从中医药治疗新传染病论温病学的现代发展

回顾中医温病学科的发展历史,结合现代中医药治疗新出现的传染病的临床实际,从“温病”范畴的扩大、“温邪”认识的深入以及相应治法的出现等方面探讨现代温病学的发展趋势。     

定喘汤治疗哮喘随机对照试验的系统评价

目的:系统地评价传统中药复方定喘汤治疗哮喘的疗效及不良反应。方法:系统、全面检索国内外相关数据库,鉴定并纳入定喘汤与安慰剂、西药等治疗哮喘的随机对照试验(RCT),采用国际公认的评价标准对纳入试验的质量包括随机化、分配隐藏、盲法、退出与失访进行评价,进而对疗效进行系统综合分析。结果:共计27篇RCT(2497名患者)文献符合纳入标准,但方法学质量较低,纳入的RCT文献中未发现定喘汤与安慰剂对照的研究。结果表明,定喘汤在改善哮喘症状方面明显优于单纯西医治疗;定喘汤联合西药在哮喘肺通气功能改善方面与单纯西医对症治疗相比,具有明显优势。所有纳入试验均未报告严重不良反应。结论:现有中等级别的证据表明,定喘汤在控制哮喘症状方面有一定疗效。然而,现有的RCT方法学和报告质量较低,疗效的证据需要进一步大样本严格设计的临床试验证实。     

数据挖掘在中医治疗抑郁症方药文献研究中的应用

目的：探讨数据挖掘在中医治疗抑郁症方药文献研究中的应用。方法：运用现代的数据统计方法如关联分析、聚类分析等,对历代郁证及近代文献治疗抑郁症方药进行数据挖掘。结果：运用现代的数据统计对历代郁证及近代文献治疗抑郁症方药进行数据挖掘,分析其性味归经、剂量、药物配伍及其与症状对应关系,通过分析整体数据,发掘其蕴藏的潜在规律,为优化组方配伍,指导临床运用提供依据。结论：抑郁症是一种常见的精神障碍疾病,历代医家在中医药治疗郁证方面积累了丰富的经验,数据挖掘拓展了中医药治疗抑郁症的研究思路,对推动中医药理论的继承和创新具有重要的意义。     

Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis

BackgroundSome depressed patients receive acupuncture as an adjunct to their conventional medications.ObjectiveThis review aims to provide evidence on whether acupuncture can enhance the therapeutic effectiveness of antidepressants for treating depression, and explore whether acupuncture can reduce the adverse reactions associated with antidepressants.Search strategyEnglish and Chinese databases were searched for randomized controlled trials (RCTs) published until December 1, 2021.Inclusion criteriaRCTs with a modified Jadad scale score ≥ 4 were included if they compared a group of participants with depression that received acupuncture combined with antidepressants with a control group that received antidepressants alone.Data extraction and analysisMeta-analysis was performed, and statistical heterogeneity was assessed based on Cochran’s Q statistic and its related P-value. Primary outcomes were the reduction in the severity of depression and adverse reactions associated with antidepressants, while secondary outcomes included remission rate, treatment response, social functioning, and change in antidepressant dose. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to evaluate the overall quality of evidence in the included studies.ResultsThis review included 16 studies (with a total of 1958 participants). Most studies were at high risk of performance bias and at low or unclear risk of selection bias, detection bias, attrition bias, reporting bias, and other bias. Analysis of the 16 RCTs showed that, compared with antidepressants alone, acupuncture along with antidepressants reduced the Hamilton Depression Rating Scale-17 (HAMD-17) scores (standard mean difference [SMD] ?0.44, 95% confidence interval [CI] ?0.55 to ?0.33, P < 0.01; I² = 14%), Self-rating Depression Scale (SDS) scores (SMD ?0.53, 95% CI ?0.84 to ?0.23, P < 0.01; I² = 79%), and the Side Effect Rating Scale (SERS) scores (SMD ?1.11, 95% CI ?1.56 to ?0.66, P < 0.01; I² = 89%). Compared with antidepressants alone, acupuncture along with antidepressants improved World Health Organization Quality of Life-BREF scores (SMD 0.31, 95% CI 0.18 to 0.44, P < 0.01; I² = 15%), decreased the number of participants who increased their antidepressant dosages (relative risk [RR] 0.32, 95% CI 0.22 to 0.48, P < 0.01; I² = 0%), and resulted in significantly higher remission rates (RR 1.52, 95% CI 1.26 to 1.83, P < 0.01; I² = 0%) and treatment responses (RR 1.35, 95% CI 1.24 to 1.47, P < 0.01; I² = 19%) in terms of HAMD-17 scores. The HAMD-17, SDS and SERS scores were assessed as low quality by GRADE and the other indices as being of moderate quality.ConclusionAcupuncture as an adjunct to antidepressants may enhance the therapeutic effectiveness and reduce the adverse drug reactions in patients receiving antidepressants. These findings must be interpreted with caution, as the evidence was of low or moderate quality and there was a lack of comparative data with a placebo control.Systematic review registration: INPLASY202150008.     

中药透皮吸收促进剂的研究进展

中药透皮吸收促进剂具有起效快、效果好、副作用小、无污染等优点,总结近年来常用中药透皮吸收促进剂的研究进展,中药透皮吸收促进剂主要包括单一中药透皮吸收促进剂和含中药PE多元透皮吸收促进剂,并对存在的问题及今后的研究前景进行了思考和展望。     

模糊聚类法在中医药研究中的应用

通过分析近年来模糊聚类法相关文献,就其在中医理论方面,中医临床方面的应用情况进行阐述和概括。     

角膜移植排斥反应的基础研究进展

影响异体角膜缘／角膜缘干细胞移植术成败的关键是术后移植排斥反应的防治。在参阅有关文献后，本文对术后移植排斥反应的机制、表现及早期诊断和处理方法等诸多方面进行了较为全面的综述。     

某三甲医院实施抗菌药物临床应用专项整治前后应用情况比较

目的 评价专项整治活动开展前后抗菌药物临床应用情况.方法 收集该院抗菌药物专项整治前,即2010年1月至2011年6月抗菌药物使用相关数据;与整治后2011年7月至2013年8月抗菌药物使用相关数据进行统计分析.结果 （1）实施专项整治后,该院抗菌药物使用日趋合理.监测指标中,住院患者抗菌药物使用率、抗菌药物使用强度、Ⅰ类切口抗菌药物预防使用率、外科手术预防使用抗菌药物时间在0.5～2h符合率及Ⅰ类切口手术预防用药疗程符合率整治前后差异有统计学意义（P＜0.05）.（2）该院铜绿假单胞菌和金黄色葡萄球菌耐药率在抗菌药物专项整治前后,经W检验差异有统计学意义（P＜0.05）.结论 抗菌药物专项整治非常有必要,通过专项整治,抗菌药物的使用更加合理.     

长春碱类抗肿瘤药物的研究进展

长春碱类抗肿瘤药己广泛应用于临床并显示出很好的疗效,本文综述了作用机理、临床应用、结构修饰及合成等方面的研究进展.     

含左氧氟沙星的四联疗法与常规四联疗法补救治疗幽门螺杆菌感染疗效的Meta分析

目的评价含左氧氟沙星的四联疗法与常规四联疗法相比,补救治疗幽门螺杆菌感染的疗效与安全性。方法以"左氧氟沙星OR氧氟沙星OR喹诺酮"、"幽门螺杆菌OR Hp"、"补救治疗"为关键词检索万方数字化期刊全文数据库、中国期刊全文数据库、维普中文期刊数据库、中国生物医学文献库,结合检索论文中的参考文献查询相关文献,文献检索至2012年6月。纳入含左氧氟沙星的四联疗法与常规四联疗法相比较的随机对照试验。统计学处理采用Cochrane协作网提供的RevMan 5.1软件。结果检索到符合条件的文献5篇,其中2项研究的方法学质量等级为B级,3项研究的质量为C级。共纳入432例患者,左氧氟沙星组221例,常规疗法组211例。对纳入研究进行Meta分析显示,无论按ITT分析还是按PP分析,含左氧氟沙星四联疗法的Hp根除率均高于常规四联疗法(P<0.000 1)。两组均未发生严重的不良反应。结论含左氧氟沙星的四联疗法补救治疗Hp优于常规四联疗法,且前者不良反应率较低。然而,研究所纳入试验的方法学质量均较低,临床试验和病例数太少,尚不能对其疗效得出可靠的结论。