杜长海名老中医应用药对治疗功能性便秘的临床经验探析

功能性便秘的发生严重困扰着现代人群,进而影响人们的生活质量。杜长海名老中医认为功能性便秘究其内因为大肠传导失常,外因乃现代人的生活方式、紧张的生活氛围等等,因此杜老结合自己数十年的临床经验,根据中医辨证总结出临床常用药对,对有效治疗功能性便秘进行了经验总结。     

唐祖宣国医大师应用仲景对药治疗风湿病经验

对药是临床常用的配伍形式,也常是方剂的核心,多能相伍以增效。唐祖宣国医大师临床擅用仲景对药治疗各种风湿类疾病,或寒热并用,或表里兼治,用于临床取得了较好的效果。本文对唐老应用附子配地黄、附子配知母、乌头配麻黄、防己配防风、防己配黄芪及芍药配甘草等常用对药治疗风湿病的经验及现代研究进展进行了详细介绍。     

胶类中药的特点及现代研究分析

动物胶类药物在很多疾病的治疗和保健中发挥重要作用。许多古籍中均有以胶类入方治疗疾病的记载。近年来，胶类药物的相关研究逐渐增多，应用领域也在不断扩大。笔者通过对常用胶类药物的发展变化、药性归经、现代药理作用、临床应用、胶类新药开发前景、质量控制方法等方面的分析总结，整理出胶类中药的发展变迁及现代研究进展，为今后胶类药物的开发利用提供参考。     

某院重点监控中成药的管理实践

目的：探索对中成药重点监控药品合理使用的有效药事管理措施。方法：基于药品销售金额、DDDs，和DUI为评价指标，通过四步筛选法确定中成药重点监控目录，结合用药合理性评价结果进行药事管控。通过对比监管前后某院医疗指标变化情况，对管理效果进行参考性评价。结果：在疗效相同的前提下，重点监控中成药的金额占比持续下降，中成药的药占比由24.4%下降至15.8%；中成药的人均药费由1 492.5元降至878.3元；而病种类数、收治人数、治愈率均无显著性差异。中成药的用药不合理使用率也大幅度下降。结论：通过建立重点监控中成药的管理措施，规范医疗机构药物使用并取得一定成效。为中成药的管理提供新的思路。     

Herbal medicinal products for inflammatory bowel disease: A focus on those assessed in double‐blind randomised controlled trials

Inflammatory bowel disease patients frequently use herbal products as complementary or alternative medicines to current pharmacotherapies and obtain information on them mainly from the internet, social media, or unlicensed practitioners. Clinicians should therefore take a more active role and become knowledgeable of the mechanisms of action and potential drug interactions of herbal medicines for which evidence of efficacy is available. The therapeutic efficacy and safety of several herbal medicines have been studied in double‐blind randomised controlled trials (RCTs). Evidence of efficacy is available for Andrographis paniculata extract; curcumin; a combination of myrrh, extract of chamomile flower, and coffee charcoal; and the Chinese herbal medicines Fufangkushen colon‐coated capsule and Xilei san in patients with ulcerative colitis; and Artemisia absinthium extract and Boswellia serrata resin extract in patients with Crohn's disease. However, most of this evidence comes from single small RCTs with short follow‐up, and the long‐term effects and safety of their use have not yet been established. Thus, our findings indicate that further appropriately sized RCTs are necessary prior to the recommended use of these herbal medicines in therapy. In the meantime, increasing awareness of their use, and potential drug interactions among physicians may help to reduce unwanted effects and adverse disease outcomes.     

基于网络药理学和分子对接探讨钩藤-全蝎药对治疗支气管哮喘的作用机制＊

目的通过网络药理学和分子对接探究钩藤-全蝎药对治疗支气管哮喘的药理作用机制。方法通过TCMSP、TCMIP数据库搜集钩藤、全蝎的活性成分及其作用靶点,并使用Cytoscape软件进行可视化分析成分-靶点网。通过OMIM、GeneCards数据库搜集支气管哮喘的疾病靶点,整合钩藤-全蝎药对与支气管哮喘的共有靶点。利用String平台构建对共有靶点互作PPI网络,并进行GO和KEGG富集分析,通过Cytoscape软件构建成分-靶点-通路网络模型。最后通过Autodock分子对接进行验证。结果经过筛选发现钩藤-全蝎药对37个活性化合物和234个药物靶点,与哮喘6010个靶点取交集得到35个共有靶点。钩藤-全蝎包含槲皮素、山奈酚、育亨宾碱、β-谷甾醇等重要活性成分;根据PPI网络分析,核心网络连接度高的潜在治疗靶点有IL6、CASP3、ECFR、ESR1、MAPK8等;根据KEGG富集分析结果显示,钩藤-全蝎药对主要通过PI3 K-Akt信号通路、TNF信号通路,HIF-1信号通路、M APK信号通路、NF-κB信号通路等来治疗哮喘;钩藤-全蝎药对活性成分与核心靶点的分子对接结果均显示出较好的结合活性。结论钩藤-全蝎药对治疗哮喘呈现出多成分、多靶点、多通路的特点,其核心成分槲皮素、山奈酚、育亨宾碱、β-谷甾醇等可能通过CASP3、MAPK8、ESR1、IL6、ECFR等靶点调节多条通路发挥抗炎、调节免疫、抗氧化应激、改善气道重塑等作用,从而对哮喘达到有效的治疗。     

The Internet and lifestyle drugs: an analysis of demographic characteristics,methods, and motives of online purchasers of illicit lifestyle drugs in the Netherlands

Abstract

Aims: The Internet has marked a revolution in the supply of illegal drugs, while at the same time, new types of illegal and semilegal drugs increasingly are becoming available. In order to deepen our understanding of the demand and supply of these new drugs on the Internet, this study focuses on the demographic characteristics, methods and preferences of people who purchase ‘lifestyle drugs’ through the surface web.

Methods: Data were obtained through the following two surveys: a prevalence study of 50,848 Dutch respondents and an in-depth study of 153 people who have purchased lifestyle drugs online.

Findings: At least 10.2% of the Dutch adult population has bought medicines online; the majority being lifestyle drugs (5.2%). In addition, an estimated 1.6% of the Dutch population has purchased medicines illicitly, with the majority of products concerning lifestyle drugs (0.9%). Illicit lifestyle drugs are primarily purchased through e-commerce sites and online pharmacies, and users report high satisfaction rates.

Conclusion: Purchasing lifestyle drugs is characterised by specific online dynamics, as the drugs are often openly accessible and the boundaries between legal and illegal sale blurred. As new types of drugs become available, it is important to further monitor customers’ preferences and experiences.     

对上海青浦区基本药物目录中抗高血压药物可负担性的实证研究

目的 评估基本药物制度下上海青浦区口服抗高血压药物的可负担性,为促进社区慢性病基本药物价格合理性提供实证依据。方法 采用WHO/HAI标准化法和贫化法对该地区口服抗高血压药物的可负担性进行评价。结果 用WHO/HAI标准化法评价结果显示,医疗保险患者对原研药和仿制药的可负担性都较好,而自费患者对原研药的可负担性较差。贫化法结果显示,使用同一通用名的5种原研药和仿制药的致贫人口数量差距较小。厄贝沙坦原研药的可负担性高于仿制药。结论 医疗保险对提高基本药物可负担性作用明显,同时要对一些具有明确循证学证据和使用人群广泛的药物给予合理的定价,以提高治疗高血压药物的可负担性。     

Time to Entry for New Cancer Medicines: From European Union–Wide Marketing Authorization to Patient Access in Belgium,Estonia, Scotland,and Sweden

Objectives

First, to quantify the median time from European Union (EU)-wide approval to first use (launch) for a sample of cancer medicines and number of launches in Belgium, Estonia, Scotland, and Sweden as of June 2015. Second, to assess whether longer times to launch or lack of launches affected medicines with high or low expected additional clinical benefit. Third, to identify possible determinants of the probability of a cancer medicine to be launched.