ABSTRACT
Objective:To evaluate the clinical efficacy of Bupi Qingfei decoction in the treatment of bronchiectasis colonized by<italic> Pseudomonas aeruginosa</italic> （PA） （lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome）. Method:A total of 72 bronchiectasis patients colonized with PA （ lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome ） were randomly divided into the observation group （36 cases， two cases were lost to follow-up and three dropped out） and control group （36 cases， three cases were lost to follow-up and four dropped out）. There were 31 cases in the observation group and 29 cases in the control group completing the trial. Patients in the observation group were treated with Bupi Qingfei decoction orally，once in the morning and again in the evening， one bag every other day， and simulated azithromycin tablet at the dose of 0.5 g，once every other day， while those in the control group with azithromycin tablet at 0.5 g，once every other day， and simulated Bupi Qingfei decoction， once in the morning and again in the evening， one bag every other day. Patients in both groups received health education and postural expectoration. The treatment lasted for 24 weeks，followed by a 24-week follow-up. The frequency of acute exacerbation，quality of life （St. George's Respiratory Questionnaire） score，traditional Chinese medicine （TCM） syndrome score，lung function ［forced expiratory volume in one second percentage of predicted（FEV<sub>1</sub>%pred） and FEV<sub>1</sub>/forced vital capacity（FVC）］， and serum immunoglobulin （Ig）A，IgE，IgG，and IgM levels of the two groups were evaluated after treatment. Result:The frequencies of acute exacerbation after 24 weeks of treatment and during the 24-week follow-up in the observation group were lower than those in the control group （<italic>P</italic><0.05）. The total quality of life （St. George's Respiratory Questionnaire） score and symptom scores in the observation group after 24 weeks of treatment were significantly decreased as compared with those before treatment （<italic>P</italic><0.05）. There was no significant improvement in the quality of life in the control group either after 24 weeks of treatment or during the 24-week follow-up. The effective rate against TCM syndrome in the observation group was 64.52%（20/31） after 12 weeks of treatment，which was obviously higher than 31.03%（9/29） in the control group （<italic>χ</italic><sup>2</sup>=6.726，<italic>P</italic><0.05）. After 24 weeks of treatment，the effective rate in the observation group was 83.87%， slightly higher than 68.97% in the control group. After 12 and 24 weeks of treatment，the scores of cough，expectoration，fatigue，anorexia，spontaneous sweating，abdominal distension， and loose stool in the observation group were better than those in the control group （<italic>P</italic><0.05）. There were no significant changes in lung function and serum immunoglobulin classes in the two groups. Conclusion:Bupi Qingfei decoction is effective in reducing the frequency of acute exacerbation， alleviating the symptoms， and improving the quality of life of bronchiectasis patients colonized by PA （lung-spleen Qi deficiency syndrome and phlegm heat accumulating in lung syndrome）.
ABSTRACT
Objective: To compare and analyze the patient perceived quality of care in primary health institutions within medical groups from the experience of Zhenjiang city in Jiangsu Province. Methods : Random selection was used picking the districts and community health centers. In this paper, one district was randomly selected from each medical group,and then one community health center (CHC) was randomly selected in the sample district. The Primary Care Assessment Tool survey (PCAT) was conducted in the sample primary health institutions. Thereafter, data analysis was conducted using the ddescriptive statistics and multi-linear regression methods. Results : Research results showed that the PCAT total score of CHC in Rehabilitation Medical Group (25. 21 ) was significantly higher than that in Jiangbin Medical Group (23.06) with the variation coefficient of β =2. 191. Except for the "extent of affiliation with a place" and " coordination (information systems),,,PCAT scores in all the other core domains were significantly higher in Rehabilitation Medical Group than those in Jiangbin Medical Group. Conclusion : Given the PCAT results, patients perception on quality of care in primary health institutions figuring in Rehabilitation Medical Group was better than those in Jiangbin Medical Group. The close relationship in management and technical skills, and the formation of interest allocation mechanism probably probably contributed into the way towards the results.