化痰祛瘀方加减联合硫唑嘌呤片治疗白塞病27例临床观察

目的：观察化痰祛瘀方加减联合硫唑嘌呤片治疗白塞病的临床疗效。方法将50例白塞病患者随机分为2组。治疗组27例予化痰祛瘀方加减联合硫唑嘌呤片治疗,对照组23例予硫唑嘌呤片治疗,2组均治疗2个月。比较2组临床疗效及治疗前后C反应蛋白（ CRP）、免疫球蛋白（ Ig） A变化。结果2组总有效率比较差异有统计学意义（P＜0．05）,治疗组疗效优于对照组。2组治疗后CRP及IgA均较本组治疗前降低（P＜0．01）,且治疗组降低更明显（P＜0．05）。结论化痰祛瘀方加减联合硫唑嘌呤片治疗白塞病疗效显著,可提高免疫力。     

Clinical trials in children

Safety and efficacy data on many medicines used in children are surprisingly scarce. As a result children are sometimes given ineffective medicines or medicines with unknown harmful side effects. Better and more relevant clinical trials in children are needed to increase our knowledge of the effects of medicines and to prevent the delayed or non-use of beneficial therapies. Clinical trials provide reliable evidence of treatment effects by rigorous controlled testing of interventions on human subjects. Paediatric trials are more challenging to conduct than trials in adults because of the paucity of funding, uniqueness of children and particular ethical concerns. Although current regulations and initiatives are improving the scope, quantity and quality of trials in children, there are still deficiencies that need to be addressed to accelerate radically equitable access to evidence-based therapies in children.     

Prescribing of the antidepressant duloxetine: Can local clinical audit findings facilitate medicines management decisions?

Introduction. Discussions regarding the inclusion of a new antidepressant within local formulary lists and prescribing guidelines may be facilitated by audits of local prescribing practice, conducted some months after the drug first becomes available for clinical use. Method. Development of five audit standards and retrospective case-note review of prescribing recommendations for the serotonin-noradrenaline reuptake inhibitor duloxetine, made in five local outpatient clinics. Results. Follow-up data were available for audit in 27 of 43 sets of medical notes. In the majority of patients (84%), the primary diagnosis was recurrent unipolar depressive disorder, the current episode having proven resistant to treatment with two other antidepressants. Where comments were made, notes indicated that 81% of patients that received duloxetine had improved and 94% had tolerated it without reported problems. Conclusions. In this sample, duloxetine prescribing in the first months after it became available appeared to occur within an appropriate patient group. Prospective evaluations in other clinical samples are warranted.     

Medicines and disease information needs of older Arabic‐speaking Australians

Aim: To explore access, satisfaction, awareness and needs for medicines and disease information (MADI) sources for older Arabic‐speaking Australians. Method: Five focus groups were conducted (in Arabic) with 29 participants with a chronic disease, aged over 65 years, and unable to speak or read English fluently. Discussions were audiotape recorded, simultaneously interpreted into English, transcribed verbatim and content analysed. Results: Arabic‐speaking general practitioners were identified as the main source of MADI, despite dissatisfaction with their counselling. Written Arabic MADI was not accessed by participants, who revealed low English and Arabic literacy levels and a reliance on family members to act as interpreters. Male participants were more concerned and active about their health and medicine information than female participants. Conclusions: This study highlighted limited availability and access to Arabic MADI for older Arabic‐speaking Australians, with reliance on Arabic‐speaking health‐care professionals for information and family members as interpreters. An accessible and sustainable system for MADI is required.     

国医大师张志远应用茯苓药对经验拾萃

国医大师张志远积累了丰富的临床用药经验,张老知药而用,并重视药物配伍。从药性及经验药对方面对张老应用茯苓经验进行论述,如茯苓配伍甘草治疗惊悸不安,茯苓配伍泽泻治疗痰饮水肿,茯苓配伍天麻治疗头眩耳鸣,茯苓配伍麻黄治疗痰饮咳嗽,拓宽了茯苓应用范围,将其灵活准确运用于诸多疾病的治疗,效果显著。