药物的剂型与其疗效 药效及毒副作用的关系

<正> 任何一种药物,要供临床使用时,必须制成适合于医疗或预防应用的形式称作药物剂型。患者到医院就诊,经医生明确诊断,即可制订正确的治疗方案,至于用药问题,往往药房有什么药就用什么药,很少有人问津对用药剂型的选择。药品生产和临床药学的实践证明,既使药品含量相同,用药方法不变,但临床疗效和副作用也可因不同厂家、甚至同一药厂生产的不同批号的同一制剂、不同剂型而异。这是由于不同厂家的制作工艺、处方内容及原辅材料等的不同,影响了制剂的生物利用度(药物剂型中能被吸收人体循环的药物相对分量及速度)所致。例如,不同药厂生产的相同剂量的地高辛片,服用后其血药浓度可相差7倍;微晶螺内     

相同药物不同剂型的疗效比较与分析

<正>药物是用来疗病治疾的,各种药都有其不同的功效,品名相同的药物由于剂型的不同也会有不尽相同的疗效,剂型系指诊断、预防及治疗疾病用的药物在供临床应用以前必须制成一定的形式[1],相同的药物所用的制备工艺和辅料的不同,其药效也有着明显的差异。目前,临床用药所涉及的药物剂型问题有很多,部分医疗机构对药物的剂型因素和合理用药的认识都不够重视,药物剂型因素已经成为医院临床用药的一个很大的"盲点"[2]。常用药物剂型主要有注射剂、片剂(普     

滴丸——中药国际化的新途径

<正>目前市场上的中药,一般采取片剂、汤剂、蜜丸和胶囊剂型。汤剂药品不便于患者随身携带和开启服用,无法适应现代人的生活节拍。蜜丸一般有效成分含量偏低,服用剂量较大。片剂药品每一小片要经过至少一吨的压力才能压合成型,片剂和胶囊剂在被服用之后,需要一段时间让胃液将其溶解,然后人体才能开始对药物的有效成分进行吸收,所以这些剂型的药品起效时间比较慢,这样显然不能满     

浅谈膏剂在儿科的临床应用

膏剂,目前多应用于成人慢性疾病调理,然其作为八种剂型之一,不同体质、不同疾病、不同年龄人均可服用。而其具有的口感好,易坚持;服用方便,易吸收;既可治病,又可补虚的优势,更适合脾胃本不足、不喜中药汤剂的小儿四季服用。     

复方甘草酸苷联合草仙乙肝治疗慢性活动性乙型肝炎的疗效观察

目的探讨复方甘草酸苷注射液联合草仙乙肝治疗慢性肝炎的疗效。方法随机分为治疗组和对照组各100例,治疗组每日服用草仙乙肝胶囊并静脉滴注复方甘草酸苷注射液加维生素C及辅酶A。对照组服用草仙乙肝胶囊并静脉滴注维生素C及辅酶A。疗程3个月,观察2组症状、体征的变化。结果治疗结束后,2组的症状和体征均有不同程度的改善,治疗组的好转率显著高于对照组。结论复方甘草酸苷联合草仙乙肝胶囊可提高慢性乙型肝炎患者的好转率。     

《食医心鉴》影响探析

《食医心鉴》由唐代成都医学博士昝殷撰于公元9世纪,其内容包括多篇食治医论与众多食疗方,对后世食治、本草、方剂及临床各科的发展都有一定影响。(1)继承《千金要方·食治》的理论,指出多种病证使用食物治疗的优势,促进了食治理论的发展与食疗方的普及。(2)记载了部分药食的性味功效、服用方法,多以常见米谷及肉类食物为主,亦包括外来药食。(3)所载食疗方记载详细,剂型多样,为后世食疗方的创制提供了参考,尤其是粥、面食、茶、酒等剂型的使用。(4)食疗方涉及病证包括内外妇儿各科,被后世众多医籍引用,促进了临床各科的发展。     

探讨阿司匹林的作用及临床问题

1897年德国化学家Felix Hoffmann博士首次合成出乙酰水杨酸,引出了阿司匹林的经典传奇[1]。阿司匹林是一种神奇的药物,大剂量服用可以消炎;中剂量服用可以镇痛;小剂量服用可以防止血小板凝结引发血管堵塞,同时可以有效地防止血栓。本文对药物阿司匹林的剂型作用及临床研究进行了综述,一方面通过对剂型的研究,使阿司匹林发挥最佳药效,减少不良反应。另一方面对阿司匹林的剂型发展趋势进行预测,从而引起人们对阿司匹林剂型研究的重视。为使阿司匹林更好的发挥其神奇功效开发合适的剂型具有重要的理论和应用前景。     

泰山赤灵芝固体灵芝精的研制

泰山赤灵芝为我国医药宝库中之珍品 ,具有扶正固本 ,滋补壮阳、延年益寿之功效 ,具有防癌、治癌和提高免疫功能的作用。将泰山赤灵芝水提取液经雾化干燥等先进技术制成固体灵芝精后 ,提高了有效成分的含量及稳定性 ,缩小了体积 ,便于服用 ,解决了贮存中易雾变、虫蛀及运输不便的难题 ,并可制成多种剂型 ,现将其制备方法报告如下。1　药物来源及研制工艺流程1.1　药物来源　泰山赤灵芝 (泰安市泰新赤灵芝开发有限公司提供 )为多孔菌科植物赤灵芝ＧａｎｏｄｅｒｍａＬｕｃｉｄｕｍ (Ｌｅｙｓｓ .ｅｘＦｒ .)Ｋａｒｓｔ。1.2　工艺流程　泰山赤…     

金鸡系列制剂质量的初步评价

目的 对金鸡系列制剂的质量进行分析,为其他简单改剂型制剂的质量评价提供参考.方法 采用薄层色谱鉴别、含量测定及特征谱图比对方法检测金鸡颗粒、薄膜衣片、耱衣片、胶囊、分散片5种剂型.结果 薄层色谱显示,薄膜衣片、糖衣片与原研药颗粒剂色谱图比较接近,而胶囊剂和分散片色谱图比较接近;含量检测显示,同一厂家不同剂型颗粒剂所含生物碱总量最低,不同厂家不同剂型,含量差异悬殊;特征图谱显示,薄膜衣片、糖衣片所含成分与原研药颗粒剂基本一致,而胶囊剂和分散片的色谱图中,少了一个特征峰.结论 几种简单改剂型的金鸡制剂的质量跟原研药颗粒剂存在较大差异,且不同剂型间也存在差异,提示对已上市简单改剂型的中成药质量有必要进行再评价.     

《太平惠民和剂局方》治妇人诸疾卷方药特点初探

通过分析《太平惠民和剂局方》治妇人诸疾卷收录83方,认为其选方用药具有以下特点:收录方剂多为历代效方,或当代验方,且适时增补续添新方;方中用药多为补益温散之品,偏重调理气血;剂型以丸、散、汤剂为主,药物根据不同要求分别精细炮制,且制剂时添加辅料亦根据功效有所改变;服用时以煮散法为主要方法,调服法则根据辨证选用不同汤饮送服。在学术上继承了汉唐重视胎产的特点,并初步形成了"妇人调其血"的学术思想。     

Value of D-Dimers in patients with acute aortic dissection

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.     

Research of combined liver-kidney transplantation model in rats

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.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

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…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.