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《广州医药》编辑部

广州医药杂志服务号
全科医学

社区孕妇孕期保健应用中医治未病的意义

Application of Traditional Chinese Medicine Prevention of Disease in Aantenatal care in A community

:98-99
 
目的 对中医治未病在社区孕妇孕期保健应用中效果进行探讨。方法 选取符合条件的300名社区孕妇,随机分为对照组和干预组,对照组不采取干预措施,干预组依据孕妇的中医体质判定表实施相应的中医干预方法,持续二个月,并对两组孕妇进行随访。对比分析两组孕妇的分娩和产后情况。结果 干预组孕妇自然分娩95例,剖宫产55例,自然分娩率高于对照组孕妇,差异有统计学意义(P<0.05);干预组新生儿巨大儿的发生率为6.7%,低于对照组的16.7%,差异有统计学意义(P<0.05);此外,干预组孕妇先兆流产、早产、妊娠期高血压和妊娠期糖尿病的发生例数低于对照组孕妇(P<0.05)。结论 应用中医治未病思想指导孕期保健,有助于减少孕产妇并发症和巨大儿发生率,保证母儿健康。
临床诊疗

多措施协作在中药注射剂药物警戒工作的应用效果

Application of multi measures for pharmacovigilance of Traditional Chinese Medicine Injections

:72-74
 
目的 探讨多措施协作在中药注射剂药物警戒工作的应用效果。方法 2012年1月—2014年12月,采取建立多措施协作,应用于中药注射剂药物警戒工作中。通过对中药注射剂的用药频度(DDDs)、日用金额(DDC)、有效率及引起不良反应(ADR)变化等进行比较分析,以评价中药注射剂使用的安全性和有效性变化情况。结果 2012—2014年,中药注射剂使用有效率从76.5%上升至91.2%,不良反应发生率则由3.12%下降至0.72%,没有重大不良反应事件发生。中药注射剂用药频率DDDs则呈下降趋势,在医院药品总DDC上升的情况下,中药注射剂DDC反而下降。结论 多措施协作有助于建立有效的药物警戒体系,有效地降低了中药注射剂不良反应发生率,提高监测工作数据分析效率和发现药物警戒信号的能力,为中药注射剂的“合理,安全,有效,经济”提供有力的保障。
论著

中药熏洗、中药离子导入加CPM综合疗法对膝关节功能障碍患者的作用效果分析

Effect analysis of traditional Chinese medicine fumigation and traditional Chinese medicine iontophoresis combined with CPM combined therapy on patients with knee joint dysfunction

:17-19
 
目的 研究中药熏洗、中药离子导入加CPM综合疗法对膝关节功能障碍患者的作用效果。方法 从2014年4月—2016年4月,于我院共有78例膝关节功能障碍病患就诊。以数字法随机分成观察组(39例)和对照组(39例)。观察组给予中药熏洗以及中药离子导入再加以CPM综合疗法进行护理,对照组仅给予CPM综合疗法护理。观察两组患者护理后膝关节疼痛程度以及活动范围。结果 观察组患者膝关节功能优者占比51.28%,总有良率为84.62%,均高于对照组的25.64%,51.28%;观察组患者膝关节活动范围优者占比51.28%,总优良率为89.74%,均高于对照组的28.21%,66.67%;观察组患者WOMAC评分中膝关节疼痛以及膝关节僵硬和膝关节功能得分均低于对照组,WOMAC总分也低于对照组,差异均有统计学意义(P均<0.05)。结论 中药熏洗、中药离子导入加CPM综合疗法能显著改善患者膝关节功能,增加活动度数,减轻疼痛等级,值得临床推广使用。
Objective To study the effect of traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM combined therapy on patients with knee joint dysfunction. Methods From April 2014 to April 2016, in our hospital there were a total of 78 cases of knee joint dysfunction disease patient treatment. With digital method they were randomly divided into observation group (39 cases) and control group (39 cases). The observation group was treated with Chinese herbal fumigation and washing and Chinese medicine iontophoresis and CPM combined therapy nursing, control group only received CPM combined therapy nursing. Observation of nursing care of the patients in the two groups were knee pain and range of motion. Results The observation group of patients with knee joint function was accounted for than 51.28%. The total yield was 84.62%. They were significantly higher than those in the control group of 25.64%, 51.28%; Observation group of patients with knee joint range of motion was accounted for than 51.28%. The total excellent and good rate was 89.74%, were significantly higher than those in the control group of 28.21%, 66.67%; Observation group, WOMAC score of knee pain and knee stiffness and knee joint function score were significantly lower than those of the control group. WOMAC score was significantly lower than that of the control group. The differences were statistically significant (P<0.05). Conclusion Traditional Chinese medicine fumigation, traditional Chinese medicine iontophoresis combined with CPM therapy could significantly improve the patient's knee function, increase the degree of activity, reduce the pain level. It is worth to have clinical application.
论著

中医药联合辨证护理对促进气血虚弱型孕妇宫颈成熟的临床研究

Clinical research on the effects of Chinese medicine dialectical care on promoting cervical ripening of pregnant women with qi-blood deficiency

:19-21
 
目的 探讨在待产孕妇中应用中医药辨证护理对促进气血虚弱型足月妊娠孕妇宫颈成熟的临产前护理策略及临床效果。方法 选取中医辨证为气血虚弱型的足月妊娠单胎头位初产妇180例,随机分为对照组即催产素组及常规护理组60例,中医药辨证护理组即在对照组的基础上入院后即给予中药口服加辨证护理60例,空白组即期待观察组及常规护理组60例。观察三组治疗前后宫颈Bishop评分,阴道及宫颈分泌物FFN(胎儿纤连蛋白)定性测定,分娩结局及对母胎的影响。结果 中医药辨证护理组在临产率、阴道分娩率及宫颈评分、FFN测定等方面较对照组及空白组均有差异,P<0.05。结论 对于气血虚弱型足月妊娠在入院后开展中医药辨证护理对临产前宫颈成熟有辅助作用,对于提高顺产率,降低高危分娩促进母儿健康有积极作用,值得推广。
Objective To explore the prenatal care strategy of applying Chinese medicine dialectical care to promoting cervical ripening of full-term pregnant women with qi-blood deficiency and its clinical effect. Methods We chose 180 first-time, full-term pregnant women with single fetus cephalic presentation who were diagnosed as with qi-blood deficiency and then randomly divided them into three groups, 60 in control group with oxytocin and usual care; 60 in group of Chinese medicine dialectical care, which provided oral use of Chinese medicine and dialectical care after those women being admitted to hospital; 60 in blank group with usual observation and care. We did Bishop assessment of neck of uterus before and after treatment in these three groups, conducted qualitative test in FFN (Fetal Fibronectin), the secreta from vagina and neck of uterus, and observed delivery outcome as well as the influence to mother and child. Results Compared with control group and blank group, the group ofChinese medicine dialectical care was outstanding in terms of labor rate, vaginal delivery rate, and FFN test(P<0.05). Conclusion Chinese medicine dialectical care boosts cervical ripening of full-term pregnant women with qi-blood deficiency. It is helpful to increase natural labor rate, reduce high-risk delivery, and promote health of mother and child. Therefore it is worth to be popularized.
论著

中医综合治疗及护理回乳的临床疗效观察

Clinical observation on delactation with combined treatment of traditional Chinese medicine and nursing

:54-56
 
目的 根据产后不同时期的乳房的生理特点,采用中医综合疗法及护理进行回乳,观察其疗效。方法 选取哺乳期断乳的妇女57例,随机分为治疗组30例及对照组27例,治疗组采用中医综合疗法回乳,对照组口服溴隐亭回乳。结果 治疗组回乳效果优于对照组,出现乳房胀痛及乳腺炎的发生率低于对照组,且无不良反应。结论 中医综合疗法回乳安全,效果显著,对回乳时出现的乳房胀痛等兼证有很好的改善,对乳腺炎的发生起了更好的预防作用。
Objective According to the physiological characteristics of postpartum breast, through the combined treatment of traditional Chinese medicine and nursing for delactation,and to observe the effects. Methods A total of 57 women who wanted for delactation, were selected and randomly divided into two groups, there are 30 cases in the treatment group and 27 cases in the control group, the treatment group were treated with traditional Chinese medicine and nursing, while the control group used oral bromocriptine for delactation. Results The treatment group is better than the control group, the incidence of mastitis and breast swelling in treatment group is lower than the control group, and there was no adverse reaction. Conclusion The treatment of delactation with combined treatment of traditional chinese medicine and nursing is safe and effective, it can reduce suffering of women and prevent the occurrence of mastitis.
论著

江苏地区中医药保健知识普及现状调查研究

Investigation on popularity of traditional Chinese medicine health care knowledge in Jiangsu

:52-53
 
目的 随着人们生活水平的提高,中医药在养生保健上的作用日益为人们所接受。由于人们对中医药养生保健知识和理论了解较少,本次调查为了解江苏地区居民对中医药保健知识的普及现状。方法 通过派发调查问卷,用随机抽样的方式了解中医药保健知识普及的现状。结果 了解了江苏地区人们对中医药保健知识普及的现状。结论 通过调查,团队得出中医药保健事业的弘扬与发展非一日之功,需要大家共同的努力,政府应当提高中医药保健人员的资格认定标准,各类医院也当负起宣传中医药保健知识的责任,媒体和出版机构宣传正规中医药养生保健知识。
Objective As people's living standards improved, traditional Chinese herbal medicine used in health care becomes well accepted by some fake Chinese herbal medicine doctors. So that, the knowledge of traditional medicine still needs to be popularized. The research is about how well the public know about traditional Chinese herbal medicine in Jiangsu area. Methods We random selected certain amount of citizens to be the informed of the cognition degree of traditional Chinese medicine in public by letting the finish questionnaire. Results We get to know about the current situation of Chinese medicine health care knowledge in Jiangsu area. Conclusion Through the investigation, we need common efforts, carrying and inheriting traditional Chinese medicine. The government should improve the personnel qualification standard of Chinese medicine health care. Hospital will also promote Chinese medicine health care knowledge, and the media and publishing agencies has responsibility to advocate correct Chinese medicine health care knowledge.
临床诊疗

中药西药治疗哺乳期子宫上环术后子宫异常出血的疗效分析

Curative Effect Analysis of Traditional Chinese Medicine Combined Western Medicine in Treatment of Verine Bleeding after Ring Surgery

:99-100
 
目的 通过对比观察常规西药和当归芍药散加减治疗哺乳期子宫上环术后子宫异常出血的临床效果,探讨其安全有效的治疗方法。方法 选取在哺乳期行子宫上环术的妇女96例,随机分为两组,西药组采用常规西药治疗,中药组采用当归芍药散加减方剂治疗。观察术前、术后及治疗后月经量的变化,并对实验结果进行分析和评价。结果 所有96例患者在行子宫上环术后均出现月经量较术前增多(P<0.05),在经过药物治疗后,所有患者月经量较治疗前减少(P<0.05),并治疗后月经量与术前月经量相比波动较小,差异无统计学意义(P>0.05)。中药组与西药组比较,治疗后月经量稍增多,差异无统计学意义(P>0.05)。西药组有5例患者出现头痛、头晕、恶心、呕吐等不适,对症处理或减量后好转,中药组无不良反应病例。结论 西药及中药治疗哺乳期子宫上环术后子宫异常出血效果相当,当归芍药散加减方剂副作用小,具有较高的可靠性和安全性,值得借鉴与推广。
临床诊疗

女性盆底治疗仪配合中药治疗盆底功能障碍性疾病(FPFD)疗效观察

Observation of FPFD Treated by Female Pelvic Cavity Therapeutic Equipment Combined with Chinese Medicine

:67-69
 
目的 探讨盆底肌康复仪配合中药补中益气汤对盆底功能障碍性疾病的治疗疗效。方法 对300例女性盆底功能障碍性疾病(FPFD)的患者采用盆底肌康复仪同时配合中药补中益气汤协同治疗从而弥补单纯盆底康复治疗不足。结果 产后一年内的早期盆底肌力松弛治愈率达83.82%; SUI组治疗后的临床症状控制效果及盆底肌力、持续时间优于POP组,P<0.01。结论 产后及时、早期干预盆底肌功能可有效防止盆底功能障碍性疾病的不良发展,同时配合经典方补中益气汤可益气、升阳举陷调理脏腑机能产生协同作用。
论著

2005—2024 年中医药治疗小儿腺样体肥大的可视化分析

Visual analysis of traditional Chinese medicine treatment for pediatric adenoid hypertrophy from 2005 to 2024

:1045-1054
 
       目的   探讨中医药治疗小儿腺样体肥大(AH)的研究现状、研究热点及趋势,为本领域研究者提供借鉴。方法   检索中国知网(CNKI)数据库从2005年1月1日至2024年1月31日中医药治疗小儿腺样体肥大的相关文献。运用Excel 2019分析其发文量,运用CiteSpace 6.2.R6软件分析其作者、机构、关键词。结果   共纳入文献395篇,年发文量整体呈现波动上升的趋势;发文量最多的作者为姜之炎;发文量最多的研究机构为山东中医药大学。初步形成了以姜之炎、俞景茂、阎兆君为核心的研究团队;研究机构以中医类院校及其附属医院为主。高频关键词提示当前研究热点前三位为中医药治疗方法、临床疗效。结论  AH领域研究内容主要以内治法、外治法、作用机制为主;研究热点逐渐从临床研究转向作用机制等实验研究;应用“数据挖掘”“网络药理学”等计算机技术研究AH会成为趋势。
       Objective  To explore the research status,research hotspots,and trends of traditional Chinese medicine in the treatment of adenoid hypertrophy in children,to provide a reference for researchers in this field.Methods  The relevant literature on the treatment of adenoid hypertrophy in children with traditional Chinese medicine was searched in the CNKI database from January 1,2005,to January 31,2024.Excel 2019 was applied to analyze the number of published papers,and CiteSpace 6.2.R6 software was applied to analyze its authors,institutions,and keywords.Results  A total of 395 papers were included,and the annual number of papers showed a fluctuating upward trend.The author with the largest number of papers was JIANG Zhiyan.Shandong University of Traditional Chinese Medicine was the research institution with the largest number of papers.The core  research teams including JIANG Zhiyan,YU Jingmao,and YAN Zhaojun were initially formed.The  research institutions were mainly Chinese medicine colleges and their affiliated hospitals.High-frequency keywords suggest that the current top three research hotspots were traditional Chinese medicine treatment methods,clinical efficacy.Conclusions  The research content in this field is mainly based on internal treatment,external treatment,and mechanism.The focus has gradually shifted from clinical research to experimental research such as mechanism.The application of computer technologies such as “data mining” and “network pharmacology” for this disease will become a trend.
医院管理

广州中医优势病种分值付费政策实施效果探析

Analysis on the effect of dominant diseases of traditional Chinese medicine under the DIP payment mode in Guangzhou

:849-854
 
       目的   分析广州市中医优势病种按病种分值付费政策实施效果,以期为完善广州市中医病种付费方式改革提供参考思路。方法   以广州市某三甲中医医院住院患者在政策实施前(n=6 057)及实施后(n=7 208)住院病历为研究样本,对医院次均住院医疗费用、中医综合治疗费占比、平均住院日进行两独立样本非参数检验等描述性统计分析。  政策实施后,住院人次增长19%,患者次均住院医疗费用下降7.02%(P<0.001),中医综合治疗费用占比提升0.8%P>0.05),医疗机构平均住院日缩短0.63 d(P<0.001),入组中医优势病种患者自费率较非入组的低,医疗机构总体病例组合指数下降,中医优势病种结算有盈余。结论  中医优势病种按病种分值付费政策有利于医保-患者-医院三方共赢;但中医优势病种入组率有待提高,建议加大对中医医疗机构的支持与助力;中医综合治疗费用占比提升不显著,建议完善中医治疗项目医疗服务价格动态调整机制;中医优势病种仅局限在住院,建议实现诊疗单元全覆盖。
       Objective  To discuss the correlation analysis of the hospitalization expenses of TCM dominant diseases under the DIP payment mode,and provide a reference for further promoting the reform of the payment mode of TCM dominant diseases in Guangzhou.Methods  The nonparametric test was used to analyze the number of inpatients,the average hospitalization cost,and the proportion of TCM comprehensive treatment on the data of inpatient records before and after the implementation of the TCM dominant diseases policy,the sample sizes were 6 057 and 7 028 respectively.Results  After the implementation of the TCM dominant diseases policy,there was a slight fluctuation in the number of inpatients from 6 057 to 7 208,the average hospitalization cost was decreased by 7.02%(P<0.001),the proportion of TCM comprehensive treatment costs had an increase of 0.8%(P0.05),the average length of hospital stay was shorten by 0.63 days(P<0.001),the self-expense  rate of the patients with the TCM dominant diseases of in the group was lower than that of the patients without the group,the total case mix index value of the hospital decreased,but there was a surplus on the group of TCM dominant diseases settlement.Conclusios  The policy is conducive to the tripartite win-win of medical insurance,patients and hospitals.However,the enrollment rate of TCM dominant diseases need to be improved,which is suggested to increase the support for TCM hospitals.The proportion of TCM comprehensive treatment has not increased significantly,so it is suggested to improve the dynamic adjustment mechanism of medical service price of TCM treatment items.The TCM dominant diseases are only limited to hospitalization,and it is recommended to achieve full coverage of diagnosis and treatment units.
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