基于文献分析多囊卵巢综合征的中医证型分布及用药规律

目的:通过文献探析中医治疗多囊卵巢综合征(PCOS)的证型分布及临床用药规律。方法:检索2003年至2018年1月1日中国期刊全文数据库(CNKI)、万方、维普3个中文数据库中相关中医治疗PCOS的临床研究文献,建立中医治疗PCOS的整体证型及临床用药数据库,并对数据进行处理、分析。结果:①共纳入符合标准的文献252篇,方剂284首;②涉及证型共37种,其中常见证型为肾虚血瘀证、痰湿证、肾虚痰瘀证,共占43.31%;③涉及病位要素以肾为主,其次为肝、脾;涉及病性要素以血瘀、痰、湿为主;④涉及药物193味,按功效共分为16类,补虚药占41.44%,活血化瘀药占16.20%,化痰祛湿药占14.90%;⑤中医治疗PCOS药性以温、平为主,药味以甘为主,辛、苦次之。结论:PCOS病因病机复杂,以肾虚为本,血瘀、痰湿为标,治疗以补肾活血、化湿祛痰为主。     

热咳散治疗痰热内蕴型哮喘患儿的临床研究

目的:探讨痰热内蕴型哮喘婴幼儿西医常规治疗基础上使用自拟热咳散治疗的临床疗效,为其临床应用提供理论依据。方法:选取2017年3月至2018年9月中山市中医院收治的痰热内蕴型哮喘婴幼儿112例作为研究对象,根据治疗方式的不同分为对照组与观察组,每组56例。对照组采用常规治疗,观察组在对照组基础上加用自配热咳散,比较2组患儿肺功能指标（FEF25%、FEF50%、IgE）;血清生化指标（IL-6、TNF-α、CRP、Cal-3）和C-ACT和MARS-A评分的差异。结果:对照组FEF25%、FEF50%显著低于观察组,对照组IgE含量显著高于观察组,差异均有统计学意义（P<0.05）。2组患儿治疗有效率和治疗效果构成差异有统计学意义（P<0.05）。治疗后观察组IL-6、TNF-α、CRP、Cal-3含量低于对照组,观察组C-ACT评分、MARS-A评分高于对照组,差异均有统计学意义（P<0.05）。结论:相比于西医常规治疗的治疗手段,在其基础上连用自拟热咳散的治疗效果更佳,患者症状改善时间也相对较短。     

丹红注射液联合氢氯吡格雷用于脑梗死恢复期的临床观察

目的：探析脑梗死恢复期患者采取丹红注射液联合氢氯吡格雷口服进行治疗对改善神经功能的效果。方法：选取2017年5月至2019年11月马鞍山十七冶医院收治的脑梗死恢复期患者66例作为研究对象,按照随机数字表法随机分为对照组与观察组,每组33例。对照组采取氢氯吡格雷口服治疗,观察组采取丹红注射液联合氢氯吡格雷口服治疗,比较2组患者治疗有效率、神经功能缺损评分（NIHSS）、日常生活能力评分（ADL）、运动功能、不良反应发生率、洼田饮水试验等指标。结果：与对照组比较,观察组治疗有效率明显较高,差异有统计学意义（P<0.05）;与对照组比较,观察组的NIHSS评分较低,ADL评分较高,差异有统计学意义（P<0.05）;观察组的不良反应发生率明显低于对照组,差异有统计学意义（P<0.05）;2组Ⅱ级、Ⅲ级比较,差异有统计学意义（P<0.05）;2组用药后洼田饮水试验分级比较,差异有统计学意义（P<0.05）。结论：脑梗死恢复期患者采取丹红注射液联合氢氯吡格雷口服进行治疗能够提升治疗效果、改善神经功能,安全性高,可加快患者康复速度。     

我国东部地区结节性痒疹患者中医体质类型分布规律

目的探讨我国东部地区结节性痒疹患者中医体质类型的分布特点。方法采用病例对照设计方法,选取120例结节性痒疹患者作为病例组,120例健康体检者作为对照组,参照《中医体质分类与判定表》进行中医体质类型调查,分析其分布规律。结果结节性痒疹患者年龄(41.58±16.27)岁,性别男女比例约1∶1.2,体质类型分布前四位的是湿热质23例、血瘀质20例、气郁质19例、特禀质13例;健康体检者体质类型分布前四位的是平和质33例、气虚质19例、阳虚质14例、痰湿质13例;与对照组相比,病例组偏颇体质明显增多(P<0.01),2组体质构成比亦有显著性差异(P<0.01),其中湿热质、气郁质、血瘀质、特禀质较对照组转化分增加(P<0.05)。结论结节性痒疹的发病与湿热质、血瘀质、气郁质、特禀质偏颇体质类型密切相关。     

预防医学专业本科生对实施导师制的需求调查

目的了解预防医学专业本科生对导师制的需求情况,从而为预防医学本科生导师制的有效实施提供信息依据。方法采用问卷调查法对内蒙古医科大学304名大一至大五年级预防医学专业本科生进行调查,并进行相关统计分析。结果本科生对导师制的需求比例为80.3%,对本科生导师制了解较多的学生比例仅为17.4%;86.5%的学生希望在课程学业及考研方面获得导师的指导,90.1%的学生对导师指导内容的需求为科研及其他实践能力方面的锻炼。结论预防医学专业本科生对导师制需求较高但了解较少,学生对自身能力提升的需求是多方面的。为保障本科生导师制的有效实施,应加大本科生导师制的宣传力度,并从学生实际需求出发制定导师制实施方案,并重视相关保障制度的制定。     

中医院校预防医学课程思政的教学改革和实践

“课程思政”是当前高等教学中加强大学生思想政治教育的主要途径之一。本文通过探索中医院校“预防医学”课程思政的建设,从教学内容、教学方法、教学团队建设、考核方式四个方面论述了专业知识传授和思政教育育人的有机融合,在教学中实施“知识传授”与“价值引领”同向同行,培养德术兼备的“卓越医生”。     

Moderation and mediation in the psychological and drug treatment of chronic tension-type headache: The role of disorder severity and psychiatric comorbidity

We evaluated two putative moderators of treatment outcome as well as the role of Headache Management Self-Efficacy (HMSE) in mediating treatment outcomes in the drug and non-drug treatment of chronic tension-type headache (CTTH). Subjects were 169 participants (M = 38 yrs.; 77% female; M headache days/mo. = 22) who received one of four treatments in the treatment of CTTH trial (JAMA, 2001; 285: 2208–15): tricyclic antidepressant medication, placebo, (cognitive-behavioral) stress-management therapy plus placebo, and stress-management therapy plus antidepressant medication. Severity of CTTH disorder and the presence of a psychiatric (mood or anxiety) disorder were found to moderate outcomes obtained with the three active treatments and with placebo, as well as to moderate the role of HMSE in mediating improvements. Both moderator effects appeared to reflect the differing influence of the moderator variable on each of the three active treatments, as well as the fact that the moderator variables exerted the opposite effect on placebo than on the active treatments. HMSE mediated treatment outcomes in the two stress-management conditions, but the pattern of HMSE mediation was complex, varying with the treatment condition, the outcome measure, and the moderator variable. Irrespective of the severity of the CTTH disorder HMSE fully mediated observed improvements in headache activity in the two stress-management conditions. However, for patients with a mood or anxiety disorder HMSE only partially mediated improvements in headache disability, suggesting an additional therapeutic mechanism is required to explain observed improvements in headache disability in the two stress-management conditions.     

广州市老年人慢性脑供血不足的调查与诊断防治探讨

发现：66.7%的老人有慢性脑供血不足临床表现,其中95.5%的老年人对脑卒中及老年痴呆症有认识。但是85.6%表示对慢性脑供血不足的危害全然不知,只有14.4%已经有脑血管疾病的老人知道脑供血不足的危害。慢性脑供血不足如果任其发展,最终会造成脑卒中或者老年痴呆症。早期的慢性脑供血不足是可逆的,需要在饮食、生活习惯、药物治疗等受到重视,因此,让老年人正确认识慢性脑供血不足的危害,及时及早预防治疗极为迫切。     

Nonpharmacological approaches in the management of hypertension

Purpose: The purpose of this article is to discuss the holistic evaluation of the hypertensive patient and review evidence-based nonpharmacological treatments to help patients achieve maximum therapeutic benefits with minimal side effects.
Data sources: Health sciences literature was reviewed using the following databases: Medline, PubMed, and Cumulative Index to Nursing and Allied Health Literature.
Conclusions: Hypertension remains a major public health problem, affecting 65 million Americans and contributing to excess morbidity, mortality, and indirect and direct healthcare costs. Improving clinical outcomes will reduce human suffering as well as the economic burden associated with this disease. Nonpharmacological strategies are recommended as successful primary and adjunctive treatment options for lowering blood pressure. Moreover, the benefits of many of these approaches extend to and promote overall health and well-being.
Implications for practice: Nurse practitioners who incorporate nonpharmacological options in the management of hypertension can improve clinical outcomes.     

Oral medication management in inpatient psychiatric care in Turkey

The aim of this study was to describe current status of oral medication management and related situations by nurses who work on psychiatric wards in Turkey. The study was performed in 34 psychiatric wards in Turkey, and 471 nurses agreed to participate in the study. Data were collected by a questionnaire. In our study, it was determined that one quarter of the nurses do not collect data about past medication history of the patient before giving medications, and 59.7% of the nurses checked all the patients' mouths after each pill was given. The orders are checked by 80.5% of the nurses every day. The leading patient reaction nurses face during medication administration was refusal to take the medication. The nurses stated that they first informed the physician without making any intervention on patients who did not take their pills. The nurses primarily observed the patient to evaluate the effect of a medication (84.3%) and, with a similar percent (82.8%), the side effects of a medication. In conclusion, continuing education, certification and post-graduated courses is provided for nurses about their other roles and responsibilities as well as increasing the quality of oral medication administration which is a difficult area.