益脑通络汤剂治疗老年痴呆症30例临床观察

目的:观察益脑通络汤治疗老年痴呆症的临床疗效。方法:对30例老年痴呆症患者进行益脑通络汤治疗,每次服50ml,每日2次,1月为1疗程。结果:临床痊愈18例,显效8例,无效4例,总有效率88.2%。结论:益脑通络汤对治疗老年痴呆症有显著的疗效。     

基于“形神理论”探讨PTCD联合茵虎退黄方治疗梗阻性黄疸

目的:运用"形神理论"研究经皮肝穿刺胆道引流术(percutaneous transhepatic cholangial drainage,PTCD)联合茵虎退黄方治疗梗阻性黄疸后"形""神"改善情况,并对其疗效做出相应评价。方法:选取60例行PTCD后梗阻性黄疸患者随机平均分为对照组和治疗组。对照组给予单纯护肝治疗,治疗组在常规护肝治疗基础上给予茵虎退黄方。运用"形神理论"评价两组治疗后疗效。其中"形"的疗效评价为实验室检查,"神"的疗效评价包括:视觉模拟评分法(visual analogue score,VAS)和中医症状评分。结果:治疗组治疗后患者"形"的改善效果明显,胆红素及酶学水平均显著下降(P<0.05);对照组患者治疗前后丙氨酸氨基转移酶(alanine transaminase,ALT)和天门冬氨酸氨基转移酶(aspartate transaminase,AST)水平比较,差异均无统计学意义(P>0.05);对照组治疗后胆红素及γ-谷氨酰转肽酶(γ-glutamyl transpeptadase,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)水平显著降低。在缓解患者"神伤"方面,两组均可降低患者疼痛水平(VAS);治疗组患者症状的缓解率为67.0%,对照组患者症状的缓解率为40.8%,治疗组明显优于对照组(P<0.05)。结论:PTCD联合护肝治疗配伍茵虎退黄方治疗梗阻性黄疸疗效显著,可显著改善患者的"形""神"情况。     

基层医院处方点评制度对临床不合理用药的干预效果分析

目的：评价该制度对临床不合理用药的干预效果。方法通过处方点评工作发现的不合理用药问题，经药剂科处方点评小组和医务科医疗质量小组讨论确认后，先后组织学习宣传，并将点评结果纳入绩效工作考核项目等措施对临床不合理用药进行干预。结果门诊处方点评结果、住院医嘱不合理用药病例、抗菌药物分级用药指标等均有明显改善，处方合格率由85.03%、88.5%升至92.05%，不规范处方由6.08%、4.30%降至2.02%，不适宜处方由8.04%、5.90降至3.70%，超常处方由13.30%、8.30%降至6.11%，不合理用药比例由19.70%、14.80%降至9.50%，合理使用抗生素率由69.30%升至75.40%，无指征预防用药从18.12%降至10.30%。结论建立处方点评制度以干预临床不合理用药，取得了一定效果，并结合处方调配时的审核监管工作，可促进临床合理用药水平的提高.     

温肺化痰方对慢性阻塞性肺疾病急性加重期患者外周血中性粒细胞弹性蛋白酶、表皮生长因子受体表达的影响

目的 观察温肺化痰方药对痰湿蕴肺证慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）急性加重期患者外周血中性粒细胞弹性蛋白酶（neutrophil elastase,NE）和表皮生长因子受体（epithelial growth factor receptor，EGFR）表达的影响。方法 将60例COPD急性加重期痰湿蕴肺证患者随机分为治疗组和对照组各30例。两组患者均接受西医基础治疗，治疗组加用温肺化痰方药，对照组加用氨溴索针剂，10 d为1个疗程。观察并比较两组临床疗效，治疗前后分别检测两组患者血清NE、EGFR水平。结果 两组临床疗效的分布比较，差异具有统计学意义（P＜0.05），治疗组优于对照组；与治疗前比较，两组治疗后血清NE和EGFR均显著降低（P<0.05）；治疗组血清EGFR降低值显著小于对照组（P<0.05）。结论温肺化痰方药可能通过调节NE、EGFR的表达，改善COPD急性加重期患者的气道黏液高分泌状态。     

Alprazolam use and related harm among opioid substitution treatment clients – 12 months follow up after regulatory rescheduling

BackgroundAlprazolam, has been associated with disproportionate harms compared to other benzodiazepines, especially among people in opioid substitution treatment (OST). We examine the effect of the rescheduling of alprazolam in Australia, from Schedule 4 to Schedule 8 in February 2014 amongst a high-risk population of clients in OST.MethodsOST participants who reported recent (last month) alprazolam use were recruited from three Sydney clinics. Participants (n = 57) were interviewed immediately prior to rescheduling and again three months and 12 months after rescheduling. We examined self-reported patterns of drug use, drug availability, mental and physical health. A linear mixed models approach was used to analyse changes in alprazolam and other benzodiazepine use.ResultsMean days of alprazolam use in the past 28 days decreased from 13.7 to 7.1 days, and mean weekly alprazolam dose decreased from 15.1 mg to 6.1 mg at 12 months follow-up (p = 0.001). Total weekly benzodiazepine use also reduced from a mean of 222 mg diazepam equivalent to 157 mg (p = 0.044). Other substance use did not change significantly. Reported mode of cost price of street alprazolam doubled from $5 to $10 over the 12-month period.ConclusionAlprazolam rescheduling resulted in an overall reduction in alprazolam and total benzodiazepine use, without substitution with other drugs, in the short term. Unintended harms were not observed. Rescheduling appears to have been effective in reducing alprazolam use in this high-risk population.     

筋骨病的病因探讨及民间秘方治疗

从探讨筋骨病的病因入手，着重介绍运用民间中草药秘方，结合现代科技手段治疗筋骨病诸症的临床经验和方法。药灸方法配合筋骨膏、药灸油，对各症的筋骨伤痛有明显的效果。药灸法可驱风祛湿，舒筋活络，改善血液循环，消除肿胀，减轻镇痛，对早期病例更为有效。绝大多数人通过药灸治疗能够缓解症状，甚至治愈不复发。     

通络醒胃汤联合针刺疗法治疗慢性非萎缩性胃炎临床观察

目的观察通络醒胃汤结合针刺疗法治疗慢性非萎缩性胃炎临床疗效。方法将符合标准的6 0例患者随机分为治疗组与对照组,治疗组给予通络醒胃汤结合针刺疗法,对照组给予针刺疗法,针刺每日1次,中药汤剂每日1剂,水煎分2次口服,连续6次为一个疗程,期间休息1 d,继续下1个疗程,连续治疗4个疗程后评价治疗效果。结果单纯针刺疗法可以改善慢性非萎缩性胃炎的中医临床症状,其差异具有统计学意义;通络醒胃汤联合针刺疗法与单纯针刺疗法相比,在改善中医临床症状方面其差异有统计学意义;单纯针刺治疗慢性非萎缩性胃炎,其有效率为8 3.3%,针刺结合通络醒胃汤其有效率为9 3.3%,其P<0. 0 5。结论针刺疗法可以改善慢性非萎缩性胃炎临床症状,通络醒胃汤结合针刺疗法疗效优于单纯针刺疗疗法。