血必净注射液治疗Ⅲ～Ⅳ期压疮伴中重度感染的临床观察

目的:观察血必净注射液辅助治疗Ⅲ~Ⅳ期压疮伴中重度感染的临床效果及安全性。方法:选取2011年7月-2016年6月在我院治疗的Ⅲ~Ⅳ期压疮伴中重度感染患者130例,按随机数字表法分为对照组和观察组,各65例。对照组患者经冲洗后使用0.5%碘伏消毒液消毒疮面,再用0.5%碘伏消毒液将无菌纱布浸湿后湿敷疮面30 min,然后用爱康肤吸收性银离子抗菌愈合敷料填充伤口,敷料被渗液湿透2/3时换药。观察组患者在对照组治疗基础上,加用血必净注射液50 m L加入生理盐水100 m L中静脉滴注30~40 min,2~3次/d,连用7 d。两组患者疗程均为4周。比较两组患者的临床疗效、压疮愈合评分表(PUSH)评分、清创时间、局部症状消退时间、全身炎症反应综合征(SIRS)消退时间,以及不良反应发生情况。结果:观察组患者的总有效率(93.85%)明显高于对照组(80.00%),清创时间、局部症状和SIRS消退时间均明显短于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者的PUSH评分比较,差异均无统计学意义(P>0.05);治疗1~4周后,两组患者的PUSH评分均较治疗前明显下降,且观察组明显低于同期对照组,差异均有统计学意义(P<0.05)。两组患者均未见明显不良反应发生。结论:血必净注射液治疗Ⅲ~Ⅳ期压疮伴中重度感染能够有效减少炎性渗出、促进疮面坏死组织吸收、缓解局部症状和全身炎症反应、加快病变部位修复,具有较好的临床疗效和较高的安全性。     

复方桐叶烧伤油联合直线偏振光治疗不同分期压疮的疗效观察

目的 探讨复方桐叶烧伤油联合直线偏振光照射治疗不同分期压疮的临床疗效,为治疗压疮寻找更有效的方法.方法 按2016年NPUAP标准,收集住院带入诊断压疮明确病例40例为研究对象,采用随机数字表法将其分为对照组20例和试验组20例.对照组在全身治疗与局部治疗的基础上选择直线偏振光照射治疗.试验组在此基础上联合复方桐叶烧伤油治疗.比较两组患处的压疮疗效和创面平均愈合时间.结果 试验组的总有效率95％,明显高于对照组的总有效率75％,两组总有效率比较差异有统计学意义(P<0.05);试验组1～4期的压疮创面治愈时间均明显比对照组短,比较差异均有统计学意义(P<0.05).结论 复方桐叶烧伤油联合直线偏振光照射治疗不同分期压疮的疗效更好、创面平均愈合时间更短,是治疗压疮的更有效方法,在治疗压疮方面值得推广.     

中西医结合治疗肾病综合征的疗效观察

目的:探讨激素联合中医治疗肾病综合征(NS)的疗效。方法:选择我院住院治疗的NS患者100例为研究对象,并按随机化原则分为试验组和对照组。两组均用激素治疗,试验组在此基础上给予分阶段中医治疗。结果:(1)试验组总有效率为94%,对照组为64%。两组比较,P<0.05;(2)试验组血脂各项指标的改善情况优于对照组(P<0.05)。(3)试验组肾功能各项指标的改善情况优于对照组(P<0.05)。(4)试验组不良反应发生率低于对照组(P<0.05)。结论:激素联合中医治疗肾病综合征是有效途径。     

康复新液治疗口腔溃疡45例

目的探讨康复新液治疗口腔溃疡的疗效。方法选择医院2010年1月至2012年2月期间收治的口腔溃疡患者90例,随机分为两组,每组45例。两组均口服维生素C、维生素B以及采取抗感染治疗,并以0.9%氯化钠注射液清洗口腔溃疡面。对照组45例患者均给予西瓜霜喷雾剂,每日4次。治疗组患者均给予康复新液3～5 mL口服,每日4次。结果对照组愈合的时间为(5.43±1.49)d,治疗组溃疡愈合时间为(2.97±1.35)d,对照组愈合时间显著短于治疗组(P<0.05);治疗组总有效率为95.56%,对照组总有效率为71.11%,两组总有效率差异具有显著性(P<0.05)。两组患者在治疗过程中均未出现明显不良反应。结论应用康复新液治疗口腔溃疡疗效显著,无不良反应,疗程短,值得临床推广。     

康艾注射液联合放射治疗中晚期食管癌的临床对比研究

目的评价康艾注射液联合放疗治疗中晚期食管癌的近期疗效和放疗不良反应。方法将50例中晚期食管癌患者随机分为对照组和试验组,两组均采用放疗:放疗采用直线加速器6 mV-X线照射,放疗每天2 Gy总量为60⁶6 Gy(666 Gy(6⁷周),试验组在上述放疗基础上再每天静脉注射康艾注射液(长白山制药股份有限公司生产)50 mL,共计30 d,观察两组近期疗效及不良反应。结果试验组的近期总有效率为92.0%,对照组为68.0%,两组差异具有统计学意义(P<0.05)。试验组的Ⅲ/Ⅳ级消化管毒性反应、白细胞毒性反应发生率与对照组比较,均明显减轻(P<0.05)。结论康艾注射液能够有效提高中晚期食管癌放疗的临床疗效,且能显著减少放疗的不良反应。     

探讨外治法治疗下肢慢性疮面的临床疗效并评价其性价比

目的本文就下肢慢性疮面采用中医外治法治疗的临床价值及可行性进行了浅显的分析与研究。方法选择我院2014年1月至2016年1月期间收治的下肢慢性疮面80例,采用计算机法将其分为观察组和对照组,观察组予以中医外治法治疗,对照组予以地奥司明治疗,对两组患者治疗前后心理状况及疼痛情况,疮面愈合情况,疮面瘙痒改善情况,治疗满意度等指标进行观察和统计。结果观察组治疗后SAS、SDS及VAS评分较比对照组明显更低,疮面愈合情况较比对照组明显更优,疮面瘙痒改善情况及治疗满意度较比对照组明显更为理想(P<0.05)。结论中医外治法在下肢慢性疮面临床治疗中的应用效果显著,有效减轻了患者痛苦,帮助患者早日恢复健康,值得推广。     

山莨菪碱注射液联合多潘立酮片治疗弥漫性食管痉挛疗效分析

目的:探讨山莨菪碱注射液联合多潘立酮片治疗弥漫性食管痉挛的临床疗效及注意事项。方法:选取某院自2010年11月~2013年12月期间收诊的128例弥漫性食管痉挛患者作为研究对象,采用随机数字表法分为试验组(n=64例)和对照组(n=64例),试验组患者给予山莨菪碱注射液联合多潘立酮片治疗,对照组患者给予山莨菪碱注射液治疗,以治疗总有效率、痉挛缓解时间、不良反应发生率等指标来对比两组患者的临床疗效。结果:试验组的治疗总有效率(91.25%)明显高于对照组(77.65%),差异均具有统计学意义(P0.05);试验组的痉挛缓解时间(2.07±0.74)h明显短于对照组(5.38±1.26)h,差异均具有统计学意义(P0.05);试验组的不良反应发生率(8.11%)明显低于对照组(15.83%),差异均具有统计学意义(P0.05)。结论:山莨菪碱注射液联合多潘立酮片治疗弥漫性食管痉挛可以明显提高治愈率,缩短痉挛缓解时间,减少不良反应发生率,值得在临床上大力推广使用。     

美托洛尔静脉注射治疗快速心房颤动临床研究

目的:观察美托洛尔注射液治疗快速心房颤动的疗效及安全性.方法:68例快速心房颤动患者随机分为试验组与对照组,试验组34例予美托洛尔注射液5～15 mg静脉注射,对照组34例予西地兰注射液0.4～0.8 mg静脉注射,分别观察治疗前及治疗后20,40,60,120 min患者心率及血压的变化.结果:两组患者分别有19例和13例在120 min内心室率降至<100次·min-1,两组比较差异无显著性(55.88%vs38.23%,P>0.05).两组心室率降至<100次·min-1所需时间分别为(18.33±12.31)和(65.00±35.05)min,两组比较差异有显著性(P<0.01).两组起效平均时间分别为(14.00±9.95)和(62.50±41.66)min(P<0.01).两组总有效率分别为85.29%和58.82%(P<0.01).结论:美托洛尔静脉注射治疗快速房颤安全有效,为急诊科快速安全治疗快速心房颤动的可靠方法.     

手术结合中医治疗肛瘘的临床效果分析

目的探究手术与中医方法联合应用在肛瘘患者治疗中的临床效果。方法将2013年12月至2015年12月我院收治的92例肛瘘患者分为两组:对照组和试验组,每组46例。对照组给予手术方法治疗,试验组给予手术结合中医方法治疗。结果对照组的临床总有效率为73.91%,试验组的临床总有效率为93.48%,试验组患者的临床疗效明显的比对照组高(P<0.05);试验组的不良反应发生率为6.52%,对照组的不良反应发生率为17.39%,试验组患者的不良反应发生率明显的比对照组低(P<0.05)。结论手术与中医方法联合应用在肛瘘患者治疗中,可显著改善患者肛门失禁的情况,降低不良反应发生率,提高患者生存质量及临床疗效,确保患者尽早恢复健康,值得临床重视并推广。     

银杏达莫注射液治疗深Ⅱ度烧伤40例疗效分析

目的 探讨银杏达莫注射液治疗深Ⅱ度烧伤的疗效和安全性.方法 将80例深Ⅱ度烧伤患者随机分为治疗组和对照组各40例,对照组用生理盐水冲洗创面、聚维酮碘溶液消毒创面,然后用1%磺胺嘧啶银霜外敷,采用半暴露疗法或包扎疗法,每天换药一次.治疗组在对照组治疗的基础上,加用银杏达莫注射液25mL 0.9%氯化钠注射液500mL,静滴,1日1次,2周为1疗程.观察两组创面愈合时间及创面愈合率.结果 治疗组深Ⅱ度烧伤创面愈合时间(21.5±4.8d)短于对照组(23.3±6.4d),P＜0.05,治疗组创面愈合率(96.3±6.2%)高于对照组(91.3±8.8%).对照组不良反应发生率为10%,治疗组为5%,两组间的不良反应有明显的差异(P＜0.05).结论 银杏达莫注射液能明显促进深Ⅱ度烧伤创面的愈合,改善愈合质量,且比较安全.     

Treatment History: Relationship to Treatment Outcomes

It is important to understand whether the number of prior treatment episodes relate to treatment completion, discharge status, and 6-month outcomes. The data set contains information on 2,429 clients in treatment. A modified Addiction Severity Index was administered at the time of admission and at 6-months postdischarge. Additionally, length of stay and discharge status data were obtained. ANOVAs, MANOVAs, and χ² tests were used. Clients with the most prior treatment episodes had greater baseline substance use and psychosocial severity, and were more likely to be treated in residential settings. Nonetheless, treatment acceptance was greatest for these clients. Clients with no prior treatment reported the least acceptance. Treatment completion rates did not vary as a function of treatment experience. Clients achieved positive changes in multiple life domains regardless of treatment history. Nevertheless, at admission, discharge and follow-up, clients with ≥ 2 treatments generally had greater problems than clients with fewer treatments.     

The Effect of Prior Treatment on Treatment Success

The characteristics of clients discharged from federally funded treatment facilities reporting to CODAP are analyzed in terms of several variables. These are the reasons for discharge (treatment completed, transfer or referral, or treatment not completed), the primary drug of abuse at admission (opiates and nonopiates), and the number of prior treatment experiences. Two independent replications using data for two consecutive quarters produced the same results, finding that the likelihood of completing treatment decreases as the number of prior treatment experiences increases. This relationship was found to apply to both opiate and non-opiate users. Although large differences exist in completion rates between opiate and nonopiate users without prior treatment experience, only small differences exist between opiate and non-opiate users who have had prior treatment. The largest difference in treatment outcome occurs between those with no prior treatment and those who have been treated before. Having one or more prior treatment experiences does not seem to have a major impact on the probability of completing treatment.     

Alcohol Halfway Houses: Treatment Length and Treatment Outcome

A follow-up study of 196 alcohol halfway house residents did not support increased length of stay per se and improved treatment out-come. Further treatment following halfway house rehabilitation was, however, observed to have a significant impact upon outcome in the areas of productivity, criminal justice involvement, and substance abuse.     

Phased Inpatient Treatment of Polydrug Abusers: Treatment Description

Abstract

An Invited European Expert Group Meeting was held in Rotterdam that focused on research methods for hidden populations using illicit drugs. Experts from most European Community member states participated and contributed state-of-the-art presentations on various research methodologies. Attention was paid to the more quantitatively oriented research methods, such as surveys using questionnaires, interviews, and routine statistics from treatment and criminal justice as well as to more ethnographically oriented research methodologies. Recommendations were formulated for the near future: research methodology needs to meet all the classical methodological criteria, such as clear definitions, tests on reliability and validity, and clears ampling procedures. Interfacing methods is the key phrase. More quantitatively oriented methods, such as interviewing a random sample from a househ old survey, seem unsuitable for research on illicit drugs, except perhaps for the use of cannabis. A multifactorial problem, such as illicit drug use and related problems, should be approached in a multidisciplinary way; that is, the integration of different research methodologies. Comparability between individual research projects in different countries requires not only technical adjustments of the data, but also a “frame work for communication.” Data always need to be interpreted in terms of cultural context. A similar frame work should enhance studies with respect to comparison of drug policies and their consequences in different cities or countries.     

An Optimal Three Treatment Allocation for Binary Treatment Responses

ABSTRACT

An optimal target proportion is derived balancing between the needs of clinician and statistician considering a general criterion and binary treatment outcome. A response-adaptive procedure based on this optimal proportion is developed and the associated limiting results are derived. In addition, the proposed procedure is compared with the existing competitors.     

Examining Treatment Climate Across Prison-Based Substance Abuse Treatment Groups

Background: With notable exceptions, few studies have looked critically at the role and effects of factors other than individual or programmatic differences that contribute to the climate within substance abuse treatment programs. De Leon's work on the therapeutic community, however, indicates that factors beyond the individual and program can contribute to the overall functioning of similarly situated communities. Objectives: In this study, we introduce and examine the concept of the “treatment group,” the level of aggregation between the individual who participates in treatment and the organization that provides it. The treatment group refers to the social context and dynamics that operate among treatment participants, and we sought to study differences in treatment climate across 12 prison-based treatment groups within a single prison. Methods: Using data from 604 participants who were assigned at random to one of the 12 groups, we analyzed differences on seven treatment climate indicators from one month and six months into the program across the treatment groups. Results: No differences were found among the treatment groups at after one month; however, after 6 months, significant differences emerged across the groups on three treatment climate variables: program structure, counselor rapport, and counselor competence. Conclusions/Importance: This study is among the first of its kind to conceptualize and examine treatment climate across otherwise similar groups and find that differences emerge on several indicators of climate. As such, we argue that the treatment group may be important to consider in both the delivery and evaluation of substance abuse treatment.     

Drinking Goals and Their Association With Treatment Retention and Treatment Outcomes Among Clients in Outpatient Alcohol Treatment

Background: Few studies have compared characteristics of clients entering alcohol treatment who differ in their drinking goal preferences or have investigated the relevance of drinking goals as a predictor of treatment outcomes. Objectives: To investigate associations between baseline drinking goal preferences and client characteristics as well as treatment retention and outcomes among clients in outpatient alcohol treatment. Methods: Secondary data analyses on a longitudinal multicenter study investigating the effectiveness of outpatient alcohol treatment in Switzerland among 805 clients. Assessments were conducted at treatment admission, discharge, and at 6- and 12-month follow ups. At-risk drinking was assessed through the alcohol use disorders identification test. Treatment retention was defined as regular discharge with or without transition into another institution. Results: Clients aiming to abstain from drinking were more likely to be in retreatment, to be assigned to treatment by a health institution, to have no at-risk alcohol use, and to be already alcohol abstinent at the time of admission relative to clients who aimed to control their drinking. Clients without at-risk alcohol use at admission showed higher treatment retention when aiming for controlled drinking than for abstinence, while there was no difference in treatment retention among clients with at-risk use. Clients with at-risk use at admission were more likely to reach not-at-risk alcohol use status when aiming for alcohol abstinence than for controlled drinking. Conclusions: Drinking goals are associated with variables of alcohol use and treatment assignment. They have different effects on treatment retention and treatment outcomes according to alcohol use at the time of admission.