夏桂成中医治疗不孕症经前期方药的特点解析

目的：解析夏桂成教授治疗不孕症所开具经前期中药处方特点,探讨和研究其方药特点和用药规律。方法：随机抽取本院2016年9月至2017年9月不孕症经前期中药饮片处方1543张,进行数据整理、分析,研究治疗不孕症经前期的方药特点。结果：使用频率大于10%的单味中药有茯苓、炒白芍、续断、酒萸肉、赤芍、盐杜仲、莲子心等27味中药。高频药对有茯苓、炒白芍;茯苓、续断;酒萸肉、炒白芍等。基础方剂中有炒白芍、赤芍、续断、丹参、盐杜仲、茯苓、茯神、钩藤、合欢皮、莲子心、酒萸肉、醋五灵脂。结论：夏桂成教授中医治疗不孕症经前期经常使用补益药、安神药、利水渗湿药、活血化淤药、收涩药、清热药等。从分析归纳得出的基础方药看出其治法注重补肾与宁心结合,兼顾调理肝脾。     

361例新型冠状病毒肺炎患者中药治疗用药规律分析

目的 分析确诊为新型冠状病毒肺炎（COVID-19）患者的中药饮片治疗处方,统计分析用药规律。方法 收集湖北省中西医结合医院2020年2月1日—2月29日6个呼吸内科病区治疗COVID-19的中药处方,利用Excel、SPSS 25软件进行频数频率分析、关联分析、聚类分析等。结果 共纳入361例COVID-19患者治疗用中药处方共计529张,中药处方使用了292味中药,使用频数前5位的中药为茯苓、甘草、法半夏、陈皮、黄芩;中药类别频数前5位的为补虚药、化痰止咳平喘药、清热药、解表药、化湿药;关联规则显示,支持度最高的药对为茯苓和法半夏,置信度最高的药对为麸炒白术和茯苓;聚类分析共得11个聚类方。结论 通过对所收集COVID-19用药数据进行分析,发现了中药以补虚为主,辨证加入化痰、止咳、平喘、清热、健脾化湿的用药及组方特点,与国家发布的COVID-19诊疗中医药治疗用药基本一致,为COVID-19的中医药治疗提供了参考。     

中药配方颗粒治疗女大学生月经病的用药规律分析

摘 要 目的：对湖北中医药大学附属医院女大学生治疗月经病的中药配方颗粒处方进行用药规律分析,为临床合理用药提供参考。方法：收集2016年1月~2017年6月湖北中医药大学附属医院门诊治疗月经病的女大学生的中药配方颗粒处方,统计各药物使用频次、处方金额等,对频次≥100的药物进行聚类分析。结果：共收集该院中药配方颗粒处方1 103张,诊断为月经不调的患者有856例(77.61%)。根据《中华人民共和国药典》、《医院处方点评管理规范（试行）》和《中药处方书写格式及书写规范》,处方在治疗用药、用药味数、剂数和金额方面基本合理。用药频次较高的中药品种依次为当归、川芎、白芍、甘草、白术。处方统计和聚类分析结果均显示使用频次高的药物种类为补虚药和活血祛瘀药。结论：中药配方颗粒处方治疗月经病是根据个人体质使用经典方剂酌情加减药物治疗,配伍使用合理。并建议女大学生学习生活饮食规律,适当运动,保持心情舒畅,从而减少月经病的发病率。     

某医院中药饮片处方剂量调查

目的 通过对上海市嘉定区中医医院中药饮片使用剂量进行调查统计,了解该院中药饮片处方剂量现状。 方法 抽取该院2013年度1 000张中药饮片处方,对中药饮片使用频率、超剂量药味数、有毒中药饮片超剂量使用等进行统计分析。 结果 单张处方总剂量大于300 g的处方占总处方数的59.6%。使用频率前10位的中药为甘草、黄芪、炒白术、茯苓、当归、丹参、炒白芍、薏苡仁、炒杜仲、陈皮,其中大部分中药饮片有不同程度的超剂量使用。有毒中药饮片也有超剂量使用现象。 结论 中药饮片处方超剂量使用问题突出,需改进中药饮片用药现状,确保处方合理,用药安全。     

我院2013～2015年门诊中药饮片与中药免煎颗粒使用分析

摘 要 目的：了解某中医院2013～2015年门诊中药饮片及免煎颗粒的使用情况,为该类药物科学采购及临床合理使用提供参考。方法：调取该院门诊中药房2013～2015年使用的中药品种、数量、金额等数据,对用药频度（DDDs）、限定日费用(DDC)等进行统计分析。结果：中药饮片使用量及金额呈下降趋势,年销售品种金额排序连续3年均列前5位的是黄芪、茯苓、丹参、当归、白芍,DDDs排序列前5位为茯苓、当归、黄芩、丹参、黄芪。中药免煎颗粒使用量及金额均呈上升趋势。年销售金额排序连续3年均列前5位的是黄芪、茯苓、白芍、当归、丹参,DDDs排序前5位为当归、茯苓、黄芩、白芍、白术。结论：该院门诊中药饮片和中药免煎颗粒使用前10名的品种相对稳定,免煎颗粒使用量及DDDs远超过中药饮片。用药品种均为常见品,无明显使用异常,但医师用药存在趋向性。     

中西医结合医院门诊中药饮片处方点评及分析

摘 要 目的： 通过对中西医结合医院门诊中药饮片处方进行点评与分析,了解医院中药处方和中药临床使用存在的问题,为指导中药房调剂工作和临床合理用药提供参考。方法: 随机抽查我院2014年1～12月1 200张门诊中药饮片处方,对处方中不合理情况进行分析,提出合理应用中药的措施。结果: 中药饮片处方中存在临床诊断填写不全、临床诊断与用药不符、中药名称不规范、处方脚注不明确、用法用量不适宜、配伍禁忌等问题;单张处方药味数大于15个以上的处方占比为65.70%,处方平均剂量大于250g的处方占比为40.25%。结论:加强中药饮片处方的定期点评检查和质量监督,有利于提高处方质量,确保患者用药的安全和经济。     

中国药典2015年版及《临床用药须知》收载治疗溃疡性结肠炎成方制剂的用药特点分析

目的 分析中国药典2015年版及《临床用药须知》收载的治疗溃疡性结肠炎成方制剂的用药特点,为临床治疗溃疡性结肠炎提供科学合理的用药参考。方法 收集中国药典2015年版及《临床用药须知》中治疗溃疡性结肠炎的成方制剂,并进行分类、频数统计。结果 中国药典及《临床用药须知》共收录治疗溃疡性结肠炎的成方制剂9种,其处方组成药物中含中药38味,主要为补益剂、祛湿剂和表里双解剂。结论 中国药典2015年版及《临床用药须知》收载治疗溃疡性结肠炎的成方制剂以补益气血、祛湿止泻、解表清里为主要治则,药物以补虚药、清热药、理气药、止血药、收涩药、解表药、活血化瘀药使用较多。     

天津地区境外输入新型冠状病毒肺炎（COVID-19）病例中药汤剂用药规律分析

目的 总结天津地区境外输入新型冠状病毒肺炎（COVID-19）病例中医汤剂用药规律。方法 回顾性选择2019年12月—2021年5月天津市海河医院收治的境外输入轻型/普通型COVID-19病例,纳入中医治疗有效的病例为研究对象,建立数据库,录入患者一般资料、临床症状、中药处方等数据,采用数据挖掘方法,归纳中药使用频次、高频中药药对和药簇、中医聚类处方。结果 纳入患者224例,中药汤剂处方224首,涉及中药148味,高频中药35味,药性温（1 730次,41.79%）、药味苦（2 433次,39.23%）、入肺经（3 094次,30.19%）、清热药（990次,23.93%）和化痰止咳平喘药（807次,19.51%）使用频次最多;茯苓＋陈皮、半夏＋陈皮和虎杖＋陈皮是常见的药对;茯苓＋陈皮+虎杖和半夏＋陈皮+虎杖是常见的角药;得出6组中药药簇和6类中医聚类处方。结论 初步归纳出6类药簇和6个聚类处方,用于COVID-19各型各证的选方和加减,为中医治疗COVID-19提供临床选方用药参考。     

中国药典2015年版收载治疗高血压的中成药用药特点研究

目的 分析中国药典2015年版收载治疗高血压的中成药用药特点,为临床使用中成药治疗高血压提供合理用药参考。方法 收集中国药典2015年版中治疗高血压或有降压作用的中成药,并进行分类、频数统计。结果 统计出中成药共55种,中成药组方药味中使用中药品种共166种,中成药中最多的是祛风剂、理血剂和补益剂。结论 药典收载治疗高血压的中成药以平肝息风、活血化瘀、益气滋阴为主要治则,常用清热药、平肝息风药、补虚药,以清肝火,补肝、脾、肾为主。     

3401张治疗湿疹的中药饮片处方用药分析

目的：了解该院治疗湿疹的中药饮片处方的用药情况,探讨中医药治疗湿疹的用药规律。方法：抽取2018—2021年该院中医科门诊诊断为湿疹的中药饮片处方3 401张,对患者年龄、性别和处方单味中药使用频率进行调查分析。结果：3 401张治疗湿疹的中药饮片处方中,男性患者处方1 213张(占35.67%),女性患者处方2 188张(占64.33%),女性多于男性;患者年龄4～96岁,平均50岁,30～<70岁患者居多;涉及中药432味,使用频率排序居前50味的中药饮片的药物类别依次为清热药、补益药、利水渗湿药、理气药、化湿药、止咳平喘药、活血化瘀药、解表药、平肝抑阳药、泻下药、祛风湿药。结论：中医药治疗湿疹年轻患者主要以清湿热、毒邪,健脾与利湿同用;对于老年患者,根据老年人身体特性,药多在养血、润肤除燥、祛风止痒,另外配伍活血、祛湿、健脾的药物,可防止老年患者不耐受清利湿热药的苦寒、滑利、渗泄。通过采用中医个体化治疗方案辨证论治,根据湿疹的不同情况来用药,其疗效确切,具有独到的优势,值得临床应用与推广。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.