补肾安神汤治疗阴虚火旺型失眠症临床研究

目的:探讨补肾安神汤治疗阴虚火旺型失眠症的临床疗效及对睡眠质量及生活质量的影响。方法:选择阴虚火旺型失眠患者68例为研究对象。采用随机数字表法将患者分为对照组和观察组各34例。对照组口服安眠补脑口服液治疗,观察组采用自拟补肾安神汤进行治疗,两组疗程均为4周。比较两组的临床疗效及对睡眠质量和生活质量的影响。结果:治疗后,两组中医证候积分均明显下降,且观察组比对照组下降更明显(P<0.05)。两组治疗前PSQI、HADS及QLQC30评分比较差异无统计学意义(P>0.05);两组治疗后PSQI和HADS评分显著降低,QLQ-C30评分显著升高(P<0.05);观察组治疗后PSQI和HADS评分明显低于对照组,QLQ-C30评分明显高于对照组(P<0.05)。观察组治愈率及总有效率均高于对照组(P<0.05)。两组患者治疗期间均未出现明显的药物不良反应,两组之间无明显统计学差异(P>0.05)。结论:自拟补肾安神汤可显著改善阴虚火旺型失眠症患者不良情况,提高睡眠质量及生活质量,临床疗效显著。     

面肌痉挛微血管减压术中异常肌反应变化特点与术后疗效关系探究

目的探究面肌痉挛患者微血管减压术(MVD)中异常肌反应(AMR)的变化特点与术后疗效的关系。方法回顾性分析73例MVD术中采用AMR全程定量化监测患者的AMR变化特点,减压操作前AMR阈值较基础阈值升高≥1倍为A1组、1倍为A2组,手术结束时AMR完全消失为B1组、未消失为B2组,B2组中AMR阈值较基础阈值升高≥1倍为B2a组、1倍为B2b组,对各组的术后疗效进行对比分析。结果 A1组21例中,19例立即治愈,1例延迟治愈,1例未愈; A2组52例中,35例立即治愈,9例延迟治愈,8例未愈。A1组较A2组疗效好(P=0. 046)。B1组50例中,42例立即治愈,5例延迟治愈,3例未愈; B2组23例中,12例立即治愈,5例延迟治愈,6例未愈。B1组较B2组疗效好(P=0. 003)。B2 a组的治愈比例较B2 b组高(分别为14/16、3/7),差异有统计学意义(P=0. 045)。结论 AMR在术中的变化特点对术者有重要参考意义,AMR在减压前升高、在手术结束时完全消失、未消失但升高较基础阈值≥1倍者术后疗效相对较好。     

Simultaneous Determination of Six Compounds in Rat Plasma by Ultra‑Performance Liquid Chromatography with Tandem Mass Spectrometry: Application in the Pharmacokinetic Study of Qing Gan‑Shu Yu‑Fang

A rapid and high selective ultra?performance liquid chromatography (UPLC) with tandem mass spectrometry method for simultaneous determination of six compounds including albiflorin, paeoniflorin, picroside I, picroside II, saikosaponin A, and saikosaponin D in rat plasma was developed and validated using butyl p-hydroxybenzoate as an internal standard. One-step direct protein precipitation with acetonitrile was used to extract the compounds from the rat plasma samples. Chromatographic separation was achieved using an ACQUITY UPLC BEH C18 column (100 mm × 2.1 mm, 1.7 µm) at a flow rate of 0.4 mL/min, using gradient mode containing 0.1% formic acid in water and acetonitrile were used as the Mobile phase A and B. Electrospray ionization in negative ion mode and multiple reaction monitoring were used to identify and quantify active components. Calibration curves showed good linearity (R2 > 0.9908) over a wide concentration range for all compounds. The intra- and interday precision (relative standard deviation) ranged 2.4%–7.0% and 2.6%–8.0%, respectively. The accuracy (relative error) was from ?13.0% to 13.2% at all quality control levels. The recovery ranged from 81.1% to 92.5%. The validated method was successfully applied to pharmacokinetic study in rats after oral administration of Qing Gan?Shu Yu?Fang. The results show that one can draw a conclusion that these six active ingredients can be quickly absorbed and play a pharmacodynamic role rapidly in vivo.     

同步健康教育在社区居民预防骨质疏松症中的作用

目的评价同步健康教育对社区居民预防骨质疏松的作用。方法将社区居民随机分为健康教育干预组和对照组,对干预组进行同步健康教育,采用发放书面资料、健康教育讲座、个性化指导、定期复查、填写调查表等方式。对照组采用发放材料、自由就诊方式。4年后分别进行对比。结果干预组对健康知识掌握程度、行为方式、治疗效果、满意度均高于对照组。结论社区居民骨质疏松症高危人群和患者更适合面对面指导,对社区居民预防骨质疏松症实行同步健康教育干预是有效的。     

老年慢性支气管炎合并Ⅱ型呼吸衰竭采用有创-无创序贯机械通气治疗的效果及安全性观察

目的:探讨无创-有创序贯机械通气治疗老年慢性支气管炎合并Ⅱ型呼吸衰竭的临床疗效。方法:随机将2014年1月～2017年3月收治的74例老年慢性支气管炎合并Ⅱ型呼吸衰竭患者分为两组,A组采用有创机械通气治疗,B组采用有创-无创序贯机械通气治疗,比较两组的临床疗效。结果:B组治疗后的呼吸频率、SaO_2、PaCO_2、PaO_2、有创通气时间、总通气时间、住院时间、再插管率、VAP率与院内死亡率明显少于A组,组间比较差异有统计学意义(P0.05)。结论:有创-无创序贯机械通气治疗老年慢性支气管炎合并Ⅱ型呼吸衰竭,能有效改善患者的呼吸通气功能,缩短其治疗及住院时间,且治疗安全,更适合用于临床推广。