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1.
水分活度(简称a;)是食品和化妆品行业快速评价微生物风险和产品稳定性的重要指标之一。基于a;的原理深入分析a;对微生物生长的作用,综述目前药学研究中a;的应用现状,并借鉴食品、化妆品行业中a;的测量方法及应用方案,探讨a;用于中药临方制剂微生物风险控制的应用前景。此外,由于中药临方制剂对时限性的特殊要求,常规的细菌检测过程耗时过长,不能与其特性相适应,因而a;的引入将大大降低产品微生物检验的时限压力,有助于提高制剂的安全控制能力,为中药临方制剂的开发和应用提供高效可行的质控方案。  相似文献   
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目的分析中药处方点评在中药调剂中的应用效果。方法抽取未开展中药处方点评前在本院应用中药进行治疗的82例患者作为对照组;并选取实施了中药处方点评后在本院应用中药进行治疗的82例患者作为观察组。对照组患者在常规中药调剂下用药治疗,观察组患者则在融入处方点评的中药调剂下进行治疗。比较两组用药风险事件发生率、治疗有效率、不良反应发生率以及患者治疗满意度。结果观察组用药风险事件发生率2.44%低于对照组的12.20%,差异具有统计学意义(P<0.05)。观察组治疗有效率97.56%高于对照组的87.80%,不良反应发生率2.44%低于对照组的17.07%,差异均具有统计学意义(P<0.05)。观察组患者治疗满意度96.34%高于对照组的85.37%,差异具有统计学意义(P<0.05)。结论在中药调剂中开展中药处方点评,能够显著提高中药处方的合理性,进而提升中药调剂质量,显著降低患者的用药风险事件发生率,从而提高临床疗效,减少不良反应的发生,对于提高患者的用药合理性、安全性及治疗满意度,具有重要的意义。  相似文献   
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目的 从医疗机构康复医疗服务结构、环节、结局质量等方面,对2020年全国综合医院康复医学科、康复医院的医疗服务与质量安全进行分析。  相似文献   
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BackgroundFindings on the usefulness of massage therapy (MT) in postoperative pain management are often inconsistent among studies.ObjectivesThis study’s aim is to conduct a meta-analysis of randomized controlled trials (RCT) to clarify the effects of massage therapy in the treatment of postoperative pain.MethodsThree databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) were searched for RCTs published from database inception through January 26, 2021. The primary outcome was pain relief. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The random-effect model was used to calculate the effect sizes and standardized mean difference (SMD) with 95 % confidential intervals (CIs) as a summary effect. The heterogeneity test was conducted through I2. Subgroup and sensitivity analyses were used to explore the source of heterogeneity. Possible publication bias was assessed using visual inspection of funnel plot asymmetry.ResultsThe analysis included 33 RCTs and showed that MT is effective in reducing postoperative pain (SMD, −1.32; 95 % CI, −2.01 to −0.63; p = 0.0002; I2 = 98.67 %). A similar significant effect was found for both short (immediate assessment) and long terms (assessment performed 4–6 weeks after the MT). Remarkably, we found neither the duration per session nor the dose had an impact on the effect of MT and there seemed to be no difference in the effects of different MT types. In addition, MT seemed to be more effective for adults. Furthermore, MT had better analgesic effects on cesarean section and heart surgery than orthopedic surgery.LimitationsPublication bias is possible due to the inclusion of studies in English only. Additionally, the included studies were extremely heterogeneous. Double-blind research on MT is difficult to implement, and none of the included studies is double-blind. There was some heterogeneity and publication bias in the included studies. In addition, there is no uniform evaluation standard for the operation level of massage practitioners, which may lead to research implementation bias.ConclusionsMT is effective in reducing postoperative pain in both short and long terms.  相似文献   
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ObjectivesTo map the randomized trial evidence describing the feasibility of discontinuing active medications with potential adverse effects in older patients.DesignScoping review with systematic search of PubMed, Embase, and Cochrane Library.Setting and ParticipantsRandomized trials investigating discontinuation of a single medicine or medicine class in patients with mean age ≥65 years.MethodsWe extracted trial characteristics including study design and assessed bias. As proxies for the “feasibility of discontinuation,” we extracted the “dropout rate” and “disease recurrence rate.”ResultsWe identified 40 trials investigating discontinuation of symptomatic (n = 26), preventive (n = 6), or both preventive and symptomatic medicines (n = 8) against psychiatric (n = 10), neurologic (n = 9), musculoskeletal (n = 8), cardiovascular (n = 5), respiratory (n = 4), and urologic diseases (n = 4). Five discontinuation designs were used, 75% (30/40) of trials were placebo-controlled, and 48% (19/40) of trials had bias disfavoring discontinuation. The dropout rate was similar between the discontinuation group and the continuation group in 79% of the trials (30/38), whereas disease recurrence was similar in 72% (23/32) of the trials. In 42% (13/31) of trials reporting both dropout rate and disease recurrence rate, the differences between groups were statistically insignificant and less than 10%; these trials investigated discontinuation of cholinesterase inhibitors for Alzheimer's disease in various settings (n = 3), alendronate for osteoporosis (n = 3), glucosamine for osteoarthritis, lithium as adjunct for unipolar depression, statins for cardiovascular disease in patients with limited life expectancy, droxidopa for neurogenic orthostatic hypotension, tamsulosin for lower urinary tract symptoms, sertraline for major depressive episode, and fentanyl patch for low back or osteoarthritis pain.Conclusions and ImplicationsWe identified 40 randomized trials using a variety of designs investigating discontinuation of both symptomatic and preventive medicines in older patients. Discontinuation of medicines seems feasible for most of the investigated medicines. This scoping review can guide clinical practice and future trials on deprescribing.  相似文献   
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目的:观察肾康注射液联合青霉素与替米沙坦治疗肾小球肾炎合并急性间质性肾炎患者的效果。方法:选取134例肾小球肾炎合并急性间质性肾炎患者为研究对象,按随机数字表法将其分成观察组与对照组各67例。对照组给予青霉素联合替米沙坦治疗,观察组在对照组基础上加用肾康注射液治疗,比较两组临床疗效、治疗前后肾功能指标[血管内皮生长因子(VEGF)、胱抑素C(CysC)、单核细胞趋化蛋白-1(MCP-1)]水平和不良反应发生率。结果:观察组治疗总有效率为97.01%(65/67),明显高于对照组的85.07%(57/67),差异有统计学意义(P<0.05);治疗后,观察组VEGF、CysC和MCP-1水平均低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:肾康注射液联合青霉素与替米沙坦治疗肾小球肾炎合并急性间质性肾炎患者可提高治疗总有效率,降低肾功能指标水平,其效果优于青霉素联合替米沙坦治疗。  相似文献   
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[目的] 总结全国名中医范永升教授运用青蒿治疗系统性红斑狼疮(systemic lupus erythematosus,SLE)的临床经验,提高对SLE的认识。[方法] 通过跟师学习,收集范教授诊治的SLE患者的临床资料,以及整理医案、查询相关文献,回顾分析范教授在SLE的不同阶段运用青蒿及并配伍相关药物的临床经验,并以验案佐证。[结果] 范教授通过辨证论治,以青蒿之清热解毒,治疗SLE轻型阴虚兼有热毒证;以青蒿之透邪滋阴,治疗SLE轻型余邪内伏证;以青蒿之清胆理气,治疗SLE重型肝郁血瘀证。所举病案中分别以解毒祛瘀滋阴方及蒿芩清胆汤治疗轻型及重型SLE,治疗后患者症状改善,SLE疾病活动(systemic lupus erythematosus disease activity index,SLEDAI)评分降低。[结论] 范教授针对SLE的不同阶段,运用青蒿清透虚热、凉血除蒸、解暑截疟,并配伍相关药物,疗效显著,其经验值得推广学习。  相似文献   
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