中医药在新型冠状病毒肺炎治疗中的研究进展

中医药,是包括汉族和少数民族医药在内的中国各民族医药的统称。2019年底爆发的新型冠状病毒肺炎是近代最为严重的传染性疾病之一。疫情发生之后,中医药在治疗新型冠状病毒肺炎等方面发挥了积极作用。本文分析了中医理论对新型冠状病毒肺炎的认识,总结了新型冠状病毒肺炎患者常见的临床症状,并介绍了几种中医药治疗新型冠状病毒肺炎的疗效和可能机制,以及目前在临床的使用情况,为中药治愈新型冠状病毒肺炎提供临床用药指导。     

《新型冠状病毒肺炎诊疗方案(试行第七版)》中的中药注射剂合理使用及用药监护要点

摘要：中药注射剂在新型冠状病毒肺炎重型和危重型患者的治疗中发挥了重要作用,《新型冠状病毒肺炎诊疗方案(试行第七版)》中已收载8种中药注射剂。本文查阅相关参考文献,结合临床用药经验,对所收载的8种中药注射剂的临床合理用药及用药监护要点进行整理归纳,供临床医务人员参考,以便促进中药注射剂在防治新型冠状病毒肺炎中的合理使用,发挥其特有疗效。     

哺乳期女性服用洛匹那韦/利托那韦对乳儿影响的研究进展

洛匹那韦/利托那韦是国内批准用于治疗人类免疫缺陷病毒(HIV)感染的药物,在目前国内新型冠状病毒肺炎治疗中,也被多版指南列为有效的抗病毒药物.对于已经确诊的新型冠状病毒肺炎的产妇,在哺乳期将面临抗病毒药物选择的问题.通过检索国内外数据库文献,从洛匹那韦/利托那韦的药代动力学、真实世界中洛匹那韦/利托那韦在乳汁和乳儿体内...     

新型冠状病毒肺炎治疗中的药物不良反应与防治

围绕《新型冠状病毒感染的肺炎诊疗方案(试行第六版)》中的治疗试用药物,包括抗病毒药物、糖皮质激素和中药,从各药的作用机制、药物相互作用、药物不良反应等方面,综述新型冠状病毒肺炎(COVID-19)治疗中可能出现的不良反应及防治策略,为临床治疗方案的合理选择提供参考。     

氯喹治疗冠状病毒感染的研究现状与药学监护

国家卫生健康委员会和国家中医药管理局发布的《新型冠状病毒肺炎诊疗方案(试行第六版)》首次提出可试用磷酸氯喹治疗新型冠状病毒肺炎(COVID-19)。氯喹治疗病毒感染的作用机制包括通过pH依赖性抑制病毒穿入、脱壳等复制过程而发挥抑制病毒作用;通过干扰病毒黏蛋白与血管紧张素转化酶2的结合而发挥抑制病毒作用以及通过抑制肿瘤坏死因子α等炎性细胞因子表达和细胞自噬作用抑制炎性反应。氯喹治疗冠状病毒感染的研究多为体外试验,目前尚无该药用于COVID-19有效性和安全性评价的临床研究结果。氯喹可导致多个系统或器官的不良反应,包括心血管系统、眼、皮肤、消化系统、神经精神系统、内分泌系统、血液系统和耳等,而且与多种药物存在相互作用。本文对临床用药过程中的药学监护提出了具体建议。     

新型冠状病毒肺炎潜在治疗药物——洛匹那韦/利托那韦

新型冠状病毒即严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus2,SARS-CoV-2)是2019年12月在中国首次发现的一种新型病毒,其在全国范围内快速传播,造成了严重的新型冠状病毒肺炎(corona virus disease 2019,COVID-19)疫情。目前尚没有针对性的药物或疫苗可用于临床防治。洛匹那韦/利托那韦复方制剂(lopinavir and ritonavir compound,LPV/r;商品名:克力芝)是由艾伯维公司研发的一种临床已用于治疗人类免疫缺陷病毒1型感染的蛋白酶抑制剂,有临床研究证明其可显著降低SARS冠状病毒感染患者的死亡率。研究表明LPV/r可通过结合冠状病毒的3C样蛋白酶发挥抗冠状病毒作用。《新型冠状病毒肺炎诊疗方案》(试行第六版)已推荐将其作为COVID-19治疗的试用药物,目前有13项基于LPV/r的干预治疗临床试验正在开展。本文就LPV/r的基本信息、作用机制和临床试验等情况作一概述。     

14省市新型冠状病毒肺炎中医药预防方案比较研究

通过检索国家和地方政府、卫生健康委员会、疾病预防控制中心和药品监督管理局网站,获取不同省份新型冠状病肺炎中医药预防方案,对不同省份中医药预防新型冠状病毒肺炎进行对比分析,同时采用可视化软件对方剂中的中药进行网络分析,期望为预防新型冠状病毒肺炎的药物选择提供帮助.     

利巴韦林在新型冠状病毒肺炎治疗中的应用及注意事项

目前针对新型冠状病毒肺炎尚无特效药物,一些药物可能在体外研究中有效,但仍处于临床试验阶段,临床应用需谨慎。利巴韦林是核苷类广谱抗病毒药物,临床上多用于治疗呼吸道合胞病毒引起的病毒性肺炎与支气管炎、皮肤疱疹病毒感染等。本文以国内外文献为基础,对利巴韦林的抗病毒作用机制、药代动力学、药效学、体外研究、既往冠状病毒中的应用、临床应用、用法用量、治疗药物监测及不良反应等方面进行综述,为利巴韦林的临床应用提供参考。     

基于系统生物学的肠菌移植在新型冠状病毒肺炎中的应用展望

目前还没有针对由严重急性呼吸综合征冠状病毒2型引起的新型冠状病毒肺炎的特效药物或治疗方法。本文通过研究新型冠状病毒肺炎、肠道菌群及免疫系统之间的关系及肠道菌群影响新型冠状病毒肺炎的相关机制, 探究粪菌移植在新型冠状病毒肺炎治疗中的应用前景, 以期为治疗新型冠状病毒肺炎提供新的方法。     

中和抗体在新型冠状病毒肺炎治疗中的重要意义:进展与展望

SARS-CoV-2感染是对全世界人类生命和健康的一大严重威胁,新型冠状病毒肺炎是由SARS-CoV-2感染引起的全球流行病.SARS-CoV-2病毒具有高度的传染性、诡异性和多变性.因此,新型冠状病毒肺炎的治疗是紧迫且有针对性的.然而,疫苗和目前使用的药物一般不具有上述特点.虽然新型冠状病毒肺炎的恢复期血浆在危重患者...     

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。     

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。     

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.     

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     

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。     

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.     

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.     

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。