Calcitonin gene-related peptide receptor antagonist ubrogepant for the treatment of acute migraine: A meta-analysis

Background:The objective of this study is to systematically evaluate the efficacy and safety of the calcitonin gene-related peptide (CGRP) receptor antagonist ubrogepant for the treatment of acute migraine.Methods:Randomized controlled trials (RCTs) of ubrogepant for treatment of acute migraine were identified in PubMed, MEDLINE, EMBASE, and the Cochrane Library from database establishment to June 2020; we also searched ClinicalTrials.gov manually during the same period. Then, RevMan 5.3 software was used to perform a meta-analysis on each outcome measure.Results:A total of 5 RCTs involving 4903 patients were included; there were 3358 cases in the ubrogepant group and 1545 cases in the placebo group. The meta-analysis showed the following results: at 2 hours postdose, the percentages of participants reporting pain relief and the absence of photophobia, nausea, and phonophobia were significantly higher in the ubrogepant group than in the placebo group (odds ratio [OR] = 1.71, 95%CI: 1.48–1.97, P < .00001; OR = 1.33, 95%CI: 1.22–1.45, P < .00001; OR = 1.07, 95%CI: 1.03–1.11, P = .0006; OR = 1.21, 95%CI: 1.14–1.28, P < .00001). The incidence of common adverse events was similar between the 2 groups (P > .05).Conclusion:Ubrogepant is effective and safe for the treatment of acute migraine.Registration number:PROSPERO CRD42019145286.     

5-羟色胺再摄取抑制剂联合胰岛素治疗躯体形式障碍对照研究

目的探讨高选择性5羟色胺再摄取抑制剂联合胰岛素治疗躯体形式障碍的临床疗效。方法将59例躯体形式障碍患者随机分为A组30例、B组29例，两组均口服高选择性5羟色胺再摄取抑制剂治疗，B组联合胰岛素治疗。疗程6w。于治疗前及治疗第1w、2w、4w、6w末采用汉密顿焦虑量表、汉密顿抑郁量表评定临床疗效。结果治疗6w末A组显效率53．33％，总有效率96．67％；B组分别为86．21％，100％；B组显效率显著高于A组（χ2=7．516，P〈0．01）。两组汉密顿焦虑量表、汉密顿抑郁量表评分治疗第1w末起均较治疗前有显著下降（P〈0．01），第6w末B组较A组下降显著（P〈0．05）。不良反应B组除体重增加较多外，其他因子与A组无显著性差异（P〉0．05）。结论高选择性5羟色胺再摄取抑制剂联合胰岛素治疗躯体形式障碍疗效显著，安全性高，依从性好。     

益肾健脾针刺法辅助文拉法辛治疗产后抑郁症的疗效观察及对瘦素、孤啡肽水平的影响

目的观察益肾健脾针刺法辅助文拉法辛治疗产后抑郁症(PPD)的临床疗效及对血清瘦素、孤啡肽水平的影响。方法92例PPD患者以随机数字表将患者随机分为研究组和对照组,每组46例。对照组予以文拉法辛治疗,研究组予以益肾健脾针刺法辅助文拉法辛治疗,均治疗4周。比较两组临床疗效、不良反应与治疗前后汉密尔顿抑郁量表(HAMD)评分、中医证候评分、血清瘦素、血浆孤啡肽、血清神经内分泌功能指标[多巴胺(DA)、5-羟色胺(5-HT)、促甲状腺激素(TSH)、雌二醇(E2)]水平。结果研究组总有效率高于对照组(P<0.05)。治疗后,研究组HAMD评分、中医证候评分、血浆孤啡肽、血清TSH水平低于对照组(P<0.05),研究组血清瘦素、DA、5-HT、E2水平高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论益肾健脾针刺法辅助文拉法辛治疗PPD,可显著降低患者抑郁程度,改善临床症状,调节血瘦素、孤啡肽、DA、5-HT、E2、TSH水平。     

从药学监护探讨医院临床药学开展的切入点

目的：探讨临床药师参与临床药学服务的切入点。方法：系统分析临床药师参与1例卡马西平致剥脱性皮炎患者给药方案的制定、药物不良反应的监测及用药教育等个体化的药学监护。结果：通过实施个体化的药学监护,可明显提高患者用药的安全性、有效性和合理性,改善患者预后。结论：药学监护是临床药学的重要内容,对患者进行个体化用药监护是临床药师开展工作的重要切入点。