硝苯啶与普萘洛尔治疗原发性高血压118例

原发性高血压118例(男72例,女46例;年龄54±12a;病程12±4a)采用硝苯啶(5-30mg/d,po)与普萘洛尔(5-30mg/d,po)合用治疗4a以上者,有效率100％,平均降压5.6/2.1kPa,脑卒中并发症减少,副反应轻微。复降片对照组80例(男49例,女31例;年龄52±13a;病程8±6a)采用复降片2-10片/d,po,治疗4a以上者,有效率64％,平均降压2.1/1.4kPa,与前者比较,P<0.01。     

环丙沙星治疗复治涂阳肺结核

目的 :观察环丙沙星治疗复治涂阳肺结核的疗效。方法 :将 146例复治涂阳肺结核病人分为治疗组 77例 (男性 51例 ,女性 2 6例 ,年龄 4 6±s 11a) ,对照组 69例 (男性 4 5例 ,女性 2 4例 ,年龄 4 9±11a) ,2组均应用HRZE方案 :异烟肼 (H) 0 .3g/d ;利福平 (R) 0 .4 5g/d(体重 >60kg者 0 .6g/d) ;吡嗪酰胺 (Z) 1.5g/d ;乙胺丁醇 (E) 0 .75g/d ,吡嗪酰胺为bid ,其余 3药均晨间空腹顿服 ,治疗组加环丙沙星 ,体重≥ 55kg者 0 .3g ,体重 <55kg者 0 .2 g ,po ,bid ,连用 6mo。结果 :治疗组和对照组治疗mo 6痰菌阴转率分别为 93%和 64% (P <0 .0 1) ,有显著性差异。结论 :环丙沙星可推荐治疗复治涂阳肺结核     

环丙沙星与诺氟沙星治疗尿路感染的比较

本文用环丙沙星250-500mg, po, bid,治疗尿路感染32例(男性5例,女性27例;平均年龄33±s 16a),平均疗程7±4d,有效率94％。另30例用诺氟沙星200mg, po, tid或qid,作对照,平均疗程16±3d,有效率83％。2组比较(P<0.05),提示环丙沙星效果更好。     

甲硝唑治疗盆腔炎的疗效

目的 :探讨甲硝唑的不同用药方式治疗盆腔炎的疗效。方法 :将 2 40例年龄 2 7a±s8a(2 3～5 1a) ,病程 2 .9a± 0 .9a(0 .2～ 4.7a)的盆腔炎病人 ,分为 3组 ,每组各 80例。研究组用 0 .5 %甲硝唑注射液 10 0mL灌肠 ,qd ;对照A组用 0 .5 %甲硝唑注射液 2 0 0mL ,ivgtt,qd ;对照B组用甲硝唑片0 .4g ,po ,bid ,3组均是 10d为一个疗程。结果 :总治愈率研究组为 84% (67/80例 ) ,对照A组 64%(5 1/80例 ) ,对照B组 44 % (3 5 /80例 ) ;不良反应率研究组为 10 % (8/80例 ) ,对照A组 75 % (60 /80例 ) ,对照B组 85 % (68/80例 )。结论 :甲硝唑注射液灌肠治疗盆腔炎疗效优于静脉滴注及口服组 ,静脉滴注给药疗效优于口服给药 ,且不良反应少。     

三种方案治疗消化性溃疡的成本—效果分析

目的探讨不同的药物治疗方案对幽门螺杆菌(Hp)感染的消化性溃疡所产生的经济效果.方法160例患者随机分为三组A组58例,治疗方法为枸橼酸铋钾0.22g+克拉霉素0.25g+替硝唑0.5g,po,bid×7d;B组50例,治疗方法同A组,疗程为14d;C组52例,治疗方案为奥美拉唑20mg+甲硝唑400mg+阿莫西林1g,po,bid×7d.运用经济学成本-效果分析对三种治疗方案进行分析评价.结果三种方案的成本-效果比(C/E)分别为10.52,12.74,11.70.结论A组方案是三种方案中的最佳治疗方案.     

吡哌酸和甲氧苄啶1或2天短程治疗菌痢

试用吡哌酸(PPA)和甲氧苄氨(TMP)短程治疗急性菌痢,PPA1.0g、TMP0.2gbid,治程2d,治疗55人;PPA2.0g,TMP0.4gq12h治程1d,治疗33人。均能获得很好效果:1个疗程治愈率为97％,两个疗程全部治愈。体温平均12±2.4h恢复正常,主要症状可于2.3±1.2d内消失,粪检和培养平均2.3±1.2d内转阴。1个疗程治后痢疾菌全部阴转,其中3d内阴转者88-97％,2d内阴转62-73％,1d内阴转亦达28-36％,远期症状复发率4％,未见带菌者。同时,亦未见明显毒副作用。     

丁苯酞软胶囊治疗急性缺血性脑梗死的临床观察

目的 观察丁苯酞软胶囊治疗急性缺血性脑梗死患者的临床疗效.方法 将80例急性脑梗死患者随机分为对照组(40例)和治疗组(40例).对照组予波立维75 mg/次,1次/d;他汀类药物胞磷胆碱钠注射液1.0g+生理盐水100ml静滴,1次/d;血栓通0.4 g/d静脉滴注;共14d.治疗组在对照组基础上加用丁苯酞软胶囊0.2 g/次,3次/d,连服14d.两组分别于治疗前和治疗后第14 d、30 d评定患者临床神经功能缺损程度[欧洲脑卒中量表(european stroke scale,ESS)],并进行比较.结果 治疗前对照组和治疗组ESS评分分别为(54.50±15.33)分和(53.50±15.35)分,两组比较差异无显著性(P＞0.05).经治疗后第14d、30d两组ESS评分分别为(69.60±17.78)分和(81.90±16.83)分、(74.18±17.65)分和(87.50±14.49)分,两组比较差异有极显著性(P＜0.01).结论 丁苯酞软胶囊可改善急性脑梗死的临床神经功能缺损,安全有效.     

环丙沙星治疗呼吸道、肠道及泌尿道感染

口服环丙沙星0.4-0.8g/d治疗各种感染38例(男19例,女19例,年龄38±s10a)。以头孢氨苄3-6g/d治疗呼吸道及其它感染13例(男7例,女6例,年龄33±s5a);诺氟沙星0.4-0.8g/d治疗肠道及泌尿道感染25例(男12例,女13例,年龄29±s2a)作对照。疗程均为7-14d。环丙沙星对肠道感染疗效比对照药物为好(P<0.01)。治疗组2例出现过敏反应。     

曲普利啶与马来酸氯苯那敏治疗荨麻疹的比较

目的 :观察曲普利啶对荨麻疹的疗效。方法 :117例患荨麻疹病人 ,男性 4 5例 ,女性 72例 ;年龄33.0±s 1.5a。分为治疗组 60例 ,对照组 57例。病程分别为 2 .0± 1.7a与 2 .0± 1.9a。治疗组用曲普利啶胶囊 5mg ,po ,bid ;对照组用马来酸氯苯那敏 8mg ,po ,tid。疗程为急性荨麻疹 7d ,慢性荨麻疹 30d。结果 :曲普利啶组总有效率为 83% ,与马来酸氯苯那敏组的 53%比较有显著性差异 (P<0 .0 1)。结论 :曲普利啶是治疗荨麻疹有效药物     

脑出血急性期血糖升高与患者胰岛素敏感性的关系

目的探讨高血压性脑出血急性期血糖升高患者是否存在胰岛素抵抗现象。方法将84例高血压性脑出血患者,以急性期血糖值分为血糖升高组和血糖正常组各42例;治疗1个月后测定其糖耐量试验前及后30、60、120、180min时血糖(BG)、血胰岛素(Ins)水平,计算其胰岛素敏感性指数(ISI)和神经功能缺损评分(NDS)。结果服糖后30、60min时血糖升高组的BG(10.76±2.41、9.51±0.94mmol/L)比血糖正常组(8.25±1.64、7.13±0.28mmol/L)高(P<0.05);血糖升高组的空腹Ins水平(12.37±11.25mmol/L)比血糖正常组(8.76±12.13mmol/L)高(P<0.05),服糖后30、60、120、180min时血糖升高组的Ins水平(96.42±30.58、83.64±24.05、74.63±20.46、35.48±11.32mmol/L)均明显高于血糖正常组相应时段的Ins(57.34±21.34、46.31±17.52、39.37±14.32、20.14±7.28mmol/L)水平(P<0.01);血糖升高组空腹ISI(-1.82±0.74)则低于血糖正常组(-1.34±0.56)(P<0.05),服糖后30、60、120、180min时血糖升高组的ISI(-3.45±1.59、-2.97±1.34、-2.74±1.05、-2.24±0.65)均低于血糖正常组相应时段的ISI(-2.97±1.25、-2.65±1.07、-2.36±0.84、-1.87±0.58)(P<0.05)。治疗30d后血糖升高组的NDS(23.16±10.78)高于血糖正常组(19.43±11.26)(P<0.05)。?     

诺氟沙星治疗阿米巴肝脓肿

目的：探索新的、有效的治疗阿米巴肝脓肿的药物。方法：诺氟沙星０．３－０．４９，ｔｉｄ，ｐｏ×１５ｄ，治疗３０例（男性２２例，女性８例；年龄４５±ｓ３ａ）阿米巴肝脓肿病人。用０．５％甲硝唑１００ｍＬ静脉滴注（静滴），ｂｉｄ×（３－５）ｄ，以后改为０．４ｇ，ｔｉｄ，ｐｏ×（７－１０）ｄ治疗２９例作对照。２组合并细菌感染者均加用四环素１．０ｇ，ｑｄ，静滴５－７ｄ或用氨苄西林２．０ｇ，ｔｉｄ，ｉｖ×（５－７）ｄ。结果：诺氟沙星组在治疗有效率，体温恢复正常时间，平均住院无数与甲硝唑组相似（Ｐ＞０．０５）。但脓腔缩小时间短，肝区疼痛消失早，不良反应少（Ｐ＜０．０１或０．０５）。结论：诺氟沙星治疗阿米巴肝脓肿优于甲硝唑。     

Interaction of metronidazole with phenobarbital, cimetidine, prednisone, and sulfasalazine in Crohn's disease

The influence of prednisone(PR), sulfasalazine(SZ), cimetidine(CM), and phenobarbital(PB) on the pharmacokinetics of metronidazole was investigated in six Crohn's patients. Metronidazole was first administered alone (250 mg bid, po) and then with prednisone (10 mg bid, po), sulfasalazine (1 g bid, po), cimetidine (600 mg bid) or phenobarbital (60 mg bid, po). Each regimen was followed for 6 days and sampling of blood and urine was carried out on the 7th day after the first dose of each regimen. Plasma and urine samples were analysed for the drug and its two principal metabolites, hydroxymetronidazole and metronidazole-1-acetic acid, by HPLC. When given alone, metronidazole had a mean volume of distribution of 0.667 +/- 0.15 lkg-1, a half-life of 9.7 +/- 3.1 h and an oral clearance of 0.852 +/- 0.23 (ml-1 min) kg-1. The disposition kinetics of metronidazole and its metabolites was not altered by CM and SZ. Induction of metabolism of metronidazole by PR was made manifest in significant increases in oral clearance of the former and urinary excretion of the hydroxy metabolite, and significant decrease in AUC of the parent compound. PB also induced the metabolism of metronidazole. This induction was reflected in significant increases in the oral clearance of metronidazole and AUC of the hydroxy metabolite as well as significant decreases in AUC, half-life, and urinary excretion of the parent drug.     

环丙氟哌酸的药效学和毒理学研究

本文研究了环丙氟哌酸的体外抗菌作用、体内保护作用、小鼠和大鼠一次给药的半数致死量和安全试验。结果表明,环丙氟哌酸对革兰氏阴性菌的MIC范围为0.005～0.19μg/ml,抗菌活性强于氟哌酸、氟啶酸和吡哌酸;对革兰氏阳性菌的 MIC为0.045～1.50μg/ml,其抗革兰氏阳性菌活性明显强于上述对照药。小鼠分别感染金葡球菌、大肠杆菌和绿脓杆菌后的半数有效量明显优于氟哌酸、氟啶酸和吡哌酸。小鼠一次给药的半数致死量,口服LD_(50)为2991.52mg/kg; 静脉为223.88mg/kg;肌肉和皮下的LD_(50)分别为831.08mg/kg和1133.42mg/kg. 大鼠口服LD_(50)>5000mg/kg,静脉LD_(50)>200mg/kg;肌肉和皮下分别为>1000mg/kg和>1200mg/kg。狗口服50mg/kg日服三次为期2日和口服100mg/kg日服一次为期7日,未见毒性反应和功能改变,也未见病理组织学变化。     

地拉普利与卡托普利治疗原发性高血压的比较

目的：探索地拉普利治疗原发性高血压病的疗效。方法：原发性高血压病人３０例（男性１６例，女性１４例：年龄６２±ｓ１１ａ）采用地拉普利１５～６０ｍｇ，ｐｏ，ｂｉｄ，共４ｗｋ为地拉普利组。另设对照组３０例（男性１７例，女性１３例；年龄６５±９ａ）采用卡托普利１２．５～２５ｍｇ，ｐｏ，ｂｉｄ或ｔｉｄ共４ｗｋ为卡托普利组。结果：地拉普利组剂量３０～６０ｍｇ／ｄ，总有效率８７％，增加剂量未见疗效增加；卡托普利组总有效率９０％，组间经Ｒｉｄｉｔ分析法检验：Ｐ＞０．０５。２组副作用均轻微。结论：地拉普利治疗原发性高血压的疗效好，且安全。     

阿莫西林-克拉维酸钾治疗恶性血液病化疗后白细胞减少期并发感染

目的：观察阿莫西林＿克拉维酸钾对恶性血液病化疗后白细胞减少期并发细菌感染的疗效。方法：恶性血液病化疗后白细胞减少期病人６０例（男性３６例,女性２４例,年龄４２ａ±ｓ１５ａ）,随机分为２组（每组３０例）。治疗组用阿莫西林＿克拉维酸钾０．６２５ｇ,ｐｏ,ｂｉｄ,对照组用阿莫西林０．５ｇ,ｐｏ,ｑｉｄ,疗程均为５～７ｄ。结果：治疗组和对照组的临床有效率分别为９３％和６０％,细菌清除率分别为８６％和５２％。结论：阿莫西林＿克拉维酸钾是一种有效的治疗细菌感染的药物,无明显的不良反应。     

丙谷胺与熊去氧胆酸治疗胆囊结石疗效比较

目的：比较丙谷胺与熊去氧胆酸治疗胆囊结石的疗效。方法：将１６０例胆囊结石病人随机分为２组。丙谷胺组８０例（男性１２例，女性６８例；年龄３８±ｓ５ａ），用丙谷胺片每次５片（０．２ｇ／片），ｐｏｂｉｄ。熊去氧胆酸组８０例（男性１１例，女性６９例；年龄３７±６ａ），用熊去氧胆酸片４片（５０ｍｇ／片），ｐｏ，ｔｉｄ。２组病例均加用硝苯地平片每次１片（１０ｍｇ／片），ｐｏ，ｔｉｄ；３３％硫酸镁溶液２０ｍＬ，ｑｎ。２组疗程均为３ｍｏ。结果：丙谷胺组总有效率６０％，治愈率３０％，熊去氧胆酸组总有效率３９％和治愈率１２％（Ｐ＜０．０１）。结论：丙谷胺的疗效优于熊去氧胆酸。     

Famotidine versus omeprazole in combination with clarithromycin and metronidazole for eradication of Helicobacter pylori—a randomized, controlled trial

BACKGROUND: One-week low-dose triple therapy is currently considered the gold standard regimen for treatment of Helicobacter pylori infection. However, the mechanisms involved in the synergy between antibiotics and proton pump inhibitors are controversial. AIMS: To test the hypothesis that acid suppression represents the crucial mechanism by which the antibacterial activity of antibiotics can be enhanced, and to assess the impact of primary resistance on treatment outcome. METHODS: One hundred and twenty patients with H. pylori infection and duodenal ulcer, gastric ulcer or non-ulcer dyspepsia were randomly assigned to a 1 week course of either famotidine 80 mg b.d., clarithromycin 250 mg b.d. and metronidazole 500 mg b.d. (FCM group; n = 60) or omeprazole 20 mg o.d., clarithromycin 250 mg b.d. and metronidazole 500 mg b.d. (OCM group; n = 60). Gastroscopy was performed at baseline and 5 weeks after completion of treatment. H. pylori status was assessed by biopsy urease test, histology and culture. RESULTS: In the intention-to-treat analysis, eradication of H. pylori was achieved in 47 of 60 patients (78%; 95% CI: 66-88%) in the FCM group, compared to 44 of 60 patients (73%; 95% CI: 60-84%) in the OCM group (N.S.). Using per protocol analysis, eradication therapy was successful in 47 of 52 patients (90%; 95% CI: 79-97%) treated with FCM and 44 of 57 patients (77%; 95% CI: 64-87%) treated with OCM (N.S.). Primary metronidazole resistance was present in 27% and primary clarithromycin resistance in 8% of strains. Overall per protocol eradication rates in strains susceptible to both antibiotics and strains with isolated metronidazole resistance were 93% and 84%, respectively. No patient with clarithromycin resistance responded to treatment. CONCLUSIONS: High-dose famotidine and omeprazole, combined with clarithromycin and metronidazole, are equally effective for eradication of H. pylori. In 1-week low-dose triple therapy, metronidazole resistance has no major impact on eradication rates whereas clarithromycin resistance is associated with a poor treatment outcome.     

Comparison of two low-dose one-week triple therapy regimens with and without metronidazole for cure of H. pylori infection.

BACKGROUND: One-week triple therapy consisting of omeprazole 20 mg b.d., clarithromycin 250 mg b.d. and tinidazole 500 mg b.d. is an effective therapy for H. pylori infection with a cure rate of 93%. We therefore compared two similar 1-week regimens consisting of a lansoprazole, clarithromycin and either metronidazole or tetracycline in a prospective study. METHODS: Two cohorts, each of 60 patients suffering from H. pylori infection associated with peptic ulcer disease or ulcer-like dyspepsia, were treated for 1 week with either lansoprazole 30 mg b.d., clarithromycin 250 mg b.d. and either metronidazole 400 mg b.d. (cohort A, n = 60) or tetracycline 300 mg b.d. (cohort B, n = 60). Four weeks after treatment, cure of H. pylori infection was evaluated by endoscopy using rapid urease testing together with histology. RESULTS: In cohort A, 55 patients out of 60 showed cure of H. pylori infection (92%); the treatment was well tolerated, but three patients suffered from side-effects. In cohort B, which was free of metronidazole, 50 out of 60 patients showed cure of H. pylori infection (83%); two patients reported side-effects. The differences between the two cohorts were not statistically significant. CONCLUSION: Triple therapy for 1 week with lansoprazole as the antisecretory agent seems to be as effective as is reported for omeprazole-based regimens.     

One-week triple therapy with omeprazole, amoxycillin and either clarithromycin or metronidazole for cure of Helicobacter pylori infection

Aim: The present study was designed to evaluate the efficacy and tolerability of 1-week triple therapy regimens for Helicobacter pylori .
Methods: In two consecutive series, 120 patients with proven H. pylori infection and peptic ulcer disease or functional dyspepsia were treated with either omeprazole 20 mg b.d., amoxycillin 1 g b.d. and clarithromycin 250 mg b.d. (OAC; n=60) or with omeprazole 20 mg b.d., amoxycillin 1 g b.d. and metronidazole 400 mg b.d. over 1 week (OAM; n=60). H. pylori infection was assessed by rapid urease test, culture and histology before and 4 weeks after cessation of the eradication therapy.
Results: H. pylori eradication succeeded in 53 out of 60 patients by omeprazole–amoxycillin–clarithromycin (OAC) (88%; 95% CI 77–95%) and in 47 out of 60 patients by omeprazole–amoxycillin–metronidazole (OAM) (78%; 95% CI 66–88%) (P=0.22). Nine patients of each group available for follow-up reported adverse events (15.0 and 15.5%, respectively) without necessity of discontinuation of the study medications. Serious adverse events were not observed.
Conclusions: Simple and convenient 1-week triple therapies consisting of omeprazole, amoxycillin and either clarithromycin or metronidazole are sufficiently effective in eradicating H. pylori infection.     

利福昔明治疗急性感染性腹泻111例临床疗效及安全性

目的:评价利福昔明治疗急性感染性腹泻的临床疗效及安全性。方法:采用多中心、随机、双盲双模拟、阳性药物平行对照研究。入选急性感染性腹泻240例,完成227例,其中利福昔明组111例,男性52例,女性49例,年龄(30±s11)a,入组d1,服用利福昔明300mg和左氧氟沙星安慰剂1片,po,tid,d2~5,利福昔明400mg和左氧氟沙星安慰剂1片,po,bid;左氧氟沙星组116例,男性57例,女性59例,年龄(30±11)a,入组d1,服用左氧氟沙星100mg和利福昔明安慰剂3片,po,tid,d2~5,左氧氟沙星100mg和利福昔明安慰剂4片,po,bid。2组疗程均为3~5d。观察2组疗效和不良反应。结果:利福昔明组痊愈率和有效率分别为84.7%和100%,左氧氟沙星组痊愈率和有效率分别为77.6%和100%。2组疗效无统计学差异(P>0.05)。利福昔明组和左氧氟沙星组细菌清除率分别为100%和99%,2组无统计学差异(P>0.05)。2组均未出现不良反应。结论:利福昔明治疗急性感染性腹泻具有明显疗效,未见不良反应。