Alternative,complementary, integrative – conceptual problems in marketing healthcare ideologies and services

The terms ‘alternative medicine’, ‘complementary medicine’ and ‘integrative medicine’ are of recent origin. According to Medline and PubMed, ‘alternative medicine’ first appeared in medical journals in 1975, when Nursing Times commenced a series of articles on topics such as transcendental meditation, spiritual healing and homeopathy. According to the same databases, the first appearance of ‘complementary medicine’ occurred in 1985, when The Lancet published an article titled ‘Complementary medicine in the United Kingdom’. ‘Integrative medicine’ was introduced in an English language journal in 1995, although it had appeared in German in an article 2 years earlier and in French already in 1951. Since the terms have no historical bearing whatsoever, we claim that they are used, together with many other slogans that thrive in contemporary Western health care, for ideological or commercial reasons to promote ideologies or to facilitate the selling of products and services.     

Clinically based evidence of drug–herb interactions: a systematic review

Importance of the field: Healthcare practitioners are deeply concerned about drug–herb interactions and how concurrent administration may affect both the safety and effectiveness of prescribed drugs. Interactions between botanical medicines and synthetic drugs can be clinically relevant and it is important to understand what kinds of interactions are possible. Better knowledge in this area will help avoid negative interactions and may also help enable synergistic interactions.

Areas covered in this review: Includes articles related to the investigation of Western botanicals or whole herbal extracts in human subjects, investigating either the impact on Cytochrome P450 isoenzymes or an assessment of specific drug–herb interactions within a clinical trial. Searches were conducted in both Pubmed and EMBASE from inception to March 2009.

What the reader will gain: Knowledge regarding specific interactions to consider in clinical practice. The reader will also gain an appreciation of the complexities associated with the area of drug–herb interactions. Summary tables of relevant drug–herb interactions are presented both for the individual herbs included and at the level of the CYP450 enzymes.

Take home message: Knowledge of drug–herb interactions is limited and much more research needs to be done to further document clinically relevant interactions. Even though preclinical data are often poorly generalizable to the human situation, caution must be taken in the absence of clinical evidence especially where drugs with narrow therapeutic windows are concerned.     

浅谈临床用药的合理性评估

不合理用药现象屡禁不止,最主要的原因是我国目前尚无相应的法律法规对临床用药进行有效的制约。应用规章制度对医师的处方行为进行监管,缺乏强有力的技术支持和行政干预措施。开展合理用药评估是有效制约其处方权的办法之一,本文对评估标准、如何开展评估工作等作了研究。     

中药复方消除运动性疲劳的研究概况和展望

目的总结和概括1995～2007年中药复方抗运动性疲劳的研究概况和存在的问题,展望中药复方抗运动性疲劳的研究方向。方法:"运动性疲劳"、"复方"为关键词,检索中国期刊网1995～2007年的相关文献。结果共检索到63篇文献,其中22篇属于对中医药抗运动性疲劳的理论探讨和综述,剩余的41篇中剔除重复的研究,共有22篇文章是有关介绍中药复方消除运动性疲劳的研究。结论通过对22篇文章的综述,总结归纳了目前中药复方抗运动性疲劳的研究概况和存在的不足,并提出了对应的措施。     

The efficacy of ginseng. A systematic review of randomised clinical trials

Objective: Ginseng is one of the most popular herbal remedies, and a number of health claims are made for it. This systematic review provides an evaluation of the current evidence for or against the efficacy of ginseng root extract. Methods: Searches of the computerised literature databases Medline, Embase, Biosis, CISCOM and the Cochrane Library were performed to retrieve double-blind, randomised, placebo-controlled trials of ginseng root extract for any indication. Manufacturers and experts were contacted to provide additional information. There were no restrictions regarding the language of publication. The outcome and methodological quality of all trials were independently assessed by two reviewers. Results: Sixteen trials met the inclusion criteria and were reviewed. These trials related to physical performance, psychomotor performance and cognitive function, immunmodulation, diabetes mellitus and herpes simplex type-II infections. The evidence found for ginseng root extract is compelling for none of these indications. Conclusion: Based on these data, it is concluded that the efficacy of ginseng root extract is not established beyond reasonable doubt for any of these indications. The widespread use of ginseng as a herbal remedy warrants more rigorous investigations to assess its efficacy and safety. Received: 23 April 1999 / Accepted in revised form: 26 July 1999     

The treatment of eczema with Chinese herbs: a systematic review of randomized clinical trials

AIMS: Chinese herbal treatments are being promoted as a treatment for eczema. The aim of this study was to systematically review the evidence for or against this notion. METHODS: Extensive literature searches were carried out to identify all randomised clinical trials on the subject. Data were extracted from these in a predefined standardized fashion. RESULTS: Only two randomized clinical trials were located. Both imply that a complex mixture of Chinese herbs is more effective than placebo in treating eczema. Yet several caveats exist, most importantly the lack of independent replication. Adverse effects have also been reported. CONCLUSIONS: At present it is unclear whether Chinese herbal treatments of eczema do more good than harm.     

口腔溃疡用药概述

口腔溃疡是一种常见口腔粘膜疾病。本文从中西医的角度分析了口腔溃疡的发病原因和致病因素,并从西药、中药、中西药结合三方面概述了口腔溃疡的用药治疗方法：西药以抗菌、消炎为主;中药则以清热解毒,收敛生肌为主;中西药结合疗法更理性、更合理。     

国际抗糖尿病药物研发新进展

根据美国药物研究与生产商协会（PhRMA）发布的相关报告和新药数据库中的数据,对2013年至今进入Ⅲ期临床试验或递交新药申请（NDA）／生物制剂许可申请（BLA）的用于治疗糖尿病及其相关疾病的65种候选新药的临床研发情况进行综述。将这些候选新药分为非胰岛素类、胰岛素类和复方制剂类抗糖尿病药,并重点对递交NDA／BLA或已获得批准的抗糖尿病新药开发进行了分析和讨论。     

临床医学专业预防医学课程特色教学案例编制

教学案例作为教学知识点的重要载体,是案例教学的核心.临床医学专业的预防医学教学案例编制,既要服务于专业的课程教学目标,满足科学性与知识性的要求,又要有利于激发学生的兴趣与主动性.该课程组以社会热点、重大事件及经典案例为案例素材来源,精心编制了一套共11个特色预防医学教学案例,并给出了2个示例.该套教学案例的应用,有助于激发学生的学习兴趣,有助于学生提高动手解决预防医学相关问题的能力,体现学生在教学中的主体地位.     

加快现代中药研发提高中医药国际影响力

中药以及中医药现代化的概念应随现代科技水平的发展而不断延伸。文中阐述了中药现代化的重要性,借鉴有关文献,对中药物质基础、组方原则、药性理论等中医药基础理论进行分析,探讨现代中药提取、分离技术的特点和应用。提出实现中药国际化,不仅要实现中药标准国际化,确保中药安全性和疗效,而且要开发一批按组分(成分)配伍组方的"现代中药",以适应中药国际化和医学发展趋势的需要。     

过度训练致横纹肌溶解症并发急性肾衰竭的相关因素分析

目的探讨过度训练导致体力耗竭性横纹肌溶解症发生急性肾衰竭(ARF)的相关因素。方法回顾性地研究1993～2003年37例训练致耗竭性横纹肌溶解症患者的临床救治过程,分析其病情变化规律和误诊的原因,探讨治疗时机及不同的血液净化方法对预后的影响。结果①患者均在夏、秋季发病,主要表现为呕吐、发热、头昏、肌肉酸痛等非特异性症状熏有28例(75.67%)患者入院前被误诊为急性胃肠炎或肠型感冒,21例(56.75%)被采用了庆大霉素等氨基甙类肾毒性药物治疗,使急性肾衰竭(ARF)的诊断和治疗变的愈加复杂;②血清肌酸磷酸激酶(CK)在肌肉出现明显酸痛之前熏或在尿中肌红蛋白检出之前熏已有明显升高,并与血清钾、尿素氮、血肌酐的变化呈现显著正相关(P<0.05);③经过连续性肾脏替代治疗(CRRT)、血液透析(HD)及综合治疗,31例渡过少尿期,肾功能得以恢复。死亡6例,死亡原因为多脏器功能不全。结论①高温高湿环境因素可加重过度训练后肌肉组织损伤和全身反应,而血浆CK水平显著增高熏是横纹肌广泛变性和溶解的重要标志之一;②入院时患者器官功能障碍的数目越多,病死率越高,故早期诊断、及时去除病因及合理应用血液净化技术是降低病死率的关键。     

药物粒径缩小的意义与方法

目的简介药物粒径缩小的意义及方法方法检索相关文献,综述分析缩小药物粒径的方法或途径与意义结果与结论药物微粉化是直接实现药物粒径缩小的方法,药物可通过流能磨、胶体磨及超微粉碎机制得微粉另外．还有一些制剂新技术也可实现药物粒径缩小,如固体分散法、乳化法、脂质体法、微靛法、微球法、重结晶法等药物粒径缩小与药物给药途径、生物利用度、体内分布等的密切相关,对缩小药物粒径的方法与途径进行研究具有重要意义     

中药应用的风险管理及安全应用

从中药材、中成药以及中药注射剂三方面分析中药风险管理的必要性和可行性，探讨中药风险管理的措施，以期促进临床用药安全。     

红珊瑚的资源、化学成分及药理活性研究进展

本文对红珊瑚的资源分布、形态特征、化学成分、药理作用以及药用情况进行综述。已知珊瑚虫纲有6100多种生物,其中红珊瑚科29种。目前,红珊瑚资源匮乏,未移植成功。真伪主要以红珊瑚的放射状同心圆结构,纵向纹理,麻点状凹坑等性状进行鉴别。红珊瑚的化学成分有多种正构烷烃类、脂肪醇、偶碳醇、甾醇、角鲨烯和酸类物质,已分离得到反角黄素(4,4’-diketo-β-carotene)和顺式角黄素。红珊瑚有开窍通络,改善神经营养,修复神经病变,接骨续筋等药理作用。藏医、蒙医方剂全书中有26个方剂有红珊瑚。是科尔沁包氏祖传秘方“蒙古接骨丹”的君药。     

32例引起严重皮炎反应的药物剖析

OBJECTIVE To help the doctors recognise and treat the medicine caused disease by the retrospective analysis of the severe medicine caused dermatitis.METHODS From Janurary 2005 to December 2006,the data about the patients condition,suspected medicine,and t     

32例引起严重皮炎反应的药物剖析

目的通过对严重药物性皮炎患者的回顾性分析,帮助医务人员正确识别,治疗此类药源性疾病。方法根据2005年1月~2006年12月诊断为药物性皮炎住院患者的病史资料,对患者情况、致皮炎药物及治疗情况做统计学分析。结果致药物性皮炎的药物种类较多,情况较为复杂,因人而异,特别是有药物过敏史的患者,用药期间要严密观察。结论药物引起的严重过敏性皮炎常常有迟发性,潜伏期长的特点,对过敏的患者有时未能及时诊断,及时停药,抗过敏药物用量不足,疗程过短,由过敏药物造成的脏器功能损害不易被发现。     

Botanical medicine and cancer: a review of the safety and efficacy

It is currently estimated that > 50% of all patients diagnosed with cancer explore complementary and alternative medicine – especially herbal medicine. We conducted a comprehensive review to assess the safety and efficacy of herbal medicines commonly used by patients in an attempt to: prevent cancer; treat cancer; and treat adverse effects associated with conventional cancer treatments. Current evidence suggests that Asian ginseng, garlic, green tea, tomatoes and soy intake as part of the diet may be useful in preventing various cancers; additional research is needed in order to determine the efficacy of essiac, evening primrose oil, mistletoe, reishi, shiitake and turmeric as cancer treatments; and ginger may be effective in treating chemotherapy-induced nausea and vomiting.     

自动包药机的使用与管理

本文通过介绍自动包药机的使用与管理,分析了包药机包药的优缺点,提出相应的工作要点,以扬长避短,使自动包药机真正成为提升药学服务的有效工具。