The public health implications of the 1995 'pill scare'

The warning issued by the UK Committee on Safety Medicines in October 1995, followed by their 'Dear Doctor' letter of October 18, 1995, that oral contraceptive pills containing gestodene or desogestrel were associated with a higher risk of venous thromboembolism has had a negative impact on public heath. A significant number of women either switched brands or ceased contraception altogether following the announcement. National data suggest a strong association between the pill scare and a substantial increase in the number of unintended pregnancies, particularly significant among younger women, with use of oral contraception falling from 40 to 27% of under 16s between 1995-1996 and 1996-1997. The resulting cost of the increase in births and abortions to the National Health Service has been estimated at about Pound Sterling 21 million for maternity care and from Pound Sterling 46 million for abortion provision. The level of risk should, in future, be more carefully assessed and advice more carefully presented in the interests of public health.     

Safety of modern oral contraception: the options for women: lessons to be learned

The relatively short history of hormonal contraception has been marked by a series of 'pill scares', all of which--after creating panic among users--were proven to be unfounded in terms of public health impact. The latest pill scare, provoked by regulatory action in the United Kingdom and the Federal Republic of Germany in response to the publication of a series of articles indicating a doubling of risk of deep venous thrombosis in users of oral contraceptives containing third-generation progestins, seems finally settled: both the British and the German Drug Regulatory Authorities have now reverted their verdict. The damage unfortunately stays: hundreds of thousands of women have been compelled to abandon the pill of their choice, often deciding to drop contraception altogether, thereby exposing themselves to unwanted pregnancy and--in a number of cases--to pregnancy termination. This latest episode should be turned into something positive: we need to learn that, in the case of drugs in widespread use, before restrictive action is taken--and except for very rare and specific instances--the scientific community must carry out an exhaustive debate on the reality and importance of the observed effects. Although the public should, in each instance, be properly informed, it is only after this process has been completed that restrictive action should be taken. It is hoped that, after this last episode, all concerned have learned this simple principle and will accept being guided by it from now on.     

复方软伤伸筋丸治疗膝关节骨性关节炎临床研究

目的 :探讨复方软伤伸筋丸治疗膝关节骨性关节炎的疗效机理。方法 :采用单盲法将膝关节骨性关节炎患者 2 2 0例 ,随机分为软伤伸筋丸组 (治疗组 ) 1 60例 ,壮骨关节丸组 (对照组 ) 60例 ,对比分析两组临床疗效。结果 :1治疗组临床治愈率为 88.75 % ,总有效率为 99.3 5 % ;对照组临床治愈率为 2 3 .3 3 % ,总有效率为 91 .68% ,治疗组优于对照组 ,具有显著性差异 (P<0 .0 1 )。2复方软伤伸筋丸无毒副作用。3复方软伤伸筋丸的应用可使增生骨刺吸收 ,损伤半月板修复。结论 :复方软伤伸筋丸是一种治疗膝关节骨性关节炎安全有效药物。     

养血补肾丸治疗更年期综合征75例述要

目的：观察养血补肾丸治疗更年期综合征的临床疗效。方法：治疗组75例用养血补肾丸治疗，对照组60例，用更年康治疗。结果：治疗组总有效率96％，对照组总有效率85％，治疗组明显优于对照组（P＜0．05）；且治疗组症状改善显著，与对照组比较有统计学意义（P＜0．05，P＜0．01），养血补肾丸还能升高患者血清E2水平，治疗前后比较有显著性差异（P＜0．05）。结论：养血补肾丸治疗更年期综合征疗效确切，无副作用。     

降脂保肝丸治疗脂肪肝的研究

目的　观察降脂保肝丸对脂肪肝的治疗作用。方法　将 1 2 8例脂肪肝患者随机分为 2组 ,治疗组服用降脂保肝丸 ;对照组服用多烯康胶囊。对两组进行临床观察 1个疗程后比较疗效。结果　治疗组总有效率为 1 0 0 % ,治愈率为 80 % ;对照组总有效率为 40 % ,治愈率为6 .7%。治疗组疗效明显优于对照组 ,有非常显著性差异 (P <0 .0 1 )。结论　降脂保肝丸是目前治疗脂肪肝的有效药物     

滋肾丸中肉桂酸在大鼠体内的测定及药动学研究

目的建立简便的测定大鼠血浆中肉桂酸血药浓度的高效液相色谱法.方法样品血浆以1 moL·L-1HCI酸化,用乙酸乙酯萃取,取上清液进行分析.色谱条件为:流动相:甲醇-乙腈-水-三乙胺(7:22:73:0.2,V/V),磷酸调pH=4,流速:0.9 mL·min-1,检测波长:340nm.结果肉桂酸的血药浓度标准曲线的线性范围为1.92-192.0μg@mL-1,其最低定量限为1.92μg·mL-1,日内及日间RSD均小于8%.平均回收率为82.0%.大鼠口服滋肾丸后在体内的药动学参数为:Tmax≈0.5 h,Cmax=46.65±4.9μg@mL-1,t1/2=5.44h,k=0.127h and AUC0-t=256.91(μg·min·nL-1),AUC0-∞=290.52(μg·rmin·mL-1).结论本方法为滋肾丸中肉桂酸的血药浓度监测及药动学研究提供了方法学基础.     

高效液相色谱法测定益精丸中淫羊藿苷的含量

目的 :建立益精丸中淫羊藿苷的含量测定方法。方法 :高效液相色谱法 ,色谱柱为 ODS- C1 8(15 0 mm× 6 mm,5μm) ,流动相为乙腈 -水 (30∶ 70 ) ,流速为 1.0 ml/ min,检测波长为 2 70 nm。结果 :淫羊藿苷在 0 .2 3～ 1.16μg范围内呈良好的线性关系 ,回归方程为 A=2 1.133C+17.76 7(r=0 .9999) ,平均回收率为 98.88% ,RSD为 0 .6 7%。结论 :该法简便、快捷、灵敏 ,准确和重现性好 ,可作为益精丸的质量控制标准     

急慢性高黏滞血症模型动物血管内皮细胞分泌功能的变化及复方丹参滴丸干预作用研究

[目的]观察复方丹参滴丸对高黏滞血症血管内皮分泌功能的影响，探索其作用机制。[方法]复合因素(高分子右旋糖酐、肾上腺素、牛血清白蛋白)、长时间(112d)造成高黏滞血症慢性模型；1次性静脉注射高分子右旋糖酐，皮下注射肾上腺素造成急性高黏滞血症模型，分别用复方丹参滴丸进行治疗，观察血管内皮细胞分泌功能的变化及复方丹参滴丸的干预效果。[结果]1)慢性高黏滞血症模型血浆血栓素B2（TXB2)和内皮素(ET)浓度非常显著升高，而6-酮-前列腺素F1A(6-酮)浓度非常显著降低；2)急性高黏滞血症模型血管内皮分泌功能无显著变化；3)长期使用复方丹参滴丸能调整、改善血管内皮分泌功能的异常状态；4)复方丹参滴丸改善血管内皮分泌功能的即时效应不显著。[结论]长期应用复方丹参滴丸能调整、改善血管内皮分泌功能，血管内皮细胞可能是复方丹参滴丸的作用靶点之一，但本药改善血管内皮分泌功能的即时效应不显著。     

左归丸现代临床应用和实验研究进展

综合近10年公开发表的中西医药学术期刊，发现左归丸至少可治疗西医50种以上的疾病，尽管其适用于临床的病证复杂多变，但总以神经一内分泌一免疫网络功能的衰退和失调密切相关，辨证要点为“形衰精亏”。实验研究初步提示，左归丸对神经一内分泌一免疫网络具有多组分、多途径、多环节和多靶点的整合调节作用。     

喉咽清水蜜丸的研制及其药效学和毒理学研究

目的 :研究喉咽清水蜜丸的制备、质量控制方法及其药效学和毒理学。方法 :采用高效液相色谱法测定喉咽清水蜜丸中甘草酸的含量 ;对制剂的抗炎、镇痛、祛痰作用进行研究 ;对制剂的急性毒性和长期毒性进行研究。结果 :喉咽清水蜜丸中甘草酸的线性范围为0 0384～0 615mg/ml ,回收率为 (99 20±1 75) %。本制剂具有抗炎、镇痛、祛痰作用 ,未见明显急性毒性和长期毒性。结论 :本制剂制备工艺简单 ,质量可控 ,疗效确切 ,安全性较高。