中医心理疗法干预慢性阻塞性肺疾病患者社会心理问题探析

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)所产生的社会心理问题严重影响患者的临床症状、预后及生活质量,运用中医心理疗法进行干预,可在整体治疗的基础上突出个体差异,将“治身”与“治心”有机结合起来,通过多种途径调节人体中枢神经系统的兴奋和抑制,改善大脑皮质功能...     

妇产科专科特色处方前置审核系统的建设与应用

目的 建立适应妇产科专科特色的处方前置审核系统。方法 引进处方前置审核软件,经后台运行收集基于商业知识库规则的审方数据,建立妇产科用药规则维护分级依据,进行规则优化并形成妇产科合理用药知识库,疏通处方前置审核流程并加以实施。结果 通过抽样数据对比发现,药师审方上线后,系统预审问题数及比例、医师提交问题数及比例明显下降、医师主动返回修改问题数及比例相应上升,人员疏忽所致的严重用药错误可被拦截,药师干预处方/医嘱成功率达93.81%。结论 建立妇产科专科特色处方前置审核系统,能有效保证审方准确性,能减少临床医师和审方药师不必要的工作量,有利于处方前置审核工作的推进,进一步保障患者用药的安全性和合理性。     

中医临床处方合理性分析

目的：为规范中医临床处方行为找到思路。方法：按处方管理办法,对5000份中医处方进行了认真调查研究。对处方书写、实付药物、用药合理性、剂型选择、药物的特殊用法、用药禁忌等几方面对中医处方进行了分析。结果：2811份处方不合规范,占调查总数的56.22%,90%以上的中医处方没有注明煎煮方法。结论：中医处方规范率之低很有普遍性,提高中医业务技术水平是振兴中医药的重中之重。     

2010年门诊中药饮片处方不合理用药状况分析

目的：调查医院门诊中药饮片处方用药状况,找出处方用药的规律及存在的问题并对其进行分析,针对存在的问题采取相应的干预措施,促进中医11名床合理用药。方法：从2010年门诊中药饮片处方中随机抽取1032张,依据2010版《中国药典》、国家中医药管理局《中药处方格式及书写规范》、《四川省中药饮片处方开具规定》,采用列表分析的方法,找出处方用药的规律及存在的问题并对其进行分析。结果：该院中药饮片处方用药基本合理,但存在中药饮片处方临床诊断不规范、有毒中药饮片使用掌握不严、用药味数偏多、剂量偏大、煎服方法错误等状况。结论：该院门诊中药饮片处方存在一定的不合理用药现象,药师应真正肩负起认真审查核对处方的职责,为促进合理用药发挥应有的作用。     

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??OBJECTIVE To analyze the adjustment of therapeutic regimen and pharmaceutical care for a patient with AIDS accompanied by a variety of opportunistic infection, and to explore the work pattern of pharmacists in the clinical practice. METHODS According to the patient??s condition and clinical guidelines to disease, reasonable suggestions for rational drug use were put forward, and adverse drug reactions were also monitored by the pharmacists during the treatment. RESULTS With adjustment of therapeutic regimen and pharmaceutical care, clinical pharmacists optimized the treatment program and solved clinical programs. CONCLUSION Through participating clinical practice, pharmacists improve the safety and effectives.     

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??OBJECTIVE The analyze the results of tacrolimus blood concentrations in patients with myasthenia gravis and the influencing factors, provide references for rational clinical application. METHODS The data of tacrolimus blood concentrations and medical records in patients with myasthenia gravis in hospital were collected and analyzed from January 2013 to December 2015.Tacrolimus whole-blood concentrations were measured by chemiluminescent microparticle immunoassay and CYP3A5^*3 gene polymorphism were detected by digital fluorescence molecule hybridization fluorescence. RESULTS The range of tacrolimus trough concentrations were from 0 to 64.71 ng??mL^-1 and the average of concentration was(5.22??5.80) ng??mL^-1 in 254 cases with 171 myasthenia gravis patients. The results showed that there was a certain correlation between concentration and dosage, and concentration was also related other factors such as the combination of drugs and CYP3A5^*3 gene polymorphism. CONCLUSION The concentration of tacrolimus are affected by many factors, so when tacrolimus is used, multiple factors should be considered comprehensively to achieve individualized treatment.     

中医传承辅助系统软件开发与应用

目的:在全面客观地对中医药传承模式及方法特点进行分析的基础上,开发中医传承辅助系统.方法:该系统基于个性化需求的自助式服务平台的构建思路进行架构,以人工智能、数据挖掘、网络科学等学科的方法和技术为支撑,围绕临床诊疗和中医传承工作中的继承、发展、传播和创新4个方面的核心需求,分别构建面向临床数据的中医诊疗信息采集模块、面向中医药本体的知识管理和服务模块、面向传承创新的隐性知识挖掘模块等几大功能模块,有效地解决了中医传承过程中的非标准化、个性化等问题.结果:通过该系统的使用,能够辅助名老中医经验传承,医师个体经验总结、青年医师学习以及新药处方发现等应用.结论:该系统丰富了传承模式,有效满足了中医传承和发展的需求.     

以临床实践数据为导向构建中西医结合临床指南的设想

临床指南对于规范临床实践具有重要作用。循证临床指南强调证据的分级与评价,尤其重视随机对照试验(RCT),根据证据的级别和强度提出推荐意见。中医药诊治疾病有其自身的理论体系,中西医结合更是以复杂干预为特点,按照现代医学研究证据制定临床指南的方法,对中医药及中西医结合指南的制定存在不完全适用的具体情况。本文即提出以临床实践数据为导向构建中西医结合临床指南,与循证临床指南互为补充,并结合初步的研究加以探讨,以期为中医药、中西医结合及现代医学临床指南的构建提供新的思路。     

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??OBJECTIVE To evaluate the efficacy of medication reconciliation (MR) service provided by clinical pharmacist for chronic kidney disease(CKD).METHODS Patients with CKD administered in department of nephrology between Dec, 2017 and Mar. Total of 2018 who met the inclusion criteria were given MR service, and the newest Pharmaceutical Care Network Europe (PCNE) V8.02 classification scheme was constructed for drug related problems (DRP) to analysis and summary.RESULTS MR was conducted 48 times (accounted for 80%) on 60 patients during the study period. Total of 59 medication DRP were identified. The most common DRP was treatment effectiveness (accounted for 84.75%), there were 54 causes (accounted for 76.06%) were prescribing in 71 causes, all the causes were classified as likely to cause level 1 harm (accounted for 84.75%), clinical pharmacists made 145 interventions, 102 (70.34%) of these were completely accepted and implement.CONCLUSION DRPs are common in CKD patients, clinical pharmacists should provide MR for CKD patients, and conducted as routine work.