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1.
International Journal of Traditional Chinese Medicine ; (6): 1058-1063, 2020.
Article in Chinese | WPRIM | ID: wpr-863725

ABSTRACT

Objective:To observe the clinical efficacy of Ziyin-Heyang Decoction on the treatment of glucocorticoid-dependent primary immune thrombocytopenia. Methods:A total of 70 patients with ITP in Xiyuan Hospital of China Academy of Chinese Medical Sciences from November 2015 to November 2017 who met the inclusion criteria were divided into two groups according to the random number table method. 33 cases in the treatment group and 32 cases in the control group completed the reaserch. The control group received standard dose of prednisone acetate orally, and the dose was gradually reduced according to platelet count; and the treatment group was given Ziyin-Heyang Decoction on the basis of the control group. Both groups had one course of treatment for 8 weeks, with a total of 2 courses of treatment. Before and after treatment, TCM syndrome score was performed, PLT was detected by impedance method, bleeding score was calculated, daily dosage of prednisone acetate tablets was recorded, and platelet related antibodies (PAIgA, PAIgG, PAIgM, PAIgD) were detected by flow cytometry. Then clinical and syndrome efficacy were evaluated. Results:The total effective rate was 75.8% (25/33) in the treatment group and 53.1% (17/32) in the control group, and the difference in efficacy was statistically significant ( Z=2.846, P<0.05). For the TCM syndromes, the total effective rate was 100.0% (33/33) in the treatment group and 75.0% (24/32) in the control group, and there was a statistical difference between them ( Z=3.841, P<0.05). After treatment, the platelet count improvement [(97.6 ± 39.9)×10 9/L vs. (70.9 ± 16.6)×10 9/L, t=3.540] of the treatment group was significantly higher than that of the control group ( P<0.05). The TCM syndrome score [6.00 (4.00) vs. 10.00 (6.00), Z=3.510] of the treatment group was significantly lower than that of the control group ( P<0.05). After the treatment, the dose of prednisone acetate tablets [5.00 (17.50) mg/d vs. 27.66 (11.98) mg/d, Z=4.186] of the treatment group was significantly lower than that of the control group ( P<0.05). Bleeding score decreased in both groups, but there was no significant difference between them ( P>0.05). There was no statistically significant change in platelet related antibody levels in the treatment group before and after treatment ( P>0.05). Conclusions:The Ziyin-Heyang Decoction has advantages in improving platelet count, with drawing glucocorticoid and improving symptoms.

2.
Modern Clinical Nursing ; (6): 65-71, 2017.
Article in Chinese | WPRIM | ID: wpr-612110

ABSTRACT

Objective To establish an evaluation index system for the quality and safety of the specialized nursing care in cardiovascular medicine. Methods To screen and evaluate the safety quality evaluation index via a group discussion with Delphi method and analytic hierarchy process referenced to the literatures from the evaluation index of domestic nursing safety quality (NSQ)and on the base ofthe factor quality- quality of links-final quality3-dimensional quality structure theory by Donabedian. Results The first and second round of expert consultation and the recovery rate were 97.05% (33/34) and 94.12% (32/34) respectibely, the effective rate was 100%;The authoritative coefficient of expert of the safety quality evaluation index of the specialized nursing care is 0.867 and 0.879 respectively. In the first round, the average of the importance rating is 3.50-5.00, the standard deviation is 0-0.042 and full mark rate is 34.10%-100%. In the second round, the average of the importance rating is 3.80-4.70, the standard deviation is 0~0.047 and full mark rate is 31.60%-100%. The fluctuation degree of the first round is more than 0.10 with a low coordination degree. However, the fluctuation degree of the second round result is less than 0.10. The coordination coefficients from all qustionnair scores by experts in the two roudns are 0.169 and 0.286. The difference was statistically significant according to the chi-square analysis (X2=6.842, P=0.002). The NSQ evaluatin index included 3 first degree indexes (weight coefficient including 0.2684,link qualing 0.6144,and quality 0.1172),16 second degree indicators (weight coefficient 0.034~0.0859) and 61 third degree indexes ( weight coefficient 0.034~0.0859) and 61 third degree indexes (weight coefficient 0.0052~0.0412). Conclusions This paper preliminary established a specialied NSQ evaluation index with factor quality- quality of links-final quality 3-dimensional quality structure in the field of cardiovascular medicine, which is based on Delphi method and analytic hierarchy process. NSQ provides a measurement tool for nurses in CME.

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