Relapse of Inflammatory Bowel Disease Associated With Use of Nonsteroidal Anti-Inflammatory Drugs

To determine whether an association exists between relapse in inflammatory bowel disease and use of nonsteroidal anti-inflammatory drugs (NSAIDs), a retrospective records review was conducted of patients with Crohn's disease, ulcerative colitis, or indeterminate colitis examined at an outpatient tertiary care center between July 17, 2000, and November 1, 2001. Extracted data collected during the patient's last visit included medication use, maintenance therapy, disease activity, and smoking status. Use of NSAIDs was defined as a daily dose or more of any type the month before relapse. Of 60 patients (22, relapse; 38, remission), 9 (41%) in relapse and 10 (26%) in remission used NSAIDs. Maintenance therapy varied from 68% (relapse) to 92% (remission). The adjusted odds ratio between medication use and relapse was 6.31 (95% confidence interval, 1.16–34.38; P = .03). Use of NSAIDs was associated with relapse. A prospective cohort study that corrects for maintenance therapy is needed to evaluate this relationship.     

基于数据挖掘和“方-药-性-效”的藏医治疗慢性胃炎用药规律研究＊

目的 鉴于慢性胃炎是藏医优势病种且有较好的疗效，研究藏医治疗慢性胃炎的用药规律，为藏医临床与科研提供参考。方法 多中心收集藏医治疗慢性胃炎2613例有效临床医案，统一归纳藏医诊断确定归类分型，采用Gephi 0.9.2、SPSS Statistics 23、SPSS Modeler18等软件的描述性统计、Apriori算法、K-均值聚类分析方法，结合藏医“味性化味”药性理论进行分析，构建藏医治疗慢性胃炎的“方-药-性-效”复杂网络。结果 本研究涉及的慢性胃炎的藏医诊断可归纳为四种证型，其中隆型472例、赤巴型811例、培根型974例，其他证型356例。涉及藏药方剂共有137首，其中五鹏丸（1012次）、仁青芒觉（864次）、六味能消散（811次）等频次最高；关联规则分析发现，五味金色散和六味能消散关联最高。其中隆型以六味木香散等平隆助动、促进胃肠蠕动类方剂为主；赤巴型以五味金色散等清热凉血、消炎治疮类方剂为主；培根型以五味石榴散等平培根、助胃火类方剂为主。组方中诃子、木香、红花等使用频次最多，设置“支持度 ≥ 40%，置信度 ≥ 80%”时诃子、石榴子、木香等关联最强。药性分析发现，甘味、苦味、辛味等偏盛，十七效中以凉、钝、重、糙等为主，其中凉效、钝效可对治热、锐特性引起的胃热、胃肠糜烂等疾病，并分析方剂对治三因的比值，发现主要对治赤巴，其次为隆和培根。结论 通过构建“方-药-性-效”的研究模式，发现藏医对慢性胃炎的诊疗具有一定的规律可循，慢性胃炎在藏医诊断中可分为四种证型，总体治疗具有以“清血热-抑胃液-养胃火-通胃隆”四位一体的隐形用药规律，其中隆型以镇隆平气为主，赤巴型以清热凉血为主，培根型以平寒温胃为主，藏医临床治疗慢性胃炎提供有益参考。