右旋佐匹克隆I期耐受性试验

目的评价健康受试者单次口服右旋佐匹克隆的安全性和耐受性。方法选择18~45岁的健康受试者26例,随机分为1.8,3.75,7.5,11.25和15.0mg共5个剂量组。观察指标有临床症状、生命体征、血尿常规、肝肾功能、电解质和心电图。结果在1.8~11.25mg,各项观察指标在服药前后没有明显变化,主要药物不良反应为口苦和头晕,高剂量(15mg)出现恶心呕吐、走路不稳等。结论剂量在1.8~11.25 mg,右旋佐匹克隆的安全性和耐受性较好。     

艾司佐匹克隆对健康受试者血压的影响

目的：分析单次口服艾司佐匹克隆对健康受试者血压的影响。方法：选择18～45岁之间的健康受试者26例，随机分为1．8，3．75，7．5，11．25和15．0mg共5个剂量组。对服药后1，4，8h的血压进行监测和24h，7d随访。结果：受试者的血压在服药后呈下降趋势，服药后各时间点的血压与服药前比较差异均有显著性统计学差异（P〈0．05）；最大下降幅度为25mmHg。血压降低较明显者主要集中在服药后1～4h。11例（42．3％）受试者出现收缩压或舒张压下降〉20％的情况，11．25～15mg剂量组发生率为58．3％（7／12），高于较低剂量组的发生率（28．6％，4／14）。在11．25～15mg剂量组，有3例血压降低〉20％的受试者出现了“头晕”的不良反应。结论：应关注艾司佐匹克隆对血压的潜在影响。     

中国健康成年志愿者单次口服盐酸埃他卡林片耐受性研究

目的：在中国健康成年志愿者体内评估单次口服盐酸埃他卡林片的安全性、耐受性。方法：采用区组随机化设计,选择18～50岁健康志愿者52名,随机分配至2．5、5、10、15、20、25mg剂量组,其中2．5、25mg组各有6名受试者,其余各组均有10名受试者,男女各半,每组中均有2人（男、女各1人）接受安慰剂。严密观察给药前后的临床症状、体征、实验室指标变化,并观察试验期间发生的不良事件。结果：入选受试者给药后症状、体征以及实验室检查指标均未见有异常的改变。试验中未见严重不良事件,未见可能与药物有关的临床不良反应。结论：52名中国健康受试者单次空腹口服盐酸埃他卡林片最大剂量达25mg,比较安全,耐受性较好。     

健康志愿者单次皮下注射重组人胰高血糖素类多肽-1(7-36)[rhGLP-1(7-36)]耐受性研究

目的：在中国健康成年志愿者中评价单次皮下注射重组人胰高血糖素类多肽-1（7-36）[rhGLP-1（7-36）]的安全性、耐受性。方法：根据GCP设计试验方案，并获得伦理委员会批准。受试者须自愿签署知情同意书。选择42名18～50岁健康成人，将受试者随机分至0．10～0．45mg7个剂量组，每组6名，男女各半，分别接受单次皮下注射rhGLP-1（7-36），进行临床和实验室检查，考察药物耐受性。结果：单次皮下注射rhGLP-1（7-36）耐受性试验中，各组受试者各项指标测定值均在正常范围内，条件均衡，具较好可比性。因剂量至0．30mg时，不良事件（恶心、呕吐）在该组发生率超过50％，故于该剂量组试验完成后终止了下一剂量组试验，仅有4个剂量组共24名健康受试者完成了本试验。24例受试者完成的4个剂量组耐受性试验中，给药后实验室检查未见有临床意义的改变。试验中出现10例（共15例次）可能与药物有关的不良反应，如头晕、恶心、呕吐等，但均可耐受，且为一过性反应，于给药后1h内自行消失。其中，不良反应主要发生在0.25、0．30mg组（共7例12例次），而低剂量组（0．10、0．20mg）仅有3例发生轻度不良反应。15例次不良反应中，头晕、恶心有10例次，呕吐有5例次；整个试验过程未见严重不良事件。结论：24名中国健康成年受试者分别单次皮下注射rhGLP-1（7-36），最大剂量至0．20mg，比较安全、耐受性较好，为最大耐受剂量。而单次给药剂量至0．25mg或0．30mg则不良反应发生率较高，最大耐受剂量为0．20mg。建议单次用药剂量不宜超过0．20mg。在Ⅱ期临床试验中需严密观察恶心、呕吐这些与药物可能有关的不良反应及其发生机制。     

注射用胡黄连总苷耐受性研究

目的:评价注射胡黄连总苷在中国健康受试者的安全性和耐受性.方法:采用随机、开放、剂量递增设计.采用单剂量、多剂量给药的方法,观察用药后生命体征、心电图和实验室安全性指标.结果:32饲受试者全部完成单剂量试验,18例受试者完成多剂量试验,均可进行安全性评价.研究中除多剂量120mg组出现1例程度轻微的转氨酶一过性升高,未报告其他与药物相关的不良事件.结论:注射用胡黄连总苷单剂量30～300 mg和多剂量120～240 mg剂量范围内,对中国健康受试者安全耐受.     

单次静注头孢曲松钠/舒巴坦钠(4:1)在健康人体的耐受性

目的观察中国健康志愿者对注射用头孢曲松钠／舒巴坦钠（4：1）（第3代头孢类抗生素）单次给药的耐受性。方法24名受试者随机分为3组（每组8人），按剂量递增顺序从1．25～3．75g依次静滴头孢曲松钠／舒巴坦钠（4：1），观察给药前后受试者临床症状和实验室检查指标。结果所有受试者对注射用头孢曲松钠／舒巴坦钠（4：1）的耐受性良好，受试者未出现异常临床症状和体征；给药前后化验室检查，未发现有临床意义的变化，心电图均正常。结论受试者静注头孢曲松钠／舒巴坦钠（4：1）1．25，2．50，3．75g耐受良好，可继续进行连续给药耐受性试验研究。     

单次静滴米卡芬净钠在健康成年志愿者的耐受性

目的 评价中国健康受试者单次静脉滴注3种不同剂量注射用米卡芬净钠(抗真菌药)的安全性和耐受性.方法 选择12名18～45岁健康受试者,男女各半,用自身三交叉试验设计,用分层随机法,依次接受静脉滴注3种不同剂量的米卡芬净钠,观察并记录受试者临床体征及各种生化指标结果,采用方差分析比较给药前后各项指标变化.结果 单次静脉滴注米卡芬净钠50,100,150mg前后,受试者的体征及实验室检查指标变化,未见具有临床意义的差异.结论 中国健康人群受试者恒速静滴3个剂量(50,100,150 mg·h-1)米卡芬净均具有较好的耐受性.     

健康志愿者单次口服甲磺酸多沙唑嗪片耐受性研究

目的：在健康志愿受试者中评价单次口服国产甲磺酸多沙唑嗪的安全性和耐受性。方法：选择20名20-40岁健康受试者,随机分配至A（1mg)、B（2mg)、C（4mg)、D（6mg)、E（8mg)剂量组,观察临床症状体征和实验室检查变化。结果：各组入选受试者耐受性较好,4mg以上受试者于服药后1-3h出现轻微鼻塞、头晕,6mg以上受试者出现了直立位低血压。结论：建议首次服用剂量为0.5-1mg,临睡前服用,Ⅱ期临床推荐剂量为每次2mg比较安全,可以耐受。     

国产多沙唑嗪片的安全性和降压作用

目的:观察国产多沙唑嗪片在中国健康受试者中的安全性和降压作用,为确定Ⅱ期临床试验的剂量提供依据。方法:采用开放、随机的试验设计,将入选16名健康受试者随机分为4组,每组4名,分别单次口服递增剂量1,2,4,6mg的国产多沙唑嗪片,观察给药后的生命体征、ECC和实验室指标的变化。结果:单次给予多沙唑嗪片1,2,4mg的12名健康受试者,其生命体征、精神状态和行为均无异常变化,虽4mg组有2例出现轻度的头晕、鼻塞等症状,但受试者均能耐受。3名服用6mg受试者,给药后0.5～3.0h出现较严重的头晕、鼻塞、嗜睡、恶心、呕吐、心悸等不良反应,且难以耐受,研究者确认与研究药物有相关性。单次口服不同剂量的多沙唑嗪片后受试者卧、立位SBP和DBP变化:1和2mg剂量组均<10％,幅度均<10mmHg,无体位性低血压发生;4mg剂量组为15％～30％,幅度均<25mmHg,与临床上观察到的体位性低血压发生时间基本一致;6mg剂量组为15％～32％,最大幅度为17mmHg。在1～6mg范围内所有受试者的实验室检查均无异常。结论:考虑到受试者的安全性和耐受程度,临床口服国产多沙唑嗪片的剂量以1～4mg为宜。     

异丁司特胶囊正常人体耐受性研究

目的：观察中国健康男、女性志愿者对异丁司特胶囊的耐受性，方法：32例青年男、女入选受试验者参加了单剂量耐受性试验；8名男受试者入选参加每次10mg,q12h，持续8d的连续药耐受性试验，分别比较单次给药和连续给药试验中给药前与给药后受试者的临床症状和实验室化验结果的变化。结果：在单次口服2．5，5，10，20和30mg异丁司胶囊时，服药后1，3，6，12，24，48h时受试者的体征和实验室检查结果与给药前比较沿有区别。连续药耐受性试验结果显示服药后第5d和第10d受试者的体征和实验室检查结果与给药前比较也没有区别。结论：受试者对异丁司特胶囊具有很好的耐受性，推荐临床一次10mg的应用剂量是可以接受的。     

健康志愿者口服阿德福韦酯片的安全性和耐受性

目的:评价健康志愿者口服阿德福韦酯片的安全性和耐受性。方法:10名21~23a的健康志愿者,男女各半,口服阿德福韦酯10mg,qd,连续用药7d。观察记录临床症状、生命体征、心电图、血常规、尿常规、凝血功能、血液生化等。结果:阿德福韦酯连续给药志愿者生命体征、心电图、尿常规、血常规及凝血功能未发现有临床意义的异常变化,但个别志愿者出现丙氨酸转氨酶、肌酸激酶、乳酸脱氢酶升高,4例女性志愿者出现乏力及轻度恶心、腹泻等胃肠道症状。结论:阿德福韦酯临床使用剂量10mg,qd,安全,但长期用药需注意肝、肾功能,肌酸激酶,血清淀粉酶及乳酸脱氢酶等的变化。     

健康志愿者单次口服壮骨胶囊的安全性及耐受性研究

目的评价健康志愿者口服壮骨胶囊的安全性和耐受性.方法 34名年龄19～26岁的健康志愿者,男女各半,筛选合格后根据性别和体重随机分为600、1 200、1 800、2 400及3 000 mg 5个剂量组(每组4～8人),由最小剂量组开始,逐组进行试验.观察指标有临床症状、生命体征、心电图、血常规、尿常规、血生化、凝血功能、性激素等.结果给药后各组志愿者的生命体征、心电图、血常规、尿常规、凝血功能未发现有临床意义的异常变化.结论单次口服壮骨胶囊的剂量在3 000 mg内安全,志愿者耐受性良好.     

连续口服D-聚甘酯片的Ⅰ期临床安全性、耐受性研究

目的:评价健康志愿者连续口服国家一类新药D-聚甘酯片的安全性和耐受性。方法:29名18～55岁健康受试者,男女不限。将受试者随机分配至100,200,400,500,600和700mg剂量组,连续口服不同剂量D-聚甘酯片。各组观察指标为临床症状、生命体征和血常规、血沉、尿常规、肝、肾功能、电解质等实验室检查,并监测心电图、脑电图。结果:服药后各组受试者体征和实验室检查结果与给药前比较没有区别。个别受试者出现轻微不适及一过性肌酸激酶、丙氨酸氨基转移酶和天冬氨酸氨基转移酶增高,提示D-聚甘酯片有可能导致肌肉受损。结论:健康受试者对D-聚甘酯片连续口服有很好耐受性。最大剂量至500mg仍比较安全。     

Caffeine Moderately Antagonizes the Effects of Triazolam and Zopiclone on the Psychomotor Performance of Healthy Subjectsf

Abstract: To determine whether caffeine antagonizes the decremental effects of triazolam and zopiclone on human performance, oral single doses of 0.250 mg triazolam, 7.5 mg zopiclone, or respective placebos, with and without 300 mg caffeine, were given to parallel groups of student volunteers in two double-blind studies. Objective tests and subjective visual analogue ratings were done at baseline and 30 min. and 90 min. after the intake. In Study I, triazolam produced drowsiness at 30 min. but did not differ from the placebo in other tests. Caffeine induced alerting effects in various tests and differed from triazolam in some (digit substitution, drowsiness, calmness, mental slowness) but not all variables measured. Caffeine and triazolam were interpreted as being antagonists. In Study II, zopiclone impaired digit substitution and flicker fusion, produced exophoria and lowered systolic blood pressure. Caffeine differed from zopiclone in several test functions, but it also differed from caffeine + zopiclone whereas zopiclone differed from caffeine + zopiclone only in two tests (Maddox wing, systolic blood pressure). Thus, zopiclone counteracted the effects of caffeine more easily than caffeine counteracted the decremental effects of zopiclone. We conclude that triazolam may not differ importantly from diazepam as regards their antagonism towards caffeine, whereas further research on the antagonism between zopiclone and caffeine needs to be done.     

Caffeine moderately antagonizes the effects of triazolam and zopiclone on the psychomotor performance of healthy subjects.

To determine whether caffeine antagonizes the decremental effects of triazolam and zopiclone on human performance, oral single doses of 0.250 mg triazolam, 7.5 mg zopiclone, or respective placebos, with and without 300 mg caffeine, were given to parallel groups of student volunteers in two double-blind studies. Objective tests and subjective visual analogue ratings were done at baseline and 30 min. and 90 min. after the intake. In Study I, triazolam produced drowsiness at 30 min. but did not differ from the placebo in other tests. Caffeine induced alerting effects in various tests and differed from triazolam in some (digit substitution, drowsiness, calmness, mental slowness) but not all variables measured. Caffeine and triazolam were interpreted as being antagonists. In Study II, zopiclone impaired digit substitution and flicker fusion, produced exophoria and lowered systolic blood pressure. Caffeine differed from zopiclone in several test functions, but it also differed from caffeine + zopiclone whereas zopiclone differed from caffeine + zopiclone only in two tests (Maddox wing, systolic blood pressure). Thus, zopiclone counteracted the effects of caffeine more easily than caffeine counteracted the decremental effects of zopiclone. We conclude that triazolam may not differ importantly from diazepam as regards their antagonism towards caffeine, whereas further research on the antagonism between zopiclone and caffeine needs to be done.     

Residual effects of zopiclone and benzodiazepine hypnotics on psychomotor performance related to car driving

A double-blind, randomized, cross-over study was carried out in 10 normal healthy volunteers to investigate the residual effects of 7.5 mg zopiclone, 1 mg lormetazepam, 0.25 mg triazolam, 1 mg flunitrazepam and placebo. Tests of psychomotor performance and analogues of car driving ability were administered the morning following night-time medication. Changes with respect to placebo in an information-processing task one hour after taking the medications confirmed the hypnotic efficacy of zopiclone, triazolam and flunitrazepam. Flunitrazepam also produced a significant depression of the Critical Flicker Fusion Threshold (CFF) and increased subjective ratings of sedation one hour after nocturnal dosing. Flunitrazepam impaired the reaction time on the information-processing test the morning following doses of 1 mg.     

西药疗效不佳的患者配合中药治疗心脾两虚型失眠临床观察

目的 观察心脾两虚型失眠服用佐匹克隆片疗效不佳的患者加服归脾汤加减的临床效果.方法 选取2012年1月至2014年12月来自本院门诊的心脾两虚型失眠患者,睡前患者口服西药佐匹克隆片3.75 mg,每晚1次;将服用3d后疗效不佳的80例患者随机分为对照组和治疗组.对照组睡前口服佐匹克隆片7.50 mg,每晚1次;治疗组睡前口服佐匹克隆片3.75 mg,每晚1次,同时加用归脾汤加减治疗.2周后观察中西医临床疗效以及不良反应发生率.结果 治疗组痊愈12例,显效17例,有效10例,总有效率为97.5％;对照组痊愈8例,显效12例,有效12例,总有效率为80.0％;两组比较差异有统计学意义(P＜0.05).两组睡眠质量比较,治疗前后组内比较及治疗后组间比较,差异有统计学意义(P＜0.05).对照组、治疗组不良反应发生率分别为22.5％、5.0％,差异具有统计学意义(P＜0.05).结论 心脾两虚型失眠患者口服佐匹克隆片疗效不佳时采用中西医结合治疗临床效果明显,能够有效改善患者睡眠质量,同时不良反应发生率低,值得临床推广应用.     

Effects on postural oscillation and memory functions of a single dose of zolpidem 5 mg,zopiclone 3.75 mg and lormetazepam 1 mg in elderly healthy subjects. A randomized,cross-over,double-blind study versus placebo

OBJECTIVE: In elderly patients, both falls and impaired memory are considerable medical problems. Hypnotics, which are frequently administered to this patient group for the treatment of insomnia, should ideally not impair equilibrium or memory functions. This double-blind, randomised, four-way, cross-over study investigated the effects of frequently prescribed hypnotics from different classes on postural oscillation and memory under real life conditions. Zolpidem 5 mg, zopiclone 3.75 mg, lormetazepam 1 mg (i.e. usual starting doses in elderly) or placebo were administered at night to 48 healthy elderly volunteers aged 65 years or more. The study included four treatment periods separated by wash-out periods of at least 1 week. METHODS: Psychomotor tests up to 9 h or 10 h after drug intake included, for attention and body sway, clinical stabilometric platform (CSP) tests, simple reaction time (SRT), and the critical tracking test (CTT); for memory, the learning memory tasks (LMT) and the Sternberg memory scanning test (mean reaction time [MRT] and percentage of correct answers) were used. For subjective sleep evaluation the Leeds sleep evaluation questionnaire (LSEQ) and for sedation a visual analogue scale (VAS) were used. For safety evaluations, adverse events (AEs) were recorded. RESULTS: The results demonstrate that compared with placebo, the active drugs increased body sway (area eyes open and closed in the CSP); however, this effect disappeared after 5 h with zolpidem, while it disappeared only after 8 h with lormetazepam and zopiclone. All three drugs did not affect attention assessed by the SRT and CTT. Concerning memory, Sternberg MRT at 9 h was not significantly different up to 5 digits for all groups in comparison with placebo, while for 6 digits it was significantly increased with lormetazepam and zopiclone. In the LMT, an impairment of performance was observed with lormetazepam relative to both zolpidem and placebo. CONCLUSION: The safest compared drug with regard to body sway was zolpidem, because of its short-lasting effect. In addition, zolpidem did not show any significant effect on memory functions, in the present dose comparison.