心理护理对酒依赖患者疗效的影响

目的探讨心理护理对酒依赖患者临床疗效的影响。方法对60例酒依赖的住院患者随机分成两组各30例,对照组进行常规戒酒治疗,观察组在此基础上进行有针对性的心理护理,对比两组在治疗前后SCL-90(症状自评量表),SADQ—C(酒精依赖严重程度问卷)评分差异,比较两组的整体临床疗效。结果观察组经治疗后各量表中相关因子项评分与对照组相比出现显著统计学差异(t=2.99,P0.01),整体临床疗效明显好于对照组。结论酒依赖患者常规戒酒治疗基础上配合针对性心理护理措施能明显改善患者对酒精的依赖程度。     

社会心理干预护理对酒依赖患者疗效的对照研究

目的 探讨社会心理干预护理对酒依赖者戒酒疗效的影响.方法 将64例酒依赖的住院患者随机分成社会心理干预护理组及对照组各32例,对照组进行常规戒酒治疗,社会心理干预护理组在对照组的基础上给予社会心理干预护理.在治疗前和治疗第2、4、6、8周末分别使用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评定两组疗效....     

西酞普兰治疗酒依赖伴抑郁临床疗效观察

目的观察西酞普兰治疗酒依赖伴抑郁患者临床疗效。方法将40例符合酒依赖伴发抑郁患者随机分为研究组和对照组,在临床常规戒酒治疗同时,研究组合用西酞普兰,疗程12周,并于入组、治疗第2、4、6、8、12周进行相关量表评定对比疗效。结果两组汉密尔顿抑郁量表(HAMD)比较自第2周出现统计学差异(P0.05),自第4周至疗程结束比较有极显著性差异(P0.001);两组强制性饮酒问卷(OCDS)及酒精依赖疾患识别测验(AUDIT)比较自第4周开始出现统计学差异(P0.05),自第8周至治疗结束比较有极显著差异(P0.001)。结论西酞普兰能有效治疗酒依赖伴发的抑郁症状,迅速改善情绪,降低饮酒欲望,强化酒依赖治疗效果。     

加巴喷丁治疗酒依赖的临床疗效

目的 观察加巴喷丁治疗酒精依赖的临床疗效。方法 选取2018年2月~2019年2月我院收治的酒依赖患者82例,采用随机数字表法分为加巴喷丁组和安慰剂组,每组41例。加巴喷丁组予加巴喷丁胶囊治疗,安慰剂组予无药物成分的模拟胶囊治疗,比较两组治疗前和治疗后2、4、8、12周强制性饮酒问卷（OCDS）、宾夕法尼亚酒精渴求量表（PACS）及副反应量表（TESS）评分。结果 治疗后2周,加巴喷丁组OCDS、PACS评分与安慰剂组比较,差异无统计学意义（P＞0.05）;治疗后4、8、12周,加巴喷丁组OCDS评分、PACS评分低于安慰剂组[（52.64±1.56）分vs（53.68±1.86）分、（18.62±5.22）分vs（24.34±5.65）分]、[（49.31±1.32）分vs（51.62±1.93）分、（15.14±4.15）分vs（23.92±4.86）分]、[（46.52±1.43）分vs（51.62±1.93）分、（14.71±5.67）分vs（23.92±4.86）分],差异有统计学意义（P＜0.05）;治疗后4、8、12周,两组TESS评分比较,差异无统计学意义（P＞0.05）。结论 加巴喷丁可有效减少饮酒行为,降低渴求度,且耐受性好,不良反应轻微。     

阿坎酸治疗酒依赖的12周多中心随机双盲对照研究

目的:评价阿坎酸治疗酒依赖的疗效和安全性。方法:本研究采用随机、双盲、安慰剂对照的多中心临床试验设计。研究对象是符合美国精神障碍诊断与统计手册第4版(DSM-IV)酒依赖诊断标准的门诊或者住院患者。共入组230例,一组(n=116)用阿坎酸(体质量60 kg,1332 mg/d;≥60kg,1998 mg/d)治疗,另一组(n=114)接受安慰剂治疗,连续治疗12周。以累计戒酒天数(CAD)与校正累积戒酒持续时间(CCAD)、每次访视的复饮率、首次复饮时间作为评价疗效的主要指标。以饮酒次数、饮酒量、可视渴求量表评分、血γ-谷氨酰转移酶水平为评价疗效的次要指标。根据生命体征、实验室及心电图检查、不良事件报告评价安全性。结果:阿坎酸组与安慰剂组在累计戒酒天数[(43.7±34.7)d vs.(38.9±35.8)d]、校正累积戒酒持续时间[(52.0±41.3)%vs.(46.3±42.6)%]、每次访视的复饮率以及首次复饮时间分布等主要疗效评价指标均无统计学差异(均P0.05)。但在治疗12周后,阿坎酸组患者饮酒量的等级为戒除和小于5标准杯/d的比例(88.1%vs.78.7%)高于安慰剂组,可视渴求量表分[(2.6±2.3)vs.(3.3±2.9)]低于安慰剂组(均P0.05)。阿坎酸组和安慰剂组的不良事件发生率差异无统计学意义(22.6%vs.19.3%,P0.05)。阿坎酸组最常见的不良反应是腹泻和皮疹,与安慰剂组相比腹泻发生率(4.9%vs.3.2%)和皮疹发生率(3.9%vs.2.1%)无统计学差异(均P0.05)。结论:阿坎酸对减少酒依赖患者饮酒量、降低渴求等方面的疗效优于安慰剂,并且安全性良好。     

托吡酯预防偏头痛——Meta分析

目的：系统评价托吡酯预防偏头痛的效果。方法：运用Cochrane系统评价方法,检索PubMed（1990～2009）和CNKI数据库（1990～2009）,筛选吡托吡酯预防偏头痛的随机对照试验（randomized controlled triale,RCT）,并用RevMan5.0软件进行统计分析。结果：共初检出75篇文献,经筛选最终纳入7篇RCT进行分析,共2083例患者。Meta分析结果显示,安慰剂组与托吡酯组之间偏头痛的发作频率减少值比较,差异有统计学意义（Z=7.46, P<0.01）。结论：本系统评价结果显示,托吡酯比安慰剂更能减少偏头痛的发作频率。但由于本系统评价纳入的随机对照试验数目不多,有必要开展更多设计严谨,大样本、多中心的随机对照试验来确证这种趋势。     

氯氮平合并托吡酯维持治疗精神分裂症的疗效及安全性

目的探讨氯氮平合并托吡酯维持治疗精神分裂症的疗效及安全性。方法共纳入72例稳定服用治疗剂量或维持剂量的氯氮平患者,随机分为两组,1组合并托吡酯治疗(研究组),另1组单用氯氮平治疗(对照组)。观察治疗6个月,对比两组间治疗前后PANSS量表总分、各分量表分的减分值以及UKU不良反应量表评分。结果研究组治疗6个月后阴性量表分、一般精神病量表分及PANSS量表总分减分均较对照组差异有统计学意义(t=2.382,2.321,3.077;P均<0.05)。两组间UKU不良反应量表评分无差异(t=1.463,P>0.05)。结论氯氮平合并托吡酯长期维持治疗能有效缓解精神分裂症患者的症状,不增加不良反应。     

氟哌啶醇合并托吡酯治疗难治性Tourette综合症

目的 探讨氟哌啶醇合并托吡酯治疗难治性Tourette综合征(TS)的临床疗效和安全性。方法 将65例难治性TS患儿按病例编号分为试验组(33例)和对照组(32例)。试验组给予氟哌啶醇合并托吡酯治疗,对照组采取常规治疗[单一或联合使用氟哌啶醇(6-14mg／d)、泰必利(300-600mg／d)、安定类药物],共治疗8周。采用YGTSS、国际TS临床信息调查表、儿童行为量表(CBCL)及副反应量表(TESS),于治疗后第1、4、8周末对两组进行评估。结果 治疗第8周末,试验组的有效率为96％,高于对照组68％(P<0.01);试验组YGTSS总分低于对照组(P<0.01),减分率高于对照组(P<0.01);试验组的CBCL评分低于对照组(P<0.01);从第4周末开始试验组TESS评分低于对照组(P<0.05),并持续至第8周末(P<0.01)。结论 氟哌啶醇合并托吡酯治疗难治性TS,疗效肯定,副反应相对较轻。     

坦度螺酮合并心理干预对酒依赖的疗效

目的 探究并分析坦度螺酮合并心理干预治疗酒依赖患者的临床疗效.方法 选取我院自2009年7月-2011年7月收治的酒依赖患者74例,将其作为临床研究对象.随机分为A、B两组,每组各37例,A组患者单纯采用坦度螺酮治疗,即为对照组;B组患者采用坦度螺酮治疗的同时合并心理干预.观察两组患者的治疗效果,随访患者3～6个月,观察并记录患者的戒酒效果.结果 B组患者的焦虑及抑郁值较A组小,复饮人数较A组少（t =6.1175,6.7212;x2=5.6381,P＜0.05）,均具有统计学意义.结论 对酒依赖患者采用坦度螺酮合并心理干预的治疗方案效果显著.     

托吡酯对氯氮平所致糖脂代谢紊乱干预的研究

目的 探讨托吡酯辅助治疗氯氮平所致糖脂代谢紊乱的疗效和安全性.方法 将72例稳定服用治疗剂量或维持剂量的氯氮平患者,随机分为两组,一组合并托吡酯治疗(研究组),另一组单用氯氮平治疗(对照组).观察治疗6个月,定期测体重、腰围、血糖、血脂、UKU不良反应量表.对研究组与对照组的临床资料进行比较.结果 6个月末两组的血糖水...     

院外纳曲酮治疗酒精依赖的疗效观察

目的 :评估纳曲酮院外治疗酒依赖的临床疗效。方法 :采用随机对照的方法 ,分别对纳曲酮组和安慰剂组各 2 3例和 2 2例 ,作总疗程 12周的临床观察。结果 :纳曲酮显著降低病人对酒精的渴求程度 ,其疗后 4、 8、 12周的保持率分别为 91 3 %、 77 9%、 73 3 % ,明显高于安慰剂。纳曲酮的副作用与安慰剂相当 ,其主要副作用为轻度的恶心、厌食、头晕。结论 :纳曲酮是一种安全有效的治疗酒依赖的药物     

Hydrochlorothiazide and potassium chloride in comparison with hydrochlorothiazide and amiloride in the treatment of mild hypertension

A randomized, double-blind, cross-over study comparing 50 mg hydrochlorothiazide plus 5 mg amiloride (HCTZ/A) with 50 mg hydrochlorothiazide plus 26 mmol potassium chloride (HCTZ/K) was conducted in 18 patients with mild essential hypertension (diastolic pressure 90-105 mmHg). The sequence of treatment was: placebo for 2 weeks, one active drug for 3 weeks, placebo for 2 weeks, the other active drug for 3 weeks. The two agents were significantly and equally efficacious in lowering the systolic and diastolic blood pressure. Baseline vs. treatment mean serum potassium levels were 3.82 vs. 3.78 mmol/l for HCTZ/A and 3.82 vs. 3.70 mmol/l for HCTZ/K. The decrease in serum potassium level from baseline was significant for both agents but not significantly different when the two treatment forms were compared. Both treatment forms elevated fasting serum cholesterol and glucose. Serum triglycerides and uric acid rose significantly with HCTZ/K. Amiloride may affect the tubular handling of uric acid causing increased uric acid excretion, thus counteracting thiazide-induced hyperuricemia. During 3 weeks' extension of the main study, 5 patients received HCTZ/A in double the original dose (100 mg/10 mg) and 6 patients received HCTZ/K in double the original dose (100 mg/52 mmol). No further blood pressure reduction was observed on treatment with these doses. The mean serum potassium levels did not decrease further on doubling the HCTZ/A dose, while a significant fall was observed for HCTZ/K (3.60 vs. 3.42 mmol/l) (p less than 0.05, single tailed t-test). Both drug combinations were well tolerated and side-effects were not significantly different from those during placebo administration. This study demonstrates that 50 mg hydrochlorothiazide plus 26 mmol potassium chloride are as effective as 50 mg hydrochlorothiazide plus 5 mg amiloride, both in reducing blood pressure and preventing hypokalaemia in the treatment of essential hypertension. A small extension study indicates that amiloride might be more effective than potassium chloride in preventing hypokalaemia when high doses (100 mg/day) of hydrochlorothiazide are administered.     

Clinical efficacy of sublingual and subcutaneous birch pollen allergen-specific immunotherapy: a randomized, placebo-controlled, double-blind, double-dummy study

BACKGROUND: Both sublingual allergen-specific immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) have a documented clinical efficacy, but only few comparative studies have been performed. OBJECTIVE: To investigate the clinical efficacy of SLIT vs SCIT and secondary to compare SLIT and SCIT with placebo and to evaluate the relative clinical efficacy in relation to systemic side-effects. METHODS: A 3-year randomized, placebo-controlled, double-blind, double-dummy study including 71 adult birch pollen hay fever patients treated for two consecutive years after a baseline year. Allocation to treatment groups was based on disease severity in the baseline season, gender and age. RESULTS: Clinical efficacy was estimated in 58 patients completing the first treatment year by subtracting baseline data and by calculating the ratio first treatment season vs baseline. SLIT diminished the median disease severity to one-half and SCIT to one-third of placebo treatment. No statistical significant difference between the two groups was observed. Both for symptoms and medication scores actively treated patients showed statistically significant and clinical relevant efficacy compared with placebo. SLIT treatment only resulted in local mild side-effects, while SCIT resulted in few serious systemic side-effects. CONCLUSION: Based on the limited number of patients the clinical efficacy of SLIT was not statistically different from SCIT, and both treatments are clinically effective compared with placebo in the treatment of birch pollen rhinoconjunctivitis. The lack of significant difference between the two treatments does not indicate equivalent efficacy, but to detect minor differences necessitates investigation of larger groups. Due to the advantageous safety profile SLIT may be favored.     

Naltrexone in the treatment of alcohol dependence.

BACKGROUND: Although naltrexone, an opiate-receptor antagonist, has been approved by the Food and Drug Administration for the treatment of alcohol dependence, its efficacy is uncertain. METHODS: We conducted a multicenter, double-blind, placebo-controlled evaluation of naltrexone as an adjunct to standardized psychosocial treatment. We randomly assigned 627 veterans (almost all men) with chronic, severe alcohol dependence to 12 months of naltrexone (50 mg once daily), 3 months of naltrexone followed by 9 months of placebo, or 12 months of placebo. All patients were offered individual counseling and programs to improve their compliance with study medication and were encouraged to attend Alcoholics Anonymous meetings. RESULTS: There were 209 patients in each group; all had been sober for at least five days before randomization. At 13 weeks, we found no significant difference in the number of days to relapse between patients in the two naltrexone groups (mean, 72.3 days) and the placebo group (mean, 62.4 days; 95 percent confidence interval for the difference between groups, -3.0 to 22.8). At 52 weeks, there were no significant differences among the three groups in the percentage of days on which drinking occurred and the number of drinks per drinking day. CONCLUSIONS: Our findings do not support the use of naltrexone for the treatment of men with chronic, severe alcohol dependence.     

Sublingual immunotherapy: a double‐blind, placebo‐controlled trial with Parietaria judaica extract standardized in mass units in patients with rhinoconjunctivitis, asthma, or both

BACKGROUND: New routes of administering immunotherapy in respiratory allergy are being studied as an alternative to conventional injective immunotherapy. We carried out a study to evaluate the clinical efficacy and effects of sublingual immunotherapy in patients with Parietaria judaica-induced respiratory allergy. METHODS: A double-blind, placebo-controlled design was followed. Thirty patients with P. judaica rhinoconjunctivitis, mild asthma, or both were randomly chosen for sublingual immunotherapy (14 patients) or placebo treatment (16 patients). The patients underwent preseasonal rush induction treatment followed by coseasonal maintenance treatment during the Parietaria pollen season. Symptom and drug scores, as well as specific IgE and specific IgG4, were recorded. RESULTS: Significantly lower symptom and drug scores were found (P=0.04), especially during the Parietaria pollination period, in the immunotherapy group. No significant difference in specific IgE and specific IgG4 was detected between the active and placebo groups; a statistically significant increase of specific IgE was detected in both groups (P=0.05). No patient undergoing active sublingual immunotherapy reported local or systemic side-effects. CONCLUSIONS: Our data suggest that sublingual immunotherapy is both clinically effective and safe in treating patients with Parietaria-induced rhinoconjunctivitis and mild asthma.     

A 1-year study of salmeterol powder on pulmonary function and hyperresponsiveness to methacholine

BACKGROUND: Long-acting beta(2)-sympathomimetic agonists such as salmeterol have been proved safe and effective for the treatment of asthma. However, controversy still exists as to the appropriateness of scheduled long-term therapy with these agents. OBJECTIVE: This study assessed the degree of bronchodilation provided by treatment with salmeterol for a period of 52 weeks and evaluated bronchial hyperresponsiveness to methacholine during and after the treatment period. METHODS: Three hundred fifty-two patients with mild to moderate asthma were assessed by 12-hour serial spirometry and serial methacholine challenge tests. RESULTS: The mean area under the FEV(1) curve above baseline over 12 hours after drug at day 1 was significantly greater with salmeterol powder compared with placebo (5.06 liter hours vs 0.77 L/h) and did not change significantly over 1 year. The mean increase in the log(2) of the provocative cumulative methacholine dose producing a 20% decrease in FEV(1) (PD(20)FEV(1)) during treatment was significantly higher in the salmeterol-treated patients than in the placebo group (1.02 doubling doses vs 0.43 doubling doses at week 4, 1.06 doubling doses vs 0.41 doubling doses at week 24). At week 52 the increase from baseline in log(2)PD(20)FEV(1) was not significantly different between salmeterol and placebo (1.08 vs 0.69 doubling doses). Seven days after treatment the log(2)PD(20)FEV(1) was -0.60 doubling doses lower than baseline for salmeterol compared with 0.10 doubling doses for placebo (P =.031). Long-term salmeterol use was not associated with a deleterious effect on asthma control during and after treatment. CONCLUSION: This study demonstrates that the bronchodilator properties of salmeterol are sustained over 52 weeks and that bronchial hyperresponsiveness to methacholine is decreased to a modest degree during treatment. Clinically significant increases in hyperresponsiveness did not develop after discontinuation of salmeterol treatment.     

盐酸氨基葡萄糖联合塞来昔布治疗膝骨性关节炎的随机对照

背景：盐酸氨基葡萄糖被认为具有治疗膝关节骨性关节炎的作用,但其是否对不同程度的骨性关节炎都有效,联合应用非类固醇类抗炎药与单用盐酸氨基葡萄糖是否存在疗效差别,尚需进一步临床研究。 目的：采用前瞻性研究的方法对比单用盐酸氨基葡萄糖以及联合应用塞来昔布治疗不同程度膝关节骨性关节炎的临床疗效。 方法：采用Lequesne评分将152例膝关节骨关节炎患者分为轻、中、重度,然后随机配比法均分为单用盐酸氨基葡萄糖组和盐酸氨基葡萄糖联合塞来昔布用药组,于用药后2,4,6周以及停药8,12周统计患者Lequesne评分,用药前后及组间进行对比并统计盐酸氨基葡萄糖的不良反应。 结果与结论：在轻度骨性关节炎治疗组中,盐酸氨基葡萄糖组治疗4周、停药12周后Lequesne评分与治疗前比较,差异有显著性意义;而联合用药组治疗2周后评分即有改善,两组比较,评分在治疗2,4周差异有显著性意义,说明联合用药组效果改善更显著;中度骨性关节炎患者在治疗2,4,6周和停药8周时,联合用药患者Lequesne评分均低于单纯使用盐酸氨基葡萄糖患者,差异均有显著性意义(P < 0.05),说明在中度骨性关节炎,盐酸氨基葡萄糖联合塞来昔布治疗效果好于单独用药;重度骨性关节炎中,两组治疗后Lequesne评分与治疗前比较,均无明显改善。结果说明对于轻度膝骨性关节炎,单用盐酸氨基葡萄糖口服即可明显改善患者临床症状,对于中度膝骨关节炎,建议联合非类固醇类抗炎药类用药,可以较好改善临床症状,而对于重度膝骨关节炎,两种方法均无效。