滴维持。对照组 3 0例 ,给予进口乌拉地尔注射液用法同治疗组。结果 :国产乌拉地尔注射液对终末期肾性高血压安全有效 ,与进口乌拉地尔注射液疗效相似。结论 :国产乌拉地尔注射液对终末期肾性高血压疗效好 ,值得临床推广应用。     

利喜定治疗高血压的临床验证

目的：观察利喜定（国产乌拉地尔）与进口乌拉地尔注射剂对重症高血压及外科手术时高血压的降压疗效。方法：治疗组用利喜定12．5mg稀释以150mg.min^-1静脉滴注维持,对照组用进口乌拉地尔注射剂,试验方法与对照组相同,结果：治疗组SBP,DBP分别下降了42．7％（23．0％）,26．9mmHg(25.0%),对照组分别为39．8％（22．0％）,26．7（25．0％）mmHg,治疗前后两线血压均差异有极显著统计学意义（P＜0．01）,组间相比,治疗前后血压变化差异无统计学意义（P＞0．05）,对重症高血压及外科手术时高血压的总有效率为90．0％,96．7％,结论：利喜定为安全,有效的静脉降压药物。     

乌拉地尔与硝酸甘油在高血压危象院前急救中的应用价值对比分析

目的对比分析乌拉地尔与硝酸甘油在高血压危象院前急救中应用价值。方法选择的高血压急症患者88例,随机分为观察组和对照组,每组44例,观察组给予乌拉地尔,对照组给予硝酸甘油治疗。比较两组给药前后血压、心率变化,并统计两组治疗不良反应发生率。结果观察组临床治疗总有效率97.73%与对照组总有效率95.45%比较,差异无统计学意义(P>0.05);观察组治疗后血压、心率较对照组有显著改善,差异有统计学意义(P<0.05);观察组不良反应发生率为9.09%显著低于对照组15.91%(P<0.05)。结论乌拉地尔与硝酸甘油均可迅速降低患者血压,且作用平稳,但乌拉地尔对患者心率影响小,较硝酸甘油不良反应更少。     

莫西沙星与左氧氟沙星治疗下呼吸道感染的药物经济学评价

目的：对莫西沙星和左氧氟沙星治疗下呼吸道感染进行经济学评价。方法：根据文献选择下呼吸道感染病人98例，随机分成莫西沙星组（A）组和左氧氟沙星组（B）组，分别给予治疗。运用药物经济学的成本效果分析方法进行分析评价。结果：A组和B组治疗有效率分别为93．88％和89．80％，成本效果比（C／E）分别为23．99和7．84，ADR发生率分别为10．20％和8．16％，细菌清除率分别为97．37％和91．18％。结论：2组方案治疗下呼吸道感染的临床有效率与治愈率无显著差异，但A组的细菌清除率优于B组，B组的经济学成本优于A组。     

思瑞康与氯丙嗪治疗精神分裂症的对照研究

目的:比较思瑞康和氯丙嗪治疗精神分裂症的疗效和安全性。方法:将92例符合精神分裂症诊断标准(CCMD-3)的患者随机分为2组,每组46例,分别给予思瑞康和氯丙嗪治疗8wk,采用阳性症状与阴性症状量表(PANSS)、不良反应症状量表(TE_SS)评定疗效与不良反应。结果:思瑞康组与氯丙嗪组有效率分别为87.0%、91.3%(P>0.05)。思瑞康组嗜睡、头昏和体质量增加发生率更高(26.1%、23.9%、17.3%),氯丙嗪组锥体外副作用、心动过速和直立性虚脱发生率更高(60.9%、39.1%、32.6%)。结论:思瑞康与氯丙嗪治疗精神分裂症疗效相当,而前者不良反应相对较轻,安全性更好。     

拉米夫定联合卡介苗素治疗慢性乙型肝炎疗效观察

目的 :研究联合应用卡介苗素 (E -BCG)与拉米夫定 (3 -TC)治疗慢性乙型肝炎 (CHB)的疗效及其治疗机制。方法 :68例CHB患者随机分为治疗组 (n=37)与对照组 (n=31) ,治疗组给予E -BCG1.0mg,肌注 ,每周3次 ,连续6月 ,与3 -TC(100mg,每日1次 ,连续12个月)联合治疗 ;对照组单独用拉米夫定治疗 ,方法同上。治疗前、治疗2周、4周、8周、12周、16周、20周、26周、52周及停药后6个月分别检测HBV标志物、肝功能、肾功能及HBVDNA定量 ,并记录治疗期间临床和实验室检查发生的一切不良事件。结果 :疗程结束时 ,治疗组ALT复常率、HBeAg阴转率、HBeAg/HBeAb转换率与完全应答率分别为89.2 %、45.9 %、43.2 %与40.5 % ,高于对照组的67.7 %、22.6 %、16.1 %与16.1 % ,差异有显著性 (P<0.05)。疗程结束后6mo,治疗组HBeAg阴转率、HBeAg/HBeAb转换率分别为54.1 %与51.4 % ,明显高于对照组的19.4 %与12.9 % ,差异有非常显著性 (P<0.01)。复发率治疗组为25.0 % ,低于对照组的35.7 % ,差异有显著性 (P<0.05)。HBVDNA阴转率在两组间无显著性差异 (P>0.05)。结论 :采用3 -TC与E -BCG联合治疗CBH ,在提高ALT复常、促进HBeAg阴转与HBeAg/HBeAb转换、降低复发方面 ,较单用3 -TC更有效     

Comparison between insulin degludec/liraglutide treatment and insulin glargine/lixisenatide treatment in type 2 diabetes: a systematic review and meta-analysis

Aim: To evaluate the efficacy and adverse effects of IDegLira and IGlarLixi treatment and to perform a comparison between two strategies.

Methods: The registration number is CRD42017053952. Randomized controlled trials of IGlarLixi treatment or IDegLira treatment compared with placebo or active hypoglycemic agents in type 2 diabetes were included.

Results: Eight trials were included. The absolute HbA1c change relative to baseline after IGlarLixi treatment was ?1.50% with significance (95% CI, ?1.89% to ?1.12%, p < 0.01); the absolute HbA1c change after IDegLira treatment was ?1.89% with significance (95% CI, ?2.04% to ?1.73%, p < 0.01). Comparisons between IGlarLixi treatment and IDegLira treatment indicated no significant differences between groups. The absolute weight change after IGlarLixi treatment significantly decreased (weighted mean difference (WMD), ?0.62 kg; 95% CI, ?0.93 to ?0.31 kg, p = < 0.01), but the absolute weight change after IDegLira treatment was not significantly changed (WMD, ?0.81 kg; 95% CI, ?3.26 to 1.65 kg, p = 0.52). There were no significant differences between groups.

Conclusion: Glucose control of IGlarLixi treatment or IDegLira treatment was significantly lower than that at baseline. Comparisons between the two treatment groups indicated no significant differences between groups in absolute HbA1c changes or body weight changes relative to baseline.     

莫西沙星与左氧氟沙星在临床应用中的成本-效果分析

目的 探讨莫西沙星和左氧氟沙星在下呼吸道感染治疗中所产生的经济效果。方法根据文献选择下呼吸道感染患者98例，随机分成莫西沙星组（A组）和左氧氟沙星组（B组），分别给予治疗。运用药物经济学的成本．效果分析方法进行分析评价。结果 A组、B组治疗有效率分别为93．88％和89．80％，不良反应发生率分别为10．20％和8．16％，细菌清除率分别为97．37％和91．18％。结论 两组方案治疗下呼吸道感染的临床有效率、治愈率无显著差异，但A组的细菌清除率优于B组，B组的经济学成本优于A组。     

Safety and efficacy of bedtime versus daytime administration of the miconazole nitrate 1200 mg vaginal ovule insert to treat vulvovaginal candidiasis

ABSTRACT

Objective: Most vaginal products are self- administered at bedtime. Safety, efficacy, and therapeutic cure with bedtime versus daytime treatment of vulvovaginal candidiasis (VVC) were assessed to potentially improve compliance and convenience with vaginal antifungal treatment.

Methods: A non-inferiority study evaluated 573 women with symptoms of VVC, randomized to daytime or bedtime self-administration of single dose of miconazole nitrate 1200?mg vaginal ovule (Monistat-1).

Results: Subjects (n = 149) were evaluated for efficacy in the Daytime group and 163 in the Bedtime group. In the Daytime group, 86 (57.7%) participants achieved therapeutic cure, with 105 (70.5%) and 111 (74.5%) exhibiting mycologic and clinical cures, respectively. In the Bedtime group, 83 (50.9%) subjects achieved therapeutic cure, with 104 (63.8%) and 120 (73.6%) exhibiting mycologic and clinical cures, respectively (NS). There was no significant difference in the incidence of side effects between the two groups. Median estimated time to initial relief of itching, burning and irritation was similar for both. Miconazole nitrate 2% cream was also applied twice daily to the vulvar area for external symptoms for up to 7?days. Test-of-cure was assessed 21?days–30?days following administration of intra-vaginal drug. Time to vulvovaginal symptomatic relief and the effect of activity following daytime administration on therapeutic cure were also assessed.

Conclusion: The efficacy against a broad spectrum of pathogens and acceptability of daytime and bedtime administration of miconazole nitrate 1200?mg vaginal ovule were similar. These findings offer women a convenient option for treatment for VVC, whether self-managed or managed by their healthcare provider.     

奥拉西坦结合早期热针灸治疗脑梗死患者认知障碍的疗效观察

目的：观察奥拉西坦结合热针灸治疗脑梗死患者认知障碍的临床疗效。方法选取自2014年11月－2015年11月入住河北省沧州中西医结合医院神经内科的脑梗死患者240例,随机分为4组：奥拉西坦组、热针灸组、联合组和对照组各60例。对照组患者采用常规治疗、其他3组均在常规治疗基础上,奥拉西坦组加用奥拉西坦药物治疗、热针灸组加用早期热针灸中医治疗、联合组加用奥拉西坦结合热针灸中西医结合治疗;采用简单智能检查量表（ MMSE）评分及相关生化指标来评价治疗前后临床效果。结果 MMSE评分组内比较：奥拉西坦组和热针灸组在3个疗程后出现明显疗效,与治疗前比较,差异均具有统计学意义（ P＜0．05）;联合组在2个疗程后开始见疗效,并在3个疗程后患者MMSE分值已恢复到轻度认知障碍水平,差异均具有统计学意义（ P＜0．05）;组间比较：2个疗程结束后,联合组患者MMSE分值开始明显高于其他组,差异具有统计学意义（P＜0．05）。总有效率比较：通过3个疗程的治疗,联合组总有效率为95．0％,组间比较,联合组总有效率均高于其他3组,差异具有统计学意义（ P＜0．05）。治疗过程中联合组患者基本没有出现不良反应。结论采用奥拉西坦结合热针灸治疗脑梗死认知障碍有显著的临床疗效,体现了中西医结合治疗方法的优点。     

Efficacy of etoricoxib 60 mg/day and diclofenac 150 mg/day in reduction of pain and disability in patients with chronic low back pain: results of a 4‐week,multinational, randomized,double-blind study

ABSTRACT

Background and methods: The efficacy and safety of etoricoxib 60?mg/day in patients with established chronic low back pain (CLBP) were compared with those of diclofenac 150?mg/day in a 4‐week, multicentre, randomized, double-blind, parallel-group trial. Four hundred and forty-six adult patients with CLBP (Quebec Task Force on Spinal Disorders Class 1 or 2) and with worsening pain upon discontinuation of pre-study analgesic medication were enrolled in the study.

The study primary efficacy endpoint was change from baseline in Low Back Pain Intensity Scale (LBP‐IS) score over the 4‐week treatment period. Secondary and other efficacy endpoints included: changes in Roland and Morris Disability Questionnaire (RMDQ), Patient Global Assessment of Response to Therapy (PGART) and Low Back Pain Bothersomeness Scale (LBP-BS) scores. Early efficacy was assessed using PGART and LBP‐IS scores 4?h after the first dose on the mornings of Days 1, 2 and 3. The overall safety and tolerability of etoricoxib 60?mg/day during 4 weeks of treatment were also assessed.

Results: The least-squares mean time-weighted change from baseline LBP‐IS score over 4 weeks was –32.94?mm (95% CI –36.25, –29.63) for etoricoxib, indicating substantial efficacy in relief of pain. The treatment difference for the primary outcome was 2.51?mm (95% CI –1.50, 6.51), fulfilling the prespecified equivalence criterion of 95% confidence interval wholly within ± 10?mm. Etoricoxib improved all secondary and other efficacy outcomes.

There were no statistically significant between-group differences in the proportion of patients with one or more clinical adverse events (AEs) (etoricoxib 35%, diclofenac 39%), or the proportion of patients who discontinued due to AEs (etoricoxib 7%, diclofenac 5%).

Conclusions: The results of this study confirm that, for adult patients with CLBP, etoricoxib 60?mg once daily over 4 weeks is effective for relief of pain and improvement of physical function and comparable to high-dose diclofenac 150?mg daily.     

A comparison between IV paracetamol and IV metamizol for postoperative analgesia after retinal surgery

ABSTRACT

Objective: To assess clinical efficacy of IV paracetamol 1?g and IV metamizol 1?g on a 24‐h dosing schedule in this randomized, double-blinded, placebo-controlled study of 38 ASA physical status I–III patients undergoing retinal surgery.

Research design and methods: General anaesthesia using remifentanil, propofol, and desflurane was performed for surgery. The patients were randomly allocated to three groups, receiving infusions of paracetamol 1?g/100?mL (Para Group), of metamizol 1?g/100?mL (Meta Group), or of 100?mL of saline solution as placebo control (Plac Group) 30?min before arrival in the recovery area and every 6?h up to 24?h postoperatively. All patients had unrestricted access to intravenous opioid rescue medication.

Main outcome measures: The primary efficacy variables were pain scores at rest over 30?h postoperatively analysed by using repeated ANOVA measurement. Secondary efficacy variables were pain scores on coughing, also analysed by repeated ANOVA measurement.

Results: Five patients in the Plac Group and one patient in the Meta Group interrupted the study protocol. Regarding pain scores at rest, Mauchly-test of sphericity was significant (?p = 0.03). For the time effects a significant result was detected (?p < 0.001). The main effect between the three treatment groups was significantly different (?p = 0.01). The Bonferroni adjusted pair wise comparisons between the Plac Group and the Para Group showed a significant difference in favour of IV paracetamol (?p = 0.024; mean difference 14.8; 95% CI 1.6–28.0), between the Plac Group and the Meta Group in favour of IV metamizol (?p = 0.025; mean difference 14.4; 95% CI 1.5–27.4), and no significant difference between the Para Group and the Meta Group (?p = 1.0; mean difference 0.4; 95% CI –12.8 to 13.6). Pain scores on coughing showed a significant different main effect between the three treatment groups (?p = 0.022). The Bonferroni adjusted pair wise comparisons between the Plac Group and the Para Group showed a significant difference in favour of IV paracetamol (?p = 0.032; mean difference 17.9; 95% CI 1.3–34.6), a difference, though not reaching statistical significance, in favour of IV metamizol between the Plac Group and the Meta Group (?p = 0.081; mean difference 15.0; 95% CI –1.4 to 31.4), and no significant difference between the Para Group and the Meta Group (?p = 1.0; mean difference 2.9; 95% CI –13.8 6 to 19.6).

None of the patients experienced itching; one patient in the Meta Group developed a mild erythema. There was no statistical difference in the incidence of nausea (Plac vs. Para Group: p = 0.94, Plac vs. Meta Group: p = 0.98, Para vs Meta Group: p = 0.95) or vomiting (Plac vs. Para Group: p = 0.73, Plac vs. Meta Group: p = 0.85, Para vs Meta Group: p = 0.86) between the groups. Patients in the Plac Group experienced significantly more often sedation than patients in the Meta Group (?p = 0.049). There was a trend of higher sedation in the Plac Group than in the Para Group, which did not reach statistical significance (?p = 0.07). There was no difference in sedation between the Meta and the Para Groups (?p = 0.84).

Conclusion: IV paracetamol 1?g has a similar analgesic potency as IV metamizol 1?g for postoperative analgesia after retinal surgery.     

瑞马唑仑在内镜检查中镇静效应有效性和安全性的Meta分析

目的 系统性评价瑞马唑仑在内镜检查中镇静效应的有效性和安全性,并与丙泊酚和咪达唑仑进行比较。方法 在PubMed、Embase、Cochrane图书馆、万方数据库、CNKI等数据库进行了检索,收集了内镜检查中瑞马唑仑用于镇静的随机对照试验文献。检索时间从2018年起瑞马唑仑获批准于临床试验开始到2022年4月。搜索策略包括以下变量关键字：瑞马唑仑、胃镜检查、支气管镜检查和结肠镜检查。通过Rev Man5.4软件对纳入文献质量进行评估和对收集的资料进行Meta分析。结果 共有10项瑞马唑仑与丙泊酚和咪达唑仑的随机对照研究,共有2076 名患者纳入分析。结果表明,瑞马唑仑镇静效应优于咪达唑仑[OR = 0.03, 95% CI: (0.02, 0.05),?I2?= 0%,?p?< 0.00001];逊于丙泊酚[OR = 11.32, 95% CI: (2.12, 60.56),??I2= 0%,?p= 0.005]。瑞马唑仑起效时间较丙泊酚慢,较咪达唑仑快;但苏醒时间快于丙泊酚和咪达唑仑。与咪达唑仑相比,其不良反应发生风险无明显差异。与丙泊酚相比,瑞马唑仑的低血压、心率减慢、低氧血症和注射痛发生风险更低,但恶心发生风险升高,二者呕吐发生风险无差异。结论 瑞马唑仑用于内镜检查时,其镇静效应和起效时间优于咪达唑仑,但不及丙泊酚。苏醒时间快于丙泊酚和咪达唑仑。瑞马唑仑对呼吸瑞马唑仑对呼吸、循环抑制发生率低于丙泊酚,与咪达唑仑相比不良反应无明显差异。