衡阳市原发性高血压患者药物治疗依从性的评估

目的 分析衡阳市原发性高血压患者药物治疗依从性水平,并探讨其影响因素,为提高原发性高血压患者的用药依从性提供可靠依据.方法 采用自行编制的高血压病人依从性问卷,对300例原发性高血压患者进行用药情况及其相关因素的调查,采用χ2检验对用药依从性影响因素进行统计分析.结果 300例原发性高血压患者中服药依从性佳者为30.33%,服药依从性不佳者为69.67%.其中,年龄、就诊次数、伴随疾病数量、是否备有血压计、实际服药次数、实际服药种类等因素对服药依从性的影响具有统计学意义（P〈0.05）.结论衡阳市原发性高血压病人药物治疗的依从性不佳,医护人员可以通过加强对病人的健康教育,制定合理的治疗方案,增加门诊随访次数以提高其服药依从性.     

药学服务对患者用药合理性的干预意义初步研究

目的 探讨药学服务对患者用药合理性的干预意义.方法 将我院2011年—2013年用药干预采取常规药学服务模式的100份病历作为对照组,2014年—2016年用药干预采取新型药学服务模式的100份病历作为研究组.对比分析2组不良反应发生率、服药依从性、药品差错事件、合理服药时间.结果 研究组不良反应发生率、药品差错事件率显著低于对照组,服药依从性与合理服药时间明显高于对照组(P<0.05).结论 在患者用药中采取新型药学服务模式干预,可以明显提高用药合理性,减少不良反应与药品差错事件的发生,同时提高患者服药依从性,延长合理服药时间,值得借鉴.     

高龄收缩期高血压患者的药学监护

目的:观察药学监护在高龄高血压患者治疗中的作用。方法:选取老年病区80岁以上的86例确诊为单纯收缩期高血压患者进行药学监护,将患者随机分成观察组43例,对照组43例,对照组按照收缩高血压指南予以常规的药物治疗和健康宣教,观察组在对照组治疗和健康宣教的基础上,再予以药学监护。比较两组患者在2个月内的药物使用合理性、血压达标率、药物依从性和药物不良反应发生率。结果:通过药学监护,观察组患者的药物完全依从性明显高于对照组患者,而完全不依从性却明显低于对照组,组间比较,差异具有统计学意义(P<0.05),药物不良反应发生率亦明显低于对照组患者,组间比较,差异有统计学意义(P<0.05)。患者的用药合理性和血压达标率较对照组明显提高,差异具有统计学意义(P<0.05)。结论:药学监护能有效地促进患者遵医服药意识,降低不良反应,提高药物的治疗效果,值得临床推广使用。     

实施综合管理对社区高血压患者的临床效果评价

目的：探讨综合管理对原发性高血压患者服药依从性和控制率的影响。方法随机选择2012年11月—2014年6月我院就诊的原发性高血压患者180例分为观察组和对照组各90例,对照组就诊时常规介绍高血压基本知识,发放相关健康教育资料;观察组通过建立社区高血压患者健康档案,定期进行健康知识版面巡展及健康知识教育讲座,举办义诊、咨询活动进行综合管理：加强健康教育、简化治疗方案、实施药学监护、监测血压、取得家庭支持。结果2组患者在综合管理前依从性好33.33% vs 34.44%,高血压控制良好31.11% vs 28.89%,比较无显著性差异（P>0.05）;观察组综合管理后依从性好75.56%、高血压控制良好83.33%,高于对照组的38.89%,55.56%,差异显著（P<0.05）。结论对原发性高血压患者实施社区综合管理,可以提高服药依从性、血压控制率增加,值得应用。     

高血压患者用药依从性的影响因素分析及其对策

患者按处方或医嘱要求用药称为用药依从性,否则称为不依从性,依从性可分为完全依从性、部分依从性(依从性差)2类[1].高血压所致心血管病病死率居我国疾病死亡率之首[2].因此,高血压患者掌握正确的服药方法、时间、剂量、疗程等完整的给药方案,对提高高血压的达标率和高血压患者用药的依从性显得非常重要.本文对高血压患者常见的影响服药依从性的主要原因进行分析,并提出对策.     

高血压患者院外口服降压药物依从性分析及对策

原发性高血压是当今危害人类健康的主要疾病之一，对原发性高血压的防治是降低心脑血管疾病发病率的关键。但是目前我国原发性高血压的服药率依然相当低，院外药物治疗依从性差是一个重要原因。在高血压患者群中，服药率仅为24．8％，血压控制在正常范围者只有5．8％。为了提高高血压患者对疾病规范治疗的重要性认识，改善院外患者的服药依从性，对我院108例高血压患者出院后用药情况自设问卷进行调查分析并采取了护理对策，现报告如下。     

原发性高血压患者服药依从性及护理对策研究

目的 本研究调查原发性高血压患者服药依从性的影响因素及提高患者服药依从性的策略.方法 选择2006年1月至2007年6月在我院住院治疗的符合高血压诊断标准的原发性高血压患者100例,使用自行编制的高血压患者服药依从性问卷收集资料,资料分析使用SPSS 110.软件.结果 服药依从性好的患者40例,占40.8%;文化程度、家庭人均月收入(P<0.01)、病情分级(P<0.05)是影响高血压患者服药依从性的主要因素;导致高血压患者服药依从性差的原因,主要为忘记服药、认为疾病好转而停药,第三为不知道高血压病需长期服药.结论 原发性高血压患者服药依从性差,护理人员应加强对其的用药指导,培养患者正确的健康信念,以提高患者的服药依从性.     

药师出院用药指导对原发性高血压患者血压控制的影响

目的探讨临床药师进行出院用药指导对提高出院患者用药依从性的影响。方法将2009年1月-2009年6月心内科住院接受治疗的140例原发性高血压出院患者,随机分为试验组和对照组,各70例。试验组由临床药师进行出院用药指导,对照组由护士在出院时进行出院用药指导。出院3月后评价2组患者服药依从性、血压控制情况。结果出院3月后试验组服药依从性、血压控制效果均优于对照组（P〈0.05）。结论药师对原发性高血压患者出院用药的指导,有助于提高用药依从性,提高患者血压控制效果。     

高血压、高血脂病患者药物治疗依从性影响因素的调查分析

目的通过了解高血压病患者药物依从性情况,对其影响因素进行探讨,以提高高血压病患者的治疗依从性。方法随机选取2013年1月~2014年12月确诊为高血压病的患者100例,开展问卷调查,内容包括是否长期坚持用药、是否遵照医嘱服药等,分析患者药物治疗依从性、高血压分度与药物治疗依从性的关系,并对影响因素进行Logistic回归分析。结果 100例患者中依从性较好者35例(35%),依从性差者65例(65%),具体表现为不坚持长期用药、不遵照医嘱服药次数服药、不遵照医嘱服药剂量服药、不遵照医嘱按时用药等。多因素Logistic回归分析结果显示,患者主动终止用药、忘记用药、就医不便、药物副作用、是否从事医疗工作以及主观健康评估差等因素,对药物治疗依从性具有很大影响。结论高血压患者接受临床治疗的依从性比较差,尤其是用药依从性,以不长期用药多见,加强对高血压患者的健康教育,可以提高患者药物治疗的依从性。     

支气管哮喘患者的药学服务及临床效果分析

目的通过对支气管哮喘患者的治疗和药学服务,探讨药学监护的模式和临床效果;方法将46例哮喘患者随机分为观察组和对照组各23例,观察组,为患者制定个体化药学监护计划,进行用药基础知识、依从性、合理性、肺功能、哮喘控制测评,接受6个月的全面药学服务,并每月跟踪调查登记;对照组仅常规治疗和一般干预。结果两组患者,在哮喘用药知识、依从性、合理性、肺功能、(FEV1%、PEV%)、哮喘控制测试等方面,两组比较差异有统计学意义(P0.5)。结论药学服务能够显著改善支气管哮喘患者的知识知晓度,提高用药依从性和合理用药水平,改善肺功能、控制哮喘,提供全面的药学服务是提高支气管哮喘治疗效果的重要措施之一。     

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…     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

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.     

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.     

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.