基于数据挖掘的中药治疗不宁腿综合征的组方用药规律分析

目的:借助中医传承辅助平台(V2.5),对中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普数据库(VIP)和万方数据库中运用中医药治疗不宁腿综合征(Restless legs syndrome,RLS)的方剂进行检索归纳并分析其组方用药规律.方法:检索相关数据库从建库到2020年1月以中医药治疗RLS的文献,运用中医传承辅助平台系统,进行相关数据的挖掘分析.结果:共筛选出符合要求的167首方剂,涉及180味中药,挖掘出处方中药物的性味归经、用药频次、组方规律、药物关联度,演化得出核心组合28个、新处方14个,为中医药临床治疗RLS提供新的参考.     

基于数据挖掘技术研究中医治疗发作性睡病的组方配伍规律

目的:采用数据挖掘技术总结中医治疗发作性睡病(Narcolepsy,NRL)的用药规律.方法:收集国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、中国生物医学文献服务系统(CBM)4个数据库建库时间截至2020年8月31日发表的中医治疗NRL的相关文献,纳入标准限定处方...     

中医治疗不宁腿综合征研究进展

不宁腿综合征属于神经系统常见病,患者临床主要表现为双下肢活动欲望强烈,该不适症状多出现于晚间睡前或睡眠状态下,患者通常睡眠状态受影响严重,容易出现焦虑、抑郁等症状,对生活质量影响恶劣。近年来,对不宁腿综合征采用中医药治疗、针灸以及中医综合治疗等中医手段治疗获得较理想的成效,并且无明显毒副作用,临床治疗十分适用。     

不宁腿综合征的护理

不宁腿综合征 (ｒｅｓｔｌｅｓｓｌｅｇｓｓｙｎｄｒｏｍｅ,ＲＬＳ) ,又称不安腿综合征、多动腿综合征。其病因与发病机理尚未完全清楚 ,一般认为与局部缺血、代谢障碍及精神、遗传等因素有关。大多并发于尿毒症、糖尿病、类风湿关节炎及各种贫血等 ,也常为尿毒症出现前的先兆。据国外研究[1] ,普通人群中下肢不宁综合征的发生率从百分之几到 15 % ,大多低于 10 % ;而在尿毒症患者中则达 2 0 %左右。据日本 3所医院对 4 5 1例肾透析患者调查 ,有 2 2 0例有下肢不宁综合征 ,占 4 9%。ＲＬＳ的临床特征为腿部有异常感觉 ,如蚁行感、针刺感、痒…     

不宁腿综合征11例分析

我科2004-01/2009-01收治不宁腿综合征(Restless legsSyndrome,RLS)11例,分析如下.1 临床资料1.1 一般资料 本组男2例,女9例,年龄42~77(平均59)岁,病程5d~3a.同时患有缺铁性贫血2例,震颤麻痹1例,慢性肾病1例.     

儿童不宁腿综合征1例

1　病历简介　　患儿女 ,3岁 ,因发热 3天入院。查体 :T 38℃ ,咽充血 ,扁桃体Ⅱ度肿大 ,峡部可见疱疹 ,心、肺、腹及神经系统未见异常。实验室检查 :WBC 12 .4× 10 9/L ,N 0 .72 ,L 0 .2 8,Hb 9g/L ,RBC 3.2× 10 12 /L ;尿常规、生化常规无异常。诊断 :①疱疹性咽峡炎 ;②轻度贫血。给予抗感染、退热、纠正盆血、对症等治疗。住院期间发现患儿于夜晚睡眠时 ,尤其在入睡 1小时后即开始哭闹 ,诉双腿发痒 ,并不停地搓动 ,需家长对其双腿进行按摩、揉搓 ,约 1～ 2小时后渐入睡 ,当时查体未见异常。追问病史 ,患儿自生后 8个月始即出现…     

不宁腿综合征48例分析

目的探讨不宁腿综合征的临床表现、诊断、治疗及预后。方法对48例明确诊断的不宁腿综合征患者进行多导睡眠脑电图分析,采用左旋多巴类药物治疗,并进行随访1 a。结果 48例患者均有双下肢难以形容的感觉异常,治疗后症状减轻。结论本病是一种常见的神经系统感觉运动障碍性疾病,应用多巴胺能药物及其他对症药物,可以有效治疗。     

不宁腿综合征的发病机制及药物治疗

不宁腿综合征(restless legs syndrome,RLS))是近几年再次引起国内外倍加重视的多发病.其主要表现为双下肢难以形容的感觉异常与不适,患者被迫活动或敲打下肢以减轻其痛苦,常在夜间休息时加重.1945年瑞典神经病学家Ekbom第一次对本病作出全面的描述,故又称"Ekbom综合征".现仅对该病的发病机制和药物治疗方面的新进展作一综述.     

剑桥-霍普金斯不宁腿量表诊断中国人群不宁腿综合征的临床研究

目的：在中国人群中对自填型剑桥-霍普金斯不宁腿量表（Cambridge-Hopkins questionnaire for restless legs syndrome, CH-RLSq）诊断不宁腿综合征（restless legs syndrome/Willis-Ekbom disease, RLS/WED）的灵敏度和特异度进行验证。方法：共26例RLS/WED患者和21例对照（18例其他疾病患者和3名正常人）入组,其中其他疾病指类似RLS/WED表现的疾病（包括4例神经根病变,3例糖尿病周围神经病变,4例痛性痉挛,1例静脉曲张,另6例患者的诊断暂不确定）,所有对象均进行CH-RLSq量表检测,进行临床诊断与问卷诊断的一致性研究,并同时记录RLS/WED患者的临床资料。结果：RLS/WED的临床诊断和CH-RLSq量表的诊断具有较好的一致性（Kappa=0.745, McNemar test: P=0.216）。CH-RLSq量表诊断RLS/WED的灵敏度为80.8%,特异度为95.2%。RLS/WED患者中女性患者较多见,且患者的家族史阳性率较高、合并症较多。结论：CH-RLSq量表在我国人群的RLS/WED诊断中具有较高的灵敏度和特异度,可用来作为筛查RLS/WED的问卷。     

加巴喷丁治疗不宁腿综合征的系统评价

目的系统评价加巴喷丁治疗不宁腿综合征的临床疗效和安全性。方法计算机检索PubMed、EBMbase、CENTRAL及CBM等数据库,全面收集加巴喷丁治疗不宁腿综合征的随机对照试验(RCT)。按Cochrane系统评价方法对纳入研究进行资料提取和质量评价后,采用RevMan5.1软件进行Meta分析。结果共纳入7个RCT,1 163例患者,包括4个安慰剂平行对照试验和3个安慰剂交叉试验。Meta分析结果显示:①不宁腿综合征改变量(IRLSSG评分),加巴喷丁组明显优于安慰剂组[MD=–3.24,95%CI(–4.40,–2.09),P<0.000 01];②反应率(用研究者评价的CGI-I评分),加巴喷丁组(77%)较安慰剂组(50%)有更高的反应率[RR=1.81,95%CI(1.54,2.11),P<0.000 01];③睡眠质量:加巴喷丁组较安慰剂组能更好地减少睡眠紊乱[MD=–11.31,95%CI(–14.46,–8.16)]、保证睡眠质量[MD=0.27,95%CI(0.10,0.44)]和减轻日间嗜睡[MD=–3.96,95%CI(–6.42,–1.50)];④不宁腿综合征疼痛评分,加巴喷丁组较安慰剂组更好地减轻疼痛[MD=–0.97,95%CI(–1.47,–0.47)]。不良反应主要有嗜睡(3.1%～26.5%)、头晕(2.1%～19.5%),且加巴喷丁组发生率更高(嗜睡:P<0.000 01;头晕:P<0.000 1)。结论加巴喷丁能有效改善不宁腿综合征患者的病情,提升睡眠质量,减轻疼痛,耐受性良好。     

前后配穴埋线治疗原发性不安腿综合征伴睡眠障碍13例

不安腿综合征伴睡眠障碍是一种严重影响患者生命质量且难以根除的中枢神经系统疾病.本文将穴位埋线与常规针刺联合治疗不安腿综合征的疗效进行观察研究,以说明穴位埋线在症状改善及远期疗效上的作用和优势.结果表明,经过2个疗程的治疗后,穴位埋线在腰膝酸软、睡眠障碍及焦虑抑郁方面较普通针刺的改善程度方面更优,且疗效维持时间更久.穴位...     

From Bench to Bedside: An Overview of Rotigotine for the Treatment of Restless Legs Syndrome

Background

Restless legs syndrome (RLS) is a common chronic neurologic disorder. Symptoms are most prevalent during the evening and at night, although daytime symptoms may emerge as the disease progresses. Dopamine agonists are currently considered first-line therapy for moderate to severe idiopathic RLS. Most dopamine agonists have short half-lives and are administered in the evening, shortly before the onset of RLS symptoms. Rotigotine is a non-ergot dopamine receptor agonist that has been specifically developed as a transdermal patch to provide continuous drug delivery over a 24-hour period.

Objective

This review details the development of rotigotine, from the preclinical studies that established its pharmacokinetic profile to large-scale clinical trials in patients with RLS. Placebo-controlled trials that demonstrated the efficacy and tolerability of rotigotine are discussed, in addition to open-label studies that investigated long-term therapy.

Methods

Studies were identified by a PubMed search using the key word rotigotine in conjunction with restless legs syndrome and by reviewing reference lists of retrieved publications. All clinical trials of rotigotine in RLS published before September 2013 were included.

Results

Preclinical studies have established activity of rotigotine as a dopamine receptor agonist, and pharmacokinetic data have shown that transdermal delivery maintains stable plasma levels over 24 hours. Rotigotine has demonstrated efficacy in improving moderate to severe RLS symptoms in randomized, placebo-controlled trials, based on scores on the International RLS Study Group rating scale, the RLS-6 scale, and the Clinical Global Impression–Severity subscale. Results of an open-label extension study suggest that efficacy may be maintained for up to 5 years. A polysomnographic study demonstrated an improvement in periodic limb movement index with rotigotine, and subjective assessments have suggested beneficial effects in terms of amelioration of sleep disturbances. Premature discontinuations from rotigotine treatment have ranged from 8% to 38% in studies of 6 weeks to 12 months in duration; 57% of patients discontinued prematurely during a 5-year study. In each trial, adverse events were typical of dopaminergic stimulation and use of a transdermal patch. The most common adverse events were application-site reactions, with a reported prevalence ranging from 17% (1-month sleep laboratory trial) to 58% (5-year open-label extension study). Clinically significant augmentation was recorded in 39 of 295 patients (13%) receiving rotigotine during the 5-year study, of whom 15 (5%) were receiving a dose within the US Food and Drug Administration–approved range of 1 to 3 mg/24 h.

Conclusions

Findings from clinical studies have suggested that rotigotine is efficacious in improving RLS symptoms and is generally well-tolerated. The risk of developing clinically significant augmentation appears to be low. As such, rotigotine represents an important addition for RLS treatment.     

基于数据挖掘的数字化中医诊断系统

该文介绍了具有创新意义的新一代中医诊断系统,文章详细介绍了数据挖掘技术在这种新型中医诊断系统的运用,结合其他数字化技术,阐述了新型中医诊断系统的结构和组成,并对比传统中医诊断系统具体论证了新一代数字化中医诊断系统的优势所在.     

Effectiveness and Tolerability of Istradefylline for the Treatment of Restless Legs Syndrome: An Exploratory Study in Five Female Patients

Background: Studies of istradefylline (KW6002), an adenosine A_2A-receptor antagonist, have provided evidence of its efficacy as a nondopaminergic antiparkinsonian drug. Antiparkinsonian drugs have also had efficacy in treating restless legs syndrome (RLS).Objectives: The aims of this study were to assess the effectiveness and tolerability of istradefylline in the treatment of RLS.Methods: This was a single-center, multiparametric, prospective trial of istradefylline as a treatment for moderate to severe idiopathic RLS. It was conducted at the Shands/Jacksonville Sleep Disorders Center, University of Florida, Jacksonville, Florida, from March 2003 to October 2003. Patients received a single PO 80-mg dose QD of istradefylline in the late afternoon or early evening for 6 weeks. Appropriate tolerability evaluations (ie, vital assessments, physical examination, clinical laboratory tests, and electrocardiogram) were performed at screening, while on study drug, and after withdrawal of study drug.Results: Fifteen participants (mean [SD] age, 61 [7.1] years; range, 50-69 years) were screened for enrollment. The mean duration of RLS was 18 years. Of the 15 potential patients, 6 did not meet entry criteria, 2 withdrew consent, 1 had not completed baseline procedures at the time of study suspension, and 1 was excluded for administrative reasons. Therefore, a total of 5 patients received the study drug. Of these, 3 (60%) patients responded favorably to istradefylline treatment. Improvement in the periodic limb movement index was observed in 3 patients compared with baseline (patients 2, 4, and 5 [index score: 6, 4, 9 vs 50, 35, 18, respectively]). Improvement in the International RLS Rating Scale scores was observed in 3 patients compared with baseline (patients 2, 4, and 5 [index score: 7, 23, 9 vs 35, 25, 20, respectively]). There was a return to baseline severity in 2 of the 3 patients after withdrawal of study drug. Improvement in RLS symptoms was observed in 3 patients treated with istradefylline for 6 weeks. A clinical worsening of baseline insomnia was observed in 2 patients.Conclusions: Although we could not definitively conclude a beneficial effect based on this small exploratory trial, we found the data to be encouraging. The study drug was well tolerated. Further study of this compound in the treatment of RLS is justified.     

高尿酸血症危险因素的数据挖掘及关联规则研究

目的使用关联规则的数据挖掘方法研究分析高尿酸血症危险因素的关联性及关联强度。 方法将调查的3 724例患者和社区居民的临床情况作为数据集,使用IBM SPSS Statistic19.0软件中的Apriori算法对数据集进行分析。 结果在3 724名调查人群中,高尿酸血症占样本的13.32%,三酰甘油、肌酐、尿素氮和总胆红素异常分别占25.76%、7.90%、13.91%和13.56%,高尿酸血症患病率分别为20.24%、43.70%、22.28%和20.72%。关联规则分析结果显示,高血压（χ²=34.01,P＜0.001）、糖尿病（χ²=9.07,P=0.003）、三酰甘油（χ²=20.38,P＜0.001）、总胆红素（χ²=57.03,P＜0.001）、谷丙转氨酶（χ²=6.156,P=0.017）、肌酐（χ²=102.71,P＜0.001）和尿素氮（χ²=72.82,P＜0.001）有统计学显著性差异;而血糖（χ²=0.369,P=0.584）、总胆固醇（χ²=1.081,P=0.326）和谷草转氨酶转氨酶（χ²=3.656,P=0.074）无统计学差异。 结论高血压、肌酐、三酰甘油和总胆红素是高尿酸血症的危险因素,高尿酸血症与高血压密切相关,是高血压的独立危险因素和预测因素。