中药制剂临床不良反应分析及药房管理

目的研究中药制剂的不良反应与安全用药。方法本院于2018年7—至2019年7月开展“中药制剂不良反应分析与安全用药”研究。选取该阶段收治的117例中药制剂不良反应患者作为临床研究对象,统计分析不良反应患者之间的差异性。结果117例患者所应用的中药制剂类型为丹参川芎嗪注射液(64例)、参芎葡萄糖注射液(33例)、注射用盐酸川芎嗪(15例)、生脉注射液(5例)。≥60岁患者的不良反应发生率大于≤12岁患者、11~59岁患者,有统计学意义(P<0.05)。静脉滴注的不良反应发生率大于静脉注射(P<0.05)。患者多在用药1 h内发生不良反应;不良反应的主要累及部位依次是皮肤、消化系统、呼吸系统、循环系统等。不同中药制剂类型的不良反应也存在一定差异。结论临床对中药制剂的不良反应依然缺乏全面、深入的研究与认识,需加强中药制剂不良反应监测,合理应用中药制剂,促使临床安全用药,减少不良反应,提高患者的用药舒适度。     

肝内胆汁淤积症孕妇的胎儿不良结局分析

目的对肝内胆汁淤积症孕妇的胎儿不良结局进行分析研究。方法随机选择在本院接受治疗的肝内胆汁淤积症孕妇作为观察组,与同期在本院正常分娩的对照组孕妇相比胎儿的不良结局。结果观察组的分娩结果 :12例早产、5例流产、5例死胎、4例新生儿窒息、40例正常分娩。对照组的分娩结果 :1例早产、1例新生儿窒息,64例正常分娩。观察组中胎儿不良结局发生率显著高于对照组,P <0.05;观察组中重度患者的胎儿不良结局发生率高于轻度患者,P <0.05。结论肝内胆汁淤积症导致胎儿不良结局发生率升高,应对加强对肝内胆汁淤积症的预防从而改善胎儿结局。     

帕拉米韦注射液治疗儿童流感的临床疗效分析

目的探讨儿童流感应用帕拉米韦注射液治疗的临床疗效以及用药安全性。方法随机选定在2016年1月-2019年1月期间佛山市高明区人民医院儿科住院治疗并确诊流感A或B型患儿200例,通过随机数字法将其分为治疗组和对照组。治疗组100例用帕拉米韦注射液治疗,对照组100例用国产磷酸奥司他韦颗粒治疗,评价两组患儿治疗前后症状评分、治疗效果、治疗指标以及不良反应发生情况。结果两组患儿治疗前流感样症状评分无统计学意义(P>0.05),两组患儿治疗后较治疗前流感样症状评分均下降,差异有统计学意义(P<0.05);治疗组治疗后流感样症状评分略小于对照组,但是无统计学意义(P>0.05);治疗组治疗总有效率高于对照组,治疗组患儿发热症状缓解、全部症状缓解以及住院时间均小于对照组,存在统计学意义(P<0.05)。治疗组与对照组不良反应发生率较低,且无统计学意义(P>0.05)。结论帕拉米韦注射液可用于儿童流感治疗,不仅能够保证临床疗效,而且可加快症状缓解,同时存在较高用药安全性。     

预注右旋美托咪啶用于喉显微手术麻醉的研究

目的研究分析预注右旋美托咪啶用于喉显微手术麻醉中的临床效果。方法选取2017年12月—2018年12月本院收治的80例行喉显微手术治疗的患者为观察对象,并将其随机分为普通组与观察组,每组各40例,普通组中患者行常规诱导麻醉,观察组中患者行预注右旋美托咪啶诱导麻醉,比较两组麻醉应用效果。结果在T1、T4、T5时段,观察组患者HR、MAP水平均低于普通组,其血流动力学稳定,且不良反应发生率相比普通组降低,两组间比较差异有统计学意义(P<0.05)。结论对行喉显微手术患者在应用预注右旋美托咪啶麻醉,能改善患者血流动力学指标水平,减少患者不良反应。     

龙胆泻肝胶囊治疗肝胆湿热型分泌性中耳炎临床研究

目的:研究龙胆泻肝胶囊治疗肝胆湿热型分泌性中耳炎(SOM)的效果。方法:选取78例肝胆湿热型分泌性中耳炎患者,按随机数字表法分为试验组和对照组各39例。2组均采用鼓膜穿刺术治疗,对照组术后给予头孢克洛和氯雷他定抗感染治疗,试验组给予龙胆泻肝胶囊。评价2组治疗效果,检测治疗前后血清干扰素γ(IFN-γ)和白细胞介素-4(IL-4)水平,计算IFN-γ/IL-4,进行中医证候评分,观察患耳含积液情况。结果:试验组总有效率为92.31%,高于对照组71.79%(P<0.05)。治疗前,2组IFN-γ、IL-4和IFN-γ/IL-4比较,差异无统计学意义(P>0.05)。治疗后,2组IFN-γ、IL-4和IFN-γ/IL-4较治疗前降低,且试验组IFN-γ、IL-4和IFN-γ/IL-4均低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组各项中医症状评分比较,差异无统计学意义(P>0.05)。治疗后,2组各项中医症状评分及总分较治疗前降低,试验组各项中医症状评分及总分均低于对照组,差异有统计学意义(P<0.05)。试验组耳内含积液率为71.79%,低于对照组89.74%(P<0.05)。结论:采用龙胆泻肝胶囊治疗肝胆湿热型分泌性中耳炎,疗效令人满意,能够显著改善患者症状,可下调IFN-γ、IL-4表达,调节Th1/Th2平衡,值得临床推广应用。     

冠心病心绞痛患者行丹参多酚酸盐治疗的效果

目的分析冠心病心绞痛患者采取丹参多酚酸盐治疗效果及安全影响。方法选取本院2017年7月-2018年6月接收的冠心病心绞痛患者72例为研究对象,随机分为两组,各36例,对照组行丹参注射液治疗方案,研究组则接受丹参多酚酸盐治疗方案,对比两组临床疗效及不良反应发生率。结果在治疗总有效率方面,对照组是72.22%,研究组是94.44%,研究组较对照组更高,差异有统计学意义(P<0.05);在不良反应发生率方面,对照组与研究组分别是8.33%和5.56%,研究组与对照组差异统计学无意义(P>0.05);研究组心绞痛发作次数较对照组更低,差异存在统计学意义(P<0.05);而运动诱发ST段压低1 mm时间、运动诱发心绞痛发作时间及总运动代谢量,对照组与研究组差异统计学无意义(P>0.05)。结论冠心病心绞痛疾病治疗期间,应用丹参多酚酸盐治疗方案,不仅可以减少冠心病心绞痛发作次数,同时有助于改善患者临床症状,促进治疗效果的提高,此外,具有较高的安全性。     

Nano-curcumin therapy,a promising method in modulating inflammatory cytokines in COVID-19 patients

BackgroundAs an ongoing worldwide health issue, Coronavirus disease 2019 (COVID–19) has been causing serious complications, including pneumonia, acute respiratory distress syndrome (ARDS), and multi-organ failure. However, there is no decisive treatment approach available for this disorder, which is primarily attributed to the large amount of inflammatory cytokine production. We aimed to identify the effects of Nano-curcumin on the modulation of inflammatory cytokines in COVID-19 patients.MethodForty COVID-19 patients and 40 healthy controls were recruited and evaluated for inflammatory cytokine expression and secretion. Subsequently, COVID-19 patients were divided into two groups: 20 patients receiving Nano-curcumin and 20 patients as the placebo group. The mRNA expression and cytokine secretion levels of IL-1β, IL-6, TNF-α and IL‐18 were assessed by Real‐time PCR and ELISA, respectively.ResultOur primary results indicated that the mRNA expression and cytokine secretion of IL-1β, IL-6, TNF-α, and IL-18 were increased significantly in COVID-19 patients compared with healthy control group. After treatment with Nano-curcumin, a significant decrease in IL-6 expression and secretion in serum and in supernatant (P = 0.0003, 0.0038, and 0.0001, respectively) and IL-1β gene expression and secretion level in serum and supernatant (P = 0.0017, 0.0082, and 0.0041, respectively) was observed. However, IL-18 mRNA expression and TNF-α concentration were not influenced by Nano-curcumin.ConclusionNano-curcumin, as an anti-inflammatory herbal based agent, may be able to modulate the increased rate of inflammatory cytokines especially IL-1β and IL-6 mRNA expression and cytokine secretion in COVID-19 patients, which may cause an improvement in clinical manifestation and overall recovery.     

The Second Victim Phenomenon: How Are Midwives Affected?

Perinatal care providers are likely to encounter adverse events such as intrapartum emergencies, traumatic births, or maternal or fetal deaths. As a result of being directly or indirectly involved in an adverse event, health care providers can be considered second victims. The experience of the second victim phenomenon can lead to significant physical, psychological, and psychosocial sequelae that can negatively impact the provider's personal and professional life for either a short or long duration of time. When health care providers experience an adverse event, they may manifest symptoms of guilt, shame, blame, flashbacks, nightmares, insomnia, isolation, helplessness, and hopelessness, thereby becoming the second victim. Following an adverse event, health care providers who experience second victim phenomenon experience stages of recovery that influence subsequent professional and personal well‐being. Persons who experience the second victim phenomenon can incorporate self‐care behaviors to assist with recovery. Health care organizations have a responsibility to implement efficacious support programs that promote the provider's recovery and a return to safe and full function in the workplace.