八珍汤联合西药治疗下肢静脉性溃疡随机平行对照研究

[目的]观察八珍汤联合西药治疗下肢静脉性溃疡疗效。[方法]使用随机平行对照方法,将47例门诊及住院患者按随机数字表法分为两组。对照组23例5mL左氧氟沙星注射液+100mL生理盐水,2次/d,静注。15mL银杏达莫注射液+250mL生理盐水,1次/d,静滴;潘生丁25mg/次,3次/d,口服;或阿司匹林25mg/次,3次/d;溃疡面0.9%生理盐水清洁,配以0.1%依沙吖啶(雷佛奴尔)液或黄连素液交替外敷,配合外用中药膏药外敷创面提高疗效,根据情况采用干、湿性敷料;定期用高压氧、激光、超声波等物理疗法促进溃疡愈合。严重患者,需手术治疗。治疗组24例八珍汤(当归酒拌10g,川芎5g,白芍药8g,熟地黄酒拌15g,人参3g,白术炒10g,茯苓8g,炙甘草5g;肢凉畏寒加附子、干姜;肢体水肿加猪苓、木瓜;疼痛明显加乳香、没药),1剂/d,水煎200mL,早晚口服;西药治疗同对照组。连续治疗14d为1疗程。观测临床症状、不良反应。治疗1疗程,判定疗效。[结果]治疗组痊愈6例,显效10例,有效7例,无效1例,总有效率95.83%。对照组痊愈2例,显效5例,有效8例,无效8例,总有效率62.50%。治疗组疗效优于对照组(P0.05)。治愈时间治疗组(16.78±9.23d)明显短于对照组(28.21±12.67d)(t=3.62,P=0.0110.05)。[结论]八珍汤联合西药治疗下肢静脉性溃疡效果显著,值得推广。     

左氧氟沙星胶囊联合癃清片治疗2型糖尿病合并尿路感染的疗效观察

目的观察左氧氟沙星胶囊联合癃清片治疗2型糖尿病合并尿路感染的疗效和安全性。方法选取平邑县人民医院2012年10月-2013年10月住院的2型糖尿病合并尿路感染患者209例,将其随机分为治疗组（105例）和对照组（104例）,所有患者根据病情分别选用口服降糖药和（或）胰岛素控制血糖,并根据血糖情况调整降糖方案,使血糖控制理想。对照组患者口服盐酸左氧氟沙星胶囊,2粒／次,2次／d;治疗组在对照组基础上口服癃清片,6片／次,2次／d,两组均治疗7d。观察治疗前后患者的临床症状、尿常规变化和不良反应。结果治疗组和对照组有效率分别为95．2％、76．9％,两组比较差异有统计学意义（P〈0．05）;治疗后,患者尿常规中白细胞和红细胞计数均显著减少,治疗组减少更加明显,差异具有统计‘学意义（P〈0．05）。胃部不适为最常见的不良反应,两组间差异无统计学意义。结论左氧氟沙星胶囊联合癃清片治疗2犁糖尿病合并尿路感染有很好的疗效,治疗过程中的不良反应较少,佰得临床应用。     

清金化痰汤联合左氧氟沙星治疗痰热郁肺型社区获得性肺炎随机平行对照研究

[目的]观察清金化痰汤联合左氧氟沙星治疗痰热郁肺型社区获得性肺炎疗效。[方法]使用随机平行对照方法,将42例门诊患者按随机数字表法分为两组,对照组21例左氧氟沙星0．4＋0．9％生理盐水或5％葡萄糖250mL,1次／d,静滴。治疗组2l例清金化痰汤（黄芩、山栀子各12g,桔梗、麦冬各9g,桑白皮15g,贝母9g,知母、栝楼仁各15g,橘红、茯苓各9g,甘草3g）l剂／d,水煎200mL,早晚口服,左氧氟沙星治疗同对照组。连续治疗10d为1疗程。观测临床症状、体温、咳嗽及肺哆音、胸部影像、不良反应。治疗1疗程,判定疗效。[结果]治疗组治愈13例,显效6例,有效2例,无效0例,总有效率100％。对照组治愈5例,显效8例,有效5例,无效3例,总有效率85．71％。治疗组疗效优于对照组（P〈0．05）。[结论]清金化痰汤联合左氧氟沙星治疗痰热郁肺型社区获得性肺炎,疗效满意,无副作用,值得推广。     

莫西沙星治疗恶性肿瘤合并医院获得性肺炎的疗效观察

目的观察莫西沙星治疗恶性肿瘤合并医院获得性肺炎(HAP)的临床效果和安全性。方法 102例恶性肿瘤合并HAP病例,随机分为治疗组52例、对照组50例;治疗组应用莫西沙星治疗,对照组应用左氧氟沙星治疗,观察其临床效果和安全性。结果治疗组及对照组总有效率分别是80.8%和58.0%,痊愈率分别为50.0%和32.0%,两组共分离出细菌121株,细菌清除率分别为80.3%和58.3%、不良反应发生率分别为3.9%和10.0%,差异均有统计学意义(P<0.05)。结论莫西沙星治疗恶性肿瘤合并HAP患者临床疗效较好,细菌清除率高、优于左氧氟沙星,临床使用安全。     

口服左氧氟沙星治疗化脓性扁桃体炎疗效分析

目的评价左氧氟沙星治疗急性化脓性扁桃体炎的有效性。方法120例急性化脓性扁桃体炎的患者随机分成两组,试验组给予口服左氧氟沙星片剂500 mg,1次/d;对照组静脉滴注青霉素钠,480万单位/次,2次/d,疗程7~14 d。结果共109例完成试验,试验组57例,临床有效率为92.98%,细菌清除率为87.81%;对照组52例,临床有效率为90.38%,细菌清除率为82.86%,试验组与对照组临床有效率及细菌清除率相比较差异均无统计学意义(P>0.05)。结论口服左氧氟沙星500 mg能有效地治疗急性化脓性扁桃体炎。     

Efficacy of the combination of levofloxacin plus ceftazidime in the treatment of hospital-acquired pneumonia in the intensive care unit

To investigate the efficacy and tolerability of treatment with a combination of levofloxacin and ceftazidime in Gram-negative hospital-acquired pneumonia (HAP) in the Intensive Care Unit (ICU), we performed a prospective, open-label, non-comparative, 1-year study in an Italian ICU. Patients received levofloxacin 500 mg twice a day intravenously plus ceftazidime 2 g three times a day intravenously for 7–14 days. Primary efficacy variables were clinical and microbiological responses at test-of-cure visit. Twenty-one patients were enrolled. Pseudomonas aeruginosa and Klebsiella pneumoniae were the most frequently identified pathogens. Clinical success was achieved in 17/21 clinically evaluable patients (81%) and in 12/15 microbiologically evaluable patients (80%). Regarding only the group with ventilator-associated pneumonia, cure was achieved in 10/14 clinically evaluable patients (71%) and in 11/14 microbiologically evaluable patients (79%). Therapy was well tolerated. We conclude that this combination regimen is safe and clinically and microbiologically efficacious in the treatment of Gram-negative HAP.     

Concentrations in plasma, urinary excretion and bactericidal activity of levofloxacin (500 mg) versus ciprofloxacin (500 mg) in healthy volunteers receiving a single oral dose

In a randomised crossover study, 14 volunteers received a single oral dose of 500 mg levofloxacin or 500 mg ciprofloxacin in order to assess plasma concentrations by high-pressure liquid chromatography (up to 24 h), urinary excretion and urinary bactericidal titres (UBTs) at intervals up to 120 h. The median maximum concentration of levofloxacin in plasma was 6.1 mg/L and that of ciprofloxacin was 2.3 mg/L. The median cumulative level of renal excretion of the administered dose of the parent drug was 81.2% for levofloxacin and 36.2% for ciprofloxacin. UBTs were determined for a reference strain and nine clinical uropathogens. The median UBTs of both quinolones measured within the first 12 h were between 0 and 1:≥1024, correlating with the minimum inhibitory concentrations (MICs) of the strains. For Gram-negative strains, the UBTs of both quinolones were comparable despite the lower MICs of ciprofloxacin. During further time courses, however, the UBTs of levofloxacin were significantly higher than those of ciprofloxacin. For Gram-positive strains, for which the MICs of levofloxacin were equal to or lower than those of ciprofloxacin, the UBTs of levofloxacin were already significantly higher from the beginning. It can be concluded that overall the doses of the two tested fluoroquinolones may be considered equivalent with regard to treatment of complicated urinary tract infections, although the recommended dosing is twice daily for ciprofloxacin and once daily for levofloxacin.     

哌拉西林/他唑巴坦联合左氧氟沙星治疗下呼吸道医院感染的疗效评价

目的评价哌拉西林/他唑巴坦联合左氧氟沙星治疗心脏重症监护病房(CCU)中下呼吸道医院感染的疗效和安全性。方法回顾性分析哌拉西林/他唑巴坦联合左氧氟沙星治疗52例CCU中下呼吸道医院感染的临床疗效。结果临床总有效率为92.3%,平均疗程11.5 d,细菌清除率达84.4%,不良反应发生率7.6%。结论哌拉西林/他唑巴坦联合左氧氟沙星治疗CCU中下呼吸道医院感染临床疗效好,细菌清除率高,可作为CCU中下呼吸道医院感染的经验性用药。     

国产左旋氧氟沙星治疗细菌性感染的疗效评价

目的：评价国产盐酸左旋氧氟沙星注射液对呼吸、泌尿等系统急性细菌性感染的临床疗效及安全性。方法：１６２例患者随机分为左旋氧氟沙星治疗组６１例、氧氟沙星对照组６１例和开放组（左旋氧氟沙星）４０例。给药方法为左旋氧氟沙星注射液０．１～０．２ｇ,静滴,２次／ｄ;氧氟沙星注射液０．２～０．４ｇ,静滴,２次／ｄ;一个疗程为７～１４天。结果：左旋氧氟沙星治疗１０１例各种细菌性感染的有效率为９６．０％（９７／１０１）,细菌清除率为９１．８％（８９／９７）。对照研究显示,左旋氧氟沙星的临床疗效与氧氟沙星相当（有效率分别为９６．７％和９３．５％,Ｐ＞０．０５）,细菌清除率治疗组（８９．５％）与对照组（８９．５％）相同（Ｐ＞０．０５）。不良反应发生率治疗组（１１．５％）略低于对照组（１４．８％）（Ｐ＞０．０５）。结论：国产盐酸左旋氧氟沙星注射液对呼吸、泌尿系统等部位的急性细菌性感染有效而安全。     

口服左旋氧氟沙星在呼吸道感染患者中的药动学研究

目的 :口服左旋氧氟沙星在下呼吸道感染患者中的药代动力学研究。　 方法 :8例肺部感染的住院患者 ,单剂量口服左旋氧氟沙星片 30 0 mg后分别测定不同时间血和尿中左旋氧氟沙星浓度。用高效液相色谱法荧光检测。药时数据用 3p87计算机程序拟合求算药动学参数。　 结果 :单剂量口服 30 0 mg左旋氧氟沙星片后的主要参数为 :Cmax 3.32± 0 .4 1μg/ ml,t1/ 2 5.58± 1.86h,Tmax 2 .17± 0 .69h,AUC0 -∞ 2 3.34± 3.0 9μg/ ( ml· h)。 2 4 h尿中累积排出量 2 4 9.8± 2 4 .2 1mg,占给药剂量的 83.3%。　 结论 :左旋氧氟沙星在呼吸道感染患者中的药代动力学参数与氧氟沙星基本一致