补肾平肝方治疗阴虚阳亢型原发性高血压的前瞻性队列研究

目的观察补肾平肝方联合马来酸左旋氨氯地平片治疗阴虚阳亢型原发性高血压的临床疗效及对晨起血压和肝肾功能的影响。方法采用前瞻性队列研究方法,选取2017年9月—2018年9月于河北省中医院心血管科收住院治疗且符合入组标准的151例阴虚阳亢型原发性高血压患者作为观察对象,按自愿原则分为2组,对照组76例患者给予马来酸左旋氨氯地平片治疗,治疗组75例患者给予补肾平肝方联合马来酸左旋氨氯地平片治疗。观察2组患者治疗前及治疗14 d后中医症状积分、晨起血压及肝肾功能指标的变化,统计2组患者治疗14 d后中医证候疗效。结果治疗14 d后,2组患者的中医症状积分、晨起血压均较治疗前明显降低(P均<0.05),且治疗组均明显低于对照组(P均<0.05)。治疗前2组患者肝肾功能指标均在正常范围,治疗14 d后各指标均未见明显变化。治疗14 d后,治疗组和对照组中医证候总有效率分别为90.7%(68/75)和75.0%(57/76),治疗组明显高于对照组(P<0.05)。结论补肾平肝方联合马来酸左旋氨氯地平片治疗可显著改善阴虚阳亢型原发性高血压患者的阴虚阳亢症状,降低晨起血压,且安全。     

中药调剂管理中药配方颗粒与中药饮片应用对比分析

目的:探讨中药调剂管理过程中,中药配方颗粒与中药饮片的应用效果差异。方法:对医院开具的中药处方情况以及23名工作人员和200例患者的调查结果进行分析,探讨中药调剂管理过程中,中药配方颗粒与中药饮片的应用效果差异。结果:使用中药配方颗粒的发药出错率和调配出错率均少于使用中药饮片的方式(P<0.05)。在对23名药房工作人员的调查结果中显示,工作人员对于中药配方颗粒的每项态度均优于中药饮片(P<0.05)。在对200名患者的调查结果中显示,患者对于中药配方颗粒的每项态度均优于中药饮片(P<0.05)。结论:在中药调剂的管理过程中,中药配方颗粒的管理方式具有较多的优势,得到患者与医务工作者双方的认可。     

补肾活血法孕前治疗LPD复发性流产患者的临床疗效

目的探讨补肾活血法孕前治疗黄体功能不全(luteal phase defect,LPD)复发性流产患者,观察其对妊娠结局的改善情况。方法按照诊断标准纳入57例LPD复发性流产患者,并随机分为治疗组和对照组,治疗组予补肾活血法治疗3个月,妊娠后再予益肾安胎法保胎治疗,对照组于妊娠后予益肾安胎治疗。采用化学发光法检测血清激素指标(E_2、P、β-HCG),同时采用ELISA法检测血清Kisspeptin水平,并电话随访妊娠结局;比较治疗前后中医症状评分、血清激素及Kisspeptin指标、妊娠结局情况、安全性。结果两组患者治疗后中医症状积分、妊娠激素水平(E_2、P、β-HCG)、Kisspeptin水平、妊娠结局比较,差异有统计学意义(P0.05),两组患者均无严重不良反应。结论补肾活血法孕前治疗LPD复发性流产能显著改善其临床症状,调节妊娠激素及Kisspeptin水平,健全黄体功能,从而有效改善妊娠结局。     

补肾壮骨膏治疗围绝经期骨质疏松症临床观察

目的观察补肾壮骨膏治疗围绝经期骨质疏松症的临床疗效。方法选取2014年3月～2017年3月在我院就诊的围绝经期骨质疏松症患者80例,随机分为观察组与对照组。观察组40例,服用补肾壮骨膏、碳酸钙片;对照组40例,口服克龄蒙、碳酸钙片。观察组及对照组以4周为1个疗程,3个疗程结束后评估两组治疗效果,检测骨骼矿物质密度(BMD)及性激素(雌激素E2、卵泡刺激素FSH)。结果 3个月后随访,观察组总有效率90.0%高于对照组82.5%,差异有统计学意义(P0.05);两组BMD治疗前后比较,差异有统计学意义(P0.01);观察组E2水平明显高于对照组,FSH水平明显低于对照组,差异有统计学意义(P0.05)。结论补肾壮骨膏治疗围绝经期骨质疏松症临床疗效显著,值得临床推广。     

温阳补肾法对高原类风湿关节炎患者血清25羟维生素D3水平的影响

目的:观察温阳补肾法对高原类风湿关节炎患者血清25羟维生素D3水平的影响。方法:选取2015年7月至2017年8月青海省中医院收治的高原类风湿关节炎患者132例作为研究对象,随机分为对照组和观察组,每组66例。对照组应用常规西医治疗,观察组在对照组治疗基础上应用温阳补肾法治疗,2组均连续治疗3个月。比较2组治疗后临床疗效,统计2组治疗前后主要临床症状与体征、健康状况评定量表(HAQ)评分和DAS28评分,检测2组治疗前后实验室检查指标、血清25羟维生素D3以及血液流变学指标水平。结果:治疗后,观察组临床治疗总有效率显著高于对照组(P 0. 05); 2组关节肿胀指数、关节疼痛指数、关节压痛指数、晨僵时间、关节功能分级和20 m步行时间均较治疗前显著降低(P 0. 05),且观察组均显著低于对照组(P 0. 05); 2组HAQ评分、DAS28评分、类风湿因子(RF)、C反应蛋白(CRP)和红细胞沉降率(ESR)水平均较治疗前显著降低(P 0. 05),且观察组均显著低于对照组(P 0. 05); 2组血清25羟维生素D3水平均较治疗前显著升高(P 0. 05),且观察组显著高于对照组(P 0. 05); 2组红细胞电泳指数、红细胞压积、血浆黏度、全血低切黏度、全血高切黏度水平均较治疗前显著降低(P 0. 05),且观察组均显著低于对照组(P 0. 05)。结论:温阳补肾法治疗高原类风湿关节炎,疗效满意,同时能明显增加血清25羟维生素D3水平。     

中药配方颗粒的发展现状及国际化对策探讨

近年来,世界各国对天然药物日益重视,而中药配方颗粒既能在中医理论指导下随证加减,又有服用便捷、适宜工业生产等优点,成为推动中药"走出去"的有力助力。通过回顾中药配方颗粒的发展历程、分析相关数据和国内外发展形势,对中药配方颗粒的研究现状、市场情况及国际化发展面临的主要挑战进行探讨,提出利用政府间交往推进中药国际贸易、充分发挥海外资源平台作用、帮助监管部门建立符合中药配方颗粒特点和审批国政策的合理化国际审批方案、争取国际标准主导权的建议,为推动中药配方颗粒产业在世界范围内高质量发展提供参考。     

补肾活血汤配合鲑鱼降钙素治疗老年骨质疏松性腰椎骨折临床观察

目的分析补肾活血汤配合鲑鱼降钙素治疗老年骨质疏松性腰椎骨折的临床效果。方法选择2015年5月~2017年6月来我院就诊的老年骨质疏松性腰椎骨折患者109例为研究对象,采用随机数字表法分为对照组和观察组,109例患者在接受PKP治疗的基础上,对照组采用皮下注射鲑鱼降钙素,观察组在对照组基础上联合补肾活血汤,比较两组临床效果。结果对照组治疗前ODI(46.83±3.91)与观察组治疗前ODI(45.98±4.03)比较差异不显著(P0.05),经治疗后对照组ODI(38.91±4.09)与观察组ODI(26.28±5.21)差异显著(P0.05)。重复测量方差分析发现,两组在组间和时间具有统计学差异(P0.05),但组别与时间的交互作用差异无统计学意义(P0.05),两组术前BMD(0.69±0.06)、术后1个月(0.72±0.09)与观察组术前BMD(0.69±0.06)、术后1个月(0.72±0.09),差异不显著(P0.05)。治疗后对照组BMD术后3个月(0.72±0.09)、术后6个月(0.72±0.08)与对照组BMD术后3个月(0.73±0.09)、术后6个月(0.73±0.09),差异显著(P0.05)。对照组总有效率45例(83.33%)与观察组总有效率53例(96.36%),差异显著(P0.05)。结论补肾活血汤配合鲑鱼降钙素治疗老年骨质疏松性腰椎骨折临床效果显著,值得推广。     

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??Objective    To investigate the influence of Bushen Zhuanggu Decoction on the bone healing after teeth extraction in osteoporotic dogs. Methods    Totally 9 female adult dogs whose bilateral ovaries were surgically removed to establish osteoporosis models were randomly divided into 3 groups ??control group??Western medicine group and traditional Chinese medicine group??. Bilateral mandibular premolars were extracted 3 months after castration. Osteoporosis treatment was started the third day after tooth extraction. The dogs in the traditional Chinese medicine group??the Western medicine group and the control group were respectively fed with Bushen Zhuanggu Decoction??Estradiol Valerate Tablets and nothing. The bone mineral density??BMD?? value of dog′s lumbar spine and mandible of each group were detected before and after 3 months of castration and 3 months after teeth extraction. The tissue morphology of the mandible was observed at 1??2 and 3 months after teeth extraction. Results    Three months after teeth extraction??the BMD values of the lumbar spine and mandible in the traditional Chinese medicine group and the Western medicine group were significantly increased compared with those before the osteoporosis treatment??and there was no significant difference compared with the preoperative ones. One month after teeth extraction?? the new bone and the trabecular bone were observed in irregular patterns in the control group and the Westen medicine group??and those were arranged in a mesh pattern in the Chinese medicine group. Two months after teeh extraction??the trabecular bone structure was sparse in the control group??the Western medicine group was more than that of the new bone??and the number of trabecular bone in the Chinese medicine group was more robust. Three months after teeth extraction??the bone trabecular structure was relatively compact in the control group and the gap is small??the new bone tissue and the original bone tissue roughly fused together in the Western medicine group??the new bone tissue of the traditional Chinese medicine group was more similar to the structure of the original bone. Conclusion      Bushen Zhuanggu Decoction can make cancellous bone around the teeth extraction of the osteoporosis canine and significantly increase the amount of bone tissue??so as to promote bone reconstruction and bone healing after teeth extraction.     

Development of a predictive in vitro dissolution for clarithromycin granular suspension based on in vitro-in vivo correlations

The objective of this study was to evaluate the in vitro behavior of different clarithromycin granular suspensions based on a developed in vitro-in vivo correlation model, using one reference and two test formulations. In vitro release rate data were obtained for each product using the USP apparatus II, operated at 50?rpm under different pH conditions. The dissolution efficiency was used to analyze the dissolution data. In vivo study was performed on six healthy male volunteers under fasting condition. Correlation was made between in vitro release and in vivo absorption. A linear model was developed using percent absorbed data versus percent dissolved data from the three products. Dissolution condition of 0.1N HCl for 1?h and then phosphate buffer at pH 6.8 was found to be the most discriminating dissolution method. Rate of absorption for the reference as estimated by Wagner-Nelson deconvolution was correlated with in vitro release with a correlation coefficient of 0.99. The in vivo results for the two test products were compared to the predicted values using the reference model with a correlation coefficient of 0.94. Furthermore, multiple level C correlations were obtained for some pharmacokinetic parameters with the corresponding in vitro kinetic parameters with correlation coefficients exceeding 0.90. Moreover, the interpretation of the in vitro and in vivo data with reference to formulations was discussed.