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Objective:To observe the efficacy and safety of mechanical ventilation combined with different doses of sildenafil in the treatment of persistent pulmonary hypertension of newborn (PPHN).Methods:A total of 160 children with PPHN admitted to Dezhou Maternal and Child Health Hospital from January 2018 to December 2019 were selected and divided into group A, B, C and D by random stratification, with 40 cases in each group. All the children in the group were actively corrected for acidosis, provided with intravenous nutrition support, warmth, anti-infection and other measures, and adopted ventilator to assist mechanical ventilation. Group A, B, and C were given different doses of sildenafil 0.5, 1.0, and 2.0 mg/(kg·time) respectively, while group D was not given sildenafil treatment, but only mechanical ventilation. Blood gas analysis indexes including partial arterial oxygenpressure (PaO 2), partial arterial carbon dioxide pressure (PaCO 2), saturationoxygen (SaO 2), and pulmonary artery pressure (SPAP), systemic blood pressure (SBP) of children were tested before the treatment and 72 h after the treatment. The treatment time, hospitalization time, hospitalization expenses and the incidence of adverse reactions of mechanical ventilation in 4 groups were recorded and compared. Results:The effective rate in the group A, B and C was higher than that in the group D: 80.0%(32/40), 85.0%(34/40), 87.5%(35/40) vs. 57.5%(23/40), the difference was statistically significant ( P<0.05). Before treatment, the levels of blood gas analysis indexes in 4 groups had no significant differences ( P>0.05). After treatment, the level of PaO 2 in the group A, B and C was significantly higher than that in the group D ( P<0.05), the level of PaCO 2 in the group B and C was significantly lower than that in group D ( P<0.05), and the level of SaO 2 in the group B and C was significantly higher than that in the group D ( P<0.05). After treatment, the level of SPAP in group B and C was significantly lower than that in the group D: (28.56 ± 3.93), (27.14 ± 3.32) mmHg(1 mmHg = 0.133 kPa) vs. (33.57 ± 4.68) mmHg, P<0.05, and the level of SBP in 4 groups had no significant difference ( P>0.05). The hospitalization time and mechanical ventilation time in group A, B and C were significantly shorter than those in group D ( P<0.05). No drug-related adverse reactions, pulmonary hemorrhage, hypotension, arrhythmia, pneumothorax and other complications occurred during the treatment in the 4 groups. Conclusions:Mechanical ventilation combined with sildenafil can significantly reduce pulmonary artery pressure and improve pulmonary oxygenation in children with PPHN. In the range of 0.5 - 1.0 mg/kg, the efficacy is more obvious when increasing the dose of sildenafil.
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OBJECTIVE@#To observe the difference for vascular dementia among flipping moxibustion of medicine at acupoints in governor vessel combined with acupuncture, simple medicine and simple acupuncture.@*METHODS@#A total of 120 patients with vascular dementia were randomly assigned into a combination group, a flipping moxibustion group and an acupuncture group, 40 cases in each one, with 2 patients dropping respectively. Flipping moxibustion was used at the acupoints of group A on Monday and at the acupoints of group B on Friday in the flipping moxibustion group. The acupoints of group A were Baihui (GV 20), Dazhui (GV 14), Shenzhu (GV 12), Zhiyang (GV 9), Jizhong (GV 6), Mingmen (GV 4), Yaoyangguan (GV 3), and the acupoints of group B were Fengfu (GV 16), Taodao (GV 13), Shendao (GV 11), Jinsuo (GV 8), Xuanshu (GV 5), Changqiang (GV 1). Acupuncture was used in the acupuncture group at the main acupoints of Baihui (GV 20), Sishencong (EX-HN 1), Neiguan (PC 6), Zusanli (ST 36), Taixi (KI 3) and Xuanzhong (GB 39), matched with the acupoints based on syndrome differentiation, 30 min a time, once a day, continuous 5 times a week. The above two methods were applied in the combination group. All the treaments were for 4 weeks. The indexes were observed before and after treatment, including syndrome differentiationof TCM scale for vascular dementia (SDSVD), simple mental state scale (MMSE), self-care ability of daily life scale (ADL). The clinical effects and safety were evaluated.@*RESULTS@#After treatment, the total effective rate in the combination group was 89.5% (34/38); the rate in the flipping moxibustion group was 65.8% (25/38); the rate in the acupuncture group was 63.2% (24/38). The difference among groups was statistically significant (0.05). The SDSVD scores after treatment were lower and the MMSE and ADL scores after treatment were higher than those before treatment in the three groups (all 0.05). The treatment in the three groups was safe, without stastical significance (>0.05).@*CONCLUSION@#The effect of flipping moxibustion combined with acupuncture for vascular dementia is better than those of simple flipping moxibustion and simple acupuncture. The combination treatment achieves better effect on TCM syndrome, cognitive function and daily activity ability than the other two simple treatment.
Subject(s)
Humans , Activities of Daily Living , Acupuncture Points , Dementia, Vascular , MoxibustionABSTRACT
<p><b>OBJECTIVE</b>To compare the effects of flipping moxibustion ofmedicine combined with western medication and simple western medication for rheumatoid arthritis with cold dampnesssyndrome.</p><p><b>METHODS</b>Eighty patients were randomly assigned into an observation group and a control group, 40 cases in each group. Oral methotrexate (1 time a week) and sulfasalazine (twice a day except the day for methotrexate) were used in the two groups. Patients in the observation group were treated with flipping moxibustion ofmedicine, twice a week. The main acupoints were Shenshu (BL 23), Guanyuan (CV 4), Zusanli (ST 36), Yinlingquan (SP 9), and the matching acupoints were in the meridians related to the disease location. All the treatment was given for continuous 4 weeks. The TCM symptom score, visual analogue scale (VAS) score, blood sedimentation (ESR), rheumatoid factor (RF) and C-reactive protein (CRP) were observed before and after treatment. The effect was evaluated.</p><p><b>RESULTS</b>The total effect rate in the observation group was 95.0% (38/40), which was better than 77.5% (31/40) in the control group (<0.05). After treatment, the VAS score, TCM symptom score, RF, ESR, CRP levels decreased in the two groups (all<0.05), with better effects in the observation group (all<0.05). The adverse reactions in the observation group were lower than those in the control group.</p><p><b>CONCLUSION</b>Flipping moxibustion ofmedicine combined with western medication for rheumatoid arthritis with cold dampnesssyndrome are better than simple western medication, which are safer and more effective.</p>
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OBJECTIVE:To evaluate the economics of azithromycin vs. amocillin clavulante in the treatment of lower respirato-ry tract infections. METHODS:System evaluation was adopted to retrieve the randomized controlled trials(RCT)about azithromy-cin(test group)vs. amoxicillin clavulanate(control group)in the treatment of lower respiratory tract infections. Information was col-lected and Meta-analyses were performed. On this basis and short-term decision tree model,cost factors were added to conduct the pharmacoeconomics by the principle of PICO of Treeage Pro 2011 edition software. RESULTS:Totally 18 RCT were enrolled,in-volving 3 365 patients. Results of Meta-analysis showed that there were no significant differences in the effective rate [RR=0.93, 95%CI(0.55,1.55),P=0.77] and incidence of adverse reactions [RR=0.79,95%CI(0.62,1.0),P=0.05] between 2 groups. The av-erage treatment cost in test group and control group was respectively 790.4 yuan and 884.4 yuan,and cost-effectiveness ratio was respectively 216.0 and 245.7,and the incremental cost-effectiveness ratio(ICER)was -1 392.59. CONCLUSIONS:Azithromycin has similar efficacy and safety to amoxicillin clavulanate in the treatment of lower respiratory tract infection,however,azithromy-cin has better cost-effectiveness.