邦备治疗咳嗽变异性哮喘疗效观察

目的 :观察邦备治疗儿童咳嗽变异性哮喘 (CAV)的疗效。方法 :120例咳嗽变异性哮喘儿童随机分为治疗组和对照组各60例。治疗组使用邦备 ,6～12岁每次5ml,12～14岁每次7.5ml,每日1次 ,辅舒酮125mg,每日2次 ,连用4周 ,对照组使用辅舒酮剂量疗程同治疗组。观察两组患儿咳喘情况。结果 :治疗组、对照组显效率分别为60%和20 % (P<0.05) ,总有效率分别为93.3%和55 % (P<0.01)。结论 :邦备治疗儿童咳嗽变异性哮喘疗效明显。     

顺尔宁对90例儿童咳嗽变异性哮喘的疗效观察

目的探讨顺尔宁治疗儿童咳嗽变异性哮喘的临床疗效。方法选择2002年5月至2004年10月在我院门诊及住院咳嗽变异性哮喘患儿90例,随机分为治疗组和对照组。两组均给予止咳、抗组胺、支气管扩张剂等治疗。治疗组另外给予顺尔宁片治疗,〈6岁,每次5mg,〉6岁,每次10mg,每日1次,睡前服用。结果治疗组第2周患儿缓解率为37．5％,第4周时达75．0％;对照组第2周患儿缓解率为16．0％,第4周时为46．0％,两组比较差异有非常显著性（P〈0．01）。结论顺尔宁治疗咳嗽变异性哮喘疗效显著、确切。     

舒喘灵加西替利嗪治疗咳嗽变异性哮喘

目的　探讨舒喘灵加西替利嗪治疗咳嗽变异性哮喘的疗效。方法　 12 0例患儿随机分为 3组 ,每组 40例 ,A组 (单用舒喘灵 ) ,B组 (单用西替利嗪 ) ,C组 (舒喘灵加西替利嗪 )。剂量 :舒喘灵 :每次 0 .1mg.kg- 1 ,每日 3次 ;西替利嗪 :每日 1次。<2岁 ,每次 2 .5 mg;2～ 5岁 ,每次 3 .3 mg;5～ 8岁 ,每次 5 .0 mg;8～ 12岁 ,7.5 mg;>12岁 ,每次 10 .0 mg。结果　C组与 A组、B组疗效相比均有显著性差异 (P<0 .0 1)。结论　舒喘灵加西替利嗪联合治疗咳嗽变异性哮喘确有协同作用 ,尽快消除咳嗽症状 ,值得推广。     

白三烯受体拮抗剂治疗咳嗽变异性哮喘43例

目的探讨白三烯受体拮抗剂(孟鲁司特)治疗咳嗽变异性哮喘的疗效。方法随机选择咳嗽变异性哮喘患儿43例,在常规治疗基础上加用孟鲁司特,于治疗2周、12周评价疗效,并设对照组。结果治疗2周后,治疗组、对照组总有效率分别为58.14%,52.38%,差异无统计学意义(χ2=2.341,P>0.05)。治疗12周,2组总有效率分别为79.07%,57.14%,差异有统计学意义(χ2=4.731,P<0.05)。结论咳嗽变异性哮喘常规治疗基础上加用孟鲁司特疗效较好。     

美喘清联合孟鲁司特治疗儿童咳嗽变异性哮喘23例

目的 观察美喘清联合孟鲁司特治疗儿童咳嗽变异性哮喘的临床效果及其安全性.方法 将46例咳嗽变异性哮喘患儿随机均分为治疗组和对照组,均予美喘清每12 h口服1次,2～5岁每次12.5μg,大于5岁每次25μg;治疗组在此基础上加用孟鲁司特,2～6岁每次4 mg,大于6岁每次5 mg,每晚1次,疗程2～4周;所有患儿均子对症治疗,适当应用抗生素并行止咳治疗.结果 治疗组显效15例,有效6例,无效2例,总有效率为91.30%;对照组显效12例,有效4例,无效7例,总有效率为69.57%.两组总有效率比较,差异有显著性意义(P＜0.05).治疗组有3例出现心率增快,2例出现面部潮红、头痛,均不影响治疗,停药后症状消失.结论 美喘清联合孟鲁司特治疗儿童咳嗽变异性哮喘的临床效果较理想,可推广应用.     

止嗽散加减治疗小儿咳嗽变异性哮喘的临床研究

目的观察止嗽散对小儿咳嗽变异性哮喘的疗效。方法将110例咳嗽变异性哮喘患儿随机分为治疗组和对照组各55例,对照组给予口服沙丁胺醇、酮替芬、二氯苯那敏等;治疗组在对照组治疗方案的基础上给予止嗽散加减治疗。两周后比较两组的临床疗效。结果治疗组的总有效率为90．9％,优于对照组的总有效率（76．4％）（χ^2=4．25,P〈0．05）;6个月后咳嗽对照组复发率为60．0％,治疗组16．3％,两组差异有统计学意义（χ^2=22．18,P〈0．01）。结论常规治疗联合止嗽散加减能够明显的提高咳嗽变异性哮喘的疗效。     

孟鲁司特治疗儿童咳嗽变异性哮喘临床观察

目的 观察孟鲁司特治疗儿童咳嗽变异性哮喘的临床疗效及安全性. 方法 120例咳嗽变异性哮喘患儿按入院单双号随机分成对照组（30例）和观察组（90例）,对照组给予丙卡特罗1.25 μg·kg^-1·次^-1,2 次/d,治疗4周;观察组给予孟鲁司特（剂量：2～5岁4 mg/次;6～14岁5 mg/次）,3次/d,疗程4周.观察两组临床治疗效果及不良反应发生情况. 结果 观察组患儿肺功能状况、咳嗽症状缓解时间及咳嗽症状恶化次数均较对照组改善明显（均P＜0.05）,观察组临床治疗总有效率明显高于对照组（P＜0.05）,两组均未发生严重不良反应. 结论 孟鲁司特治疗儿童咳嗽变异性哮喘疗效明显,不良反应少,值得临床推广应用.     

孟鲁司特治疗小儿咳嗽变异性哮喘50例疗效观察

目的探讨孟鲁司特对小儿咳嗽变异性哮喘的治疗效果。方法100例咳嗽变异性哮喘患儿随机的分为治疗组和对照组,每组50例,对照组给予常规治疗,治疗组在对照组治疗方案的基础上给予孟鲁司特口服治疗。1月后比较两组的临床疗效,并随访6月,观察两组的复发情况。结果治疗组的总有效率为92．0％,优于对照组76．0％（χ^2=4．762,P〈0．05）;6个月后复发率治疗组为12％,对照组为30％,两组差异有统计学意义（χ^2=4．883,P〈0．05）。结论孟鲁司特能够明显的提高咳嗽变异性哮喘的疗效。     

槐杞黄颗粒联合孟鲁司特钠治疗儿童咳嗽变异性哮喘临床观察

目的：探讨槐杞黄颗粒联合孟鲁司特钠治疗儿童咳嗽变异性哮喘的疗效及其对肺功能、免疫功能的影响。方法：选取我院2012年1月至2013年1月收治的咳嗽变异性哮喘患儿48例,随机分为观察组和对照组各24例,均给予止咳、支气管扩张剂、抗过敏等常规治疗。观察组加用孟鲁司特钠（2～6岁每次4mg,〉6岁～12岁每次5mg,每晚1次口服）和槐杞黄颗粒（2～3岁每次5g,〉3岁～12岁每次10g,早晚各1次口服）治疗,对照组仅加用孟鲁司特钠治疗,用法用量同观察组,均连续治疗3个月。治疗3个月后比较两组临床疗效、咳嗽缓解及消退时间、肺功能和免疫功能指标变化。随访6个月,观察复发情况。结果：观察组和对照组总有效率（91．7％vs79．2％）比较差异无统计学意义（P〉0．05）,但观察组咳嗽症状缓解和消失时间均短于对照组（P〈0．05）。两组FEV1％、PEF％、IgE、CD4＋T细胞、CD8＋T细胞水平及CD4＋／CD8＋均较治疗前改善,且观察组改善程度更大（P〈0．01）。两纽随访6个月复发率比较差异无统计学意义（P〉0．05）。结论：在常规治疗基础上加用槐杞黄颗粒联合盂鲁司特钠治疗儿童咳嗽变异性哮喘,不仅具有良好的临床疗效,还能缩短咳嗽缓解及消失时间,能更好地改善患儿肺功能及免疫功能,体现了中西医结合治疗“多途径、多靶点”的整体优势。     

孟鲁司特治疗儿童咳嗽变异性哮喘的效果观察

目的观察孟鲁司特在儿童咳嗽变异性哮喘的效果,为替代激素治疗哮喘提供理论依据。方法将符合入组标准的86例儿童咳嗽变异性哮喘患者按随机数字表分为观察组43例和对照组43例,对照组给予布地奈德联合特布他林治疗,观察组给予孟鲁司特联合特布他林治疗,两组均治疗3个月,随访6个月,治疗前后观察患儿症状与肺功能指标改善情况。记录症状缓解时间,随访期间观察复发情况,比较复发率,记录不良反应发生情况,评判两组临床疗效。结果（1）观察组和对照组的总有效率分别为93．02％、95．35％,差异无统计学意义（χ2=0．367,P〉0．05）;（2）观察组和对照组的临床缓解时间、复发比例分别为（5．6±2．5）d比（5．3±3．0）d,6．98％比6．98％,差异均无统计学意义（P〉0．05）;观察组与对照组治疗前后1秒钟用力呼气容积占预计值百分比（FEV1％）、最大呼气流量占预计值百分比（PEF％）水平差异无统计学意义（P〉0．05）;（3）观察组与对照组的不良反应发生率分别为0比9．30％,差异有统计学意义（χ2=4．195,P〈0．05）。结论孟鲁司特与布地奈德治疗儿童咳嗽变异性哮喘的临床疗效相当。但孟鲁司特的安全性及治疗依从性更好,具有糖皮质激素的替代作用。     

Role of the liver in the disposition of intravenous nitroglycerin in the rat

Previous studies have indicated that the liver is the main site of nitroglycerin (NTG) elimination when the drug is systematically infused. To examine this hypothesis, we measured the apparent systemic clearance (Cls) of nitroglycerin in anesthesized rats receiving a constant intravenous infusion at a dose of 100 micrograms per kg per min. Animals were divided into shunt and sham groups; the former had undergone a portal vein ligation 10 days prior to the study, while the latter was subjected to a sham operation. On the study day, half of the animals of each group also received probenecid at 200 mg/kg, i.v., a drug previously reported to inhibit organic nitrate ester reductase (ONER) activity in rat liver. Arterial NTG samples were obtained at 41, 43 and 45 min of infusion in all four experimental groups; Cls was 439 +/- 32 ml per kg per min (mean +/- S.E.) in sham, 460 +/- 44 in sham and probenecid, 477 +/- 39 in shunt, and 461 +/- 34 in shunt and probenecid animals. During NTG infusion, hepatic blood flow (measured with a constant infusion of indocyanine green) was decreased markedly in shunted rats as was liver/body weight, indicating hepatic atrophy. The specific activity of hepatic ONER was similar in all four groups. In spite of marked differences in hepatic blood flow and hepatic mass, the Cls was similar in all four groups. The liver does not appear to be a major site for the elimination of systemic nitroglycerin as hitherto assumed.     

HACCP在学校集体食堂卫生管理中的应用研究

目的 通过HACCP在学校集体食堂管理中的应用,提高食品卫生水平,保障学生的身体健康。方法 HACCP原则。结果 食品卫生达到较高水平,极大地减少了食物中毒的发生。结论 提示HACCP原则可在学校集体食堂的卫生管理中发挥有效作用。     

半导体激光治疗老年人压疮疗效观察

目的探讨半导体激光局部照射治疗老年人压疮疗效.方法:收集2012年1月-2015年6月48例压疮患者,分为半导体组和常规组各24例.常规组采用常规治疗,半导体组采用半导体激光加常规治疗,10 d为1个疗程,不超过3个疗程.疗程结束后比较两组疗效.结果:半导体组压疮愈显率为83.33％,创面愈合时间为(12.75±5.51)d,常规组分别为54.17％和(19.63±8.65)d,组间差异有统计学意义(P＜0.05),两组均未见不良反应.结论:半导体激光加常规治疗压疮效果肯定,无明显不良反应,且操作简便.     

脑卒中恢复期患者社区综合康复的疗效观察

目的：探讨社区开展康复活动对于脑卒中患者肢体功能康复的影响。方法：选取2014年4至10月参与社区“陈睿健康工作室”康复活动的脑卒中恢复期患者50例作为观察组,选取同期延吉社区卫生服务中心门诊的50例脑卒中恢复期患者作为对照组（进行门诊随访、服药、自我康复）。采用知识、信念、行为（KAP）量表对观察组患者进行问卷调查。采用简化Fugl-Meyer肢体运动功能评分表（Fugl-Meyer assessment of motor function,FAM）比较两组患者入组时和入组6个月时的肢体功能恢复情况及对家庭医生（门诊医师）的满意度。结果：入组6个月时,两组患者的FAM均有所改善,观察组FAM得分[上肢（50.92±7.05）分,下肢（33.01±1.37）分]较对照组[上肢（34.85±6.55）分,下肢（25.20±4.88）分]更高,差异有统计学意义（t上肢=11.8215,t下肢=10.8595,P均＜0.01）。观察组患者的满意率为92%（46/50）,明显高于对照组的30%（15/50,P＜0.05）。结论：在社区开展康复活动可以促进脑卒中患者肢体功能的康复,提高患者的满意度。     

Evaluation of the safety of enalapril in the treatment of heart failure in the very old

Summary We have introduced enalapril, in doses equal to or less than the 2.5 mg currently recommended, as an adjuvant to digoxin and diuretics in 17 patients of mean (SD) age 83 (5) years with severe heart failure. Only eleven patients tolerated its introduction. Unlike those reported in younger patients, all but one of the adverse drug reactions occurred 8 h or more after the first dose. Aged patients started on ACE inhibitors should be observed in hospital until stabilized on a maintenance dose. Three patients had an adverse reaction which differed in nature from those previously reported: acute confusional state, ataxia and mesenteric ischaemia.Ten patients were discharged on 5 mg or 10 mg maintenance doses of enalapril. In nine of them improvement on triple therapy was sustained for a minimum of three months. ACE inhibition was lost in the other patient when her compliance with enalapril therapy fell to around 75%: monitoring compliance is essential when ACE inhibitors are used in low dosages.Enalapril was withdrawn during follow up in three patients because of symptoms of mesenteric ischaemia and in four because of dramatic deterioration of renal function. One of the latter was found subsequently to have severe bilateral atheromatous renal artery stenosis. When isosorbide dinitrate was substituted for enalapril, symptoms of mesenteric ischaemia resolved and renal function returned to baseline. Continuing surveillance for adverse effects is essential in patients of this age group with severe heart failure, and the risk of occult renal artery stenosis requires regular biochemical screening during follow up.The benefit to cost ratio of ACE inhibitors might be improved in aged patients by their use at an earlier stage in the natural history of heart failure, when perfusion of essential organs is not grossly impaired, but carefully monitored trials would be necessary to establish this.     

Effect of the Immunomodulator Tilorone on the in Vivo Acetylation of Procainamide in the Rat

Interferon and interferon inducers have been found to inhibit cytochrome P-450-dependent metabolism in animals and man. The effect of these agents on the acetylation of drugs has not been previously reported. Since these agents stimulate the reticuloendothelial system, together with the abundance of N-acetyltransferase in the reticuloendothelial system, it was hypothesized that these immunomodulators may affect drug acetylation. To test this hypothesis, the effect of tilorone (a synthetic interferon inducer) on the in vivo acetylation of procainamide was examined in the rat. Pretreatment with tilorone hydrochloride (50 mg/kg) 48 hr prior to the administration of procainamide hydrochloride (50 mg/kg) resulted in a 32% increase in the urinary recovery of N-acetylprocainamide and a 35% increase in the metabolic clearance of procainamide to N-acetylprocainamide. These data indicate that interferon inducers increase the N-acetylation of drugs in vivo.     

药物经济学成本-效果分析应用的相关问题探讨

目的探讨药物经济学成本-效果分析(CEA)应用的相关问题。方法运用文献计量学方法、数学证明方法等。结果与结论在运用CEA进行药品的经济性评价时,尤其需要重视临床治疗指标的选择、成本的确定、增量分析的使用和与最小成本分析的比较。     

替普瑞酮治疗老年慢性浅表性胃炎的疗效分析

目的分析替普瑞酮治疗老年慢性浅表性胃炎的疗效。方法100例老年慢性浅表性胃炎患者,通过计算机随机表数字法分为对照组和实验组,每组50例。对照组患者选择西咪替丁作为本次治疗药物,实验组患者选择替普瑞酮作为本次治疗药物。比较两组患者临床疗效、不良反应发生情况以及生活质量。结果实验组治疗总有效率92.00%高于对照组的76.00%,差异具有统计学意义(P<0.05)。实验组不良反应发生率6.00%低于对照组的20.00%,差异具有统计学意义(χ^2=4.332,P=0.037<0.05)。实验组患者治疗后的生活质量评分(68.68±4.11)分高于对照组的(57.73±3.48)分,差异具有统计学意义(t=14.377,P=0.000<0.05)。结论对于老年慢性浅表性胃炎疾病患者,选择替普瑞酮进行治疗不仅疗效更为理想,而且还不易增加患者的用药不良反应,有利于提高患者的生活质量,建议进一步推广。     

Adenosine mechanisms in the regulation of breathing in the rat

The central respiratory effects of various adenosine (A) analogues were studied in halothane-anesthetized rats. Intracerebroventricular (i.c.v.) and intraperitoneal (i.p.) injections of the A analogues (2-Cla, L-PIA, CHA and NECA) reduced minute ventilation (VE) due to decreases in respiratory frequency (f) as well as tidal volume (VT). Dose-dependent effects were seen after i.c.v. L-PIA in both normal and vagotomized rats. Analysis of the A-induced changes using the occluded breath technique revealed an increase in expiratory time (TE) as well as a decrease in inspiratory drive. NECA, a relatively specific A2 agonist seemed to be somewhat more potent in eliciting respiratory depression than a relatively specific A1 agonist like L-PIA. Pretreatment with the methylxanthine theophylline completely antagonized the respiratory depression induced by L-PIA. It is concluded that central A receptors are involved in the central regulation of breathing and that A interacts with the respiratory control system mainly by decreasing inspiratory neural drive and prolonging expiratory time.     

Nifedipine in the treatment of hypertension in the elderly

The effect of nifedipine monotherapy, retard tablets, 20 mg bid, was evaluated in 23 hypertensive patients, mean age, 79 +/- 2 years. Twenty-one patients completed an eight-week study. Blood pressure (BP) decreased to 160/90 mm Hg in 15 patients; in four additional patients diastolic BP dropped by 15% to 28%. In a subset of five patients with isolated systolic hypertension, a significant reduction in systolic BP was noted. Side effects were relatively mild and only two patients discontinued the study. The results suggest that nifedipine monotherapy offers an alternative, logic, therapeutic approach to hypertension in the elderly.