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ObjectiveTo explore the role of efficacy evaluation methods in providing evidence for traditional Chinese medicine （TCM） clinical practice guidelines based on a demonstration study of clinical efficacy evaluation of TCM for allergic rhinitis （AR），aiming to enrich the sources of evidence for guideline development. MethodReal-world data of TCM medication for AR were collected and efficacy evaluation was carried out. SPSS 16.0 software was used to calculate the conformity of clinical syndromes，main prescriptions， and medications to the guidelines. Correlation analysis of efficacy and medications was performed according to guideline conformity to compare the differences in medications between real-world clinical applications and current guidelines. ResultA total of 198 cases were collected and the clinical medications were compared with the relevant guidelines for AR. It was found that the clinical syndrome conformity was above 70%，and in addition to the guideline syndrome，there were also syndromes in six meridians and other mixed syndromes in clinical practice. The guideline conformity of the main prescriptions used in clinical practice showed a positive correlation trend with efficacy. There were some differences between the commonly used drugs in clinical practice and those recommended by the guidelines. For example，for lung Qi deficiency and cold syndrome，drugs such as Angelicae Dahuricae Radix， Magnoliae Flos， and Schisandrae Chinensis Fructus were often used. For kidney Yang deficiency syndrome，drugs such as Atractylodis Macrocephalae Rhizoma and Ostreae Concha were often used. For spleen Qi deficiency and weakness syndrome，drugs such as Poria， Cinnamomi Ramulus， and Magnoliae Flos were used. For lung Qi deficiency and cold syndrome in children，drugs such as Chebulae Fructus， Cicadae Periostracum， Zingiberis Rhizoma， and Ginseng Radix et Rhizoma were used. For lung and spleen Qi deficiency syndrome，drugs such as Dioscoreae Rhizoma， Menthae Haplocalycis Herba， Amomi Fructus， and Zingiberis Rhizoma were used. There were also some differences in the commonly used drugs for adults and children. For example，for lung Qi deficiency and cold syndrome，adults often used Angelicae Dahuricae Radix， Magnoliae Flos， and Tribuli Fructus，while children often used Ginseng Radix et Rhizoma， Paeoniae Radix Alba， and Poria. For lung meridian hidden heat syndrome， adults often used Bupleuri Radix， Asari Radix et Rhizoma， Pinelliae Rhizoma， and Xanthii Fructus， while children often used Houttuyniae Herba， Menthae Haplocalycis Herba， Citri Reticulatae Pericarpium， and Massa Medicata Fermentata. ConclusionEffective medication regimens can be screened out based on efficacy evaluation methods，which can help supplement immediate， objective， and clinically relevant evidence of medication for the development of clinical practice guidelines in TCM from the perspective of clinical effectiveness.
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Traditional Chinese medicine(TCM) formula granules are highly praised for the advanced, convenient, and modern use of Chinese medicinal materials. The safety of TCM formula granules has long been a concern of regulatory authorities and the medical industry. A multi-center, prospective, open, non-interventional, and centralized monitoring was carried out for the patients treated with TCM formula granules in 252 medical institutions from February 5, 2020 to April 19, 2022. All the case data and the incidence of adverse drug reactions/events were recorded. This study evaluated the safety of TCM formula granules, aiming to provide a reference for the clinically use. A total of 20 547 patients were included in this study. Four adverse events were recorded, including 3 adverse drug reactions with an adverse drug reaction rate of 0.015%, all of which occurred in the digestive system. There was no serious adverse event, and no factors related to adverse drug reactions/events were identified. The incidence of adverse drug reactions/events associated with China Resources Sanjiu Medical & Pharmaceutical Co., Ltd. TCM formula granules was rare, which proved their safety in clinical use. A comprehensive data mining and objective analysis was carried out for the medicines with high frequency in TCM formula granules, the commonly used medicine pairs and combinations, and departmental medication. The drug use characteristics, prescription rules, and departmental use of TCM formula granules were summarized, which can shed light on the prescription compatibility and clinical application.
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Humans , Medicine, Chinese Traditional/adverse effects , Drugs, Chinese Herbal/adverse effects , Prospective Studies , Drug-Related Side Effects and Adverse Reactions/epidemiology , ChinaABSTRACT
OBJECTIVE：To investigate the r ole of clinical pharmacists on the therapy for human herpesvirus 7（HHV-7） infection in central nervous system. METHODS ：The clinical pharmacists participated in the treatment process of the hospitalized patient who was a 15-year-old patient with central nervous system infection. The doctor initially gave Levetiracetam tablets （500 mg，bid，po）to control epilepsy symptoms ，and Acyclovir for injection （500 mg，q8 h，ivgtt）for antiviral treatment. According to the large red wheal scattered rubella on the limbs and back of the patient ，clinical pharmacists recommended to give Dexamethasone sodium phosphate injection （10 mg，qd，iv）and Loratadine tablets （10 mg，qd，po）for anti-allergy treatment ；in view of involuntary shaking of limbs in the patient ，clinical pharmacists recommended to continue to give Dexamethasone sodium phosphate injection intravenously to control inflammation and Xingnaojing injection （20 mL，qd，ivgtt） to improve the convulsion. For HHV- 7 infection，based on consulting the relevant guidelines and existing treatment experience ，the clinical pharmacists recommended discontinuation of acyclovir ， dexamethasone combined with Human immunoglobulin （pH 0278）（17.5 g，qd，ivgtt）for impact therapy should be used and adverse drug reactions and therapeutic effects should be monitored at the same time. RESULTS ： The physiciansaccepted the suggestions of clinical pharmacists. The patient was improved and discharged from the hospital after 18 days of treatment. CONCLUSIONS ： During the treatment of ineffective case of clinic rare central nervous system infectious diseases with routine a ntiviral drugs ，clinical pharmacists assisted physicians to improve their treatment plan and ensure the effectiveness and safety of patient ’s medication.
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OBJECTIVE: To analyse current situation of clinical drug use in diabetic retinopathy and provide reference for clinical rational drug use. METHODS: Two-stage sampling method was adopted which combines stratified sampling and holistic sampling, and conducted statistical analysis was conducted of with the clinical medication related data of diabetic retinopathy in 2018, which including 135 hospitals in 9 cities in “the cooperation project of hospital prescription analysis”. RESULTS: Seventeen Drugs for diabetic retinopathy were used in 135 hospitals in 2018, endocrinology contributed the most, and followed by ophthalmology, and outpatients accounted for 73.2%. The top 3 most frequently used drugs for diabetic retinopathy are calcium dobesilate, mecobalamin and pancreatic kininogenase, which accounted for 81.8% of the total 17 drugs prescription volume. It is lack of evidence for most drugs except for calcium dobesilate, and off-label use of DR drugs is common. CONCLUSION: The standardization of clinical medication for diabetic retinopathy needs to be further improved.
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Objective To provide references for rational clinical usage and purchase of TCM decoction pieces for blood-activating and stasis-removing. Methods Excel 2013 software was used to conduct statistical analysis on categories, consumption quantity, consumption sum and annual average growth rate of TCM decoction pieces for blood-activating and stasis-removing during 2011-2015 in TCM Hospital of Jiangsu Province (hereinafter refered to as our hospital). Results The consumption quantity and consumption sum of TCM decoction pieces for blood-activating and stasis-removing in our hospital increased year by year. Among all types of TCM decoction pieces for blood-activating and stasis-removing, TCM decoction pieces for activating blood and adjusting maridians occupied the largest amount, followed by TCM decoction pieces for activating blood and relieving pains, breaking up the static blood and eliminating masses, and blood-activating and wound - curing. The TCM decoction pieces with the biggest annual consumption quantity were Salviae Miltiorrhizae Radix et Rhizoma, Chuanxiong Rhizoma, and Curcumae Radix, and the TCM decoction pieces with the biggest annual consumption sum were Notoginseng Radix et Rhizoma, Salviae Miltiorrhizae Radix et Rhizoma, and Carthami Flos. Conclusion Both the consumption quantity and the consumption sum of the TCM decoction pieces for blood-activating and stasis-removing in our hospital have been increasing year by year. However, the proportion consumption quantity and the consumption sum of TCM decoction pieces and medicine utilization structure have kept stable, and in basically rational use.
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Objective:To provide reference for clinical pharmacists participating in the therapy and pharmaceutical care for ad-vanced breast cancer. Methods:By participating in the drug therapy for a case of advanced breast cancer with bone metastases pain, clinical pharmacists provided the medication analysis and the real-time pharmaceutical care according to the disease conditions during the treatment process. Results:Clinical pharmacists made full use of pharmacological knowledge to analyze and offer proposals on re-lieving pain, chemotherapy and bisphosphonates therapy,which guaranteed the safety of drug use. Conclusion: Medication analysis and pharmaceutical care performed by clinical pharmacists can ensure the safety and effectiveness of drug use for the patients with drug treatment.
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Objective:To provide reference for clinical pharmacists participating in the therapy and pharmaceutical care for ad-vanced breast cancer. Methods:By participating in the drug therapy for a case of advanced breast cancer with bone metastases pain, clinical pharmacists provided the medication analysis and the real-time pharmaceutical care according to the disease conditions during the treatment process. Results:Clinical pharmacists made full use of pharmacological knowledge to analyze and offer proposals on re-lieving pain, chemotherapy and bisphosphonates therapy,which guaranteed the safety of drug use. Conclusion: Medication analysis and pharmaceutical care performed by clinical pharmacists can ensure the safety and effectiveness of drug use for the patients with drug treatment.
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OBJECTIVE:To provide reference for rational use of anti-tumor essential medicine in the clinic. METHODS:The application of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 was analyzed statistically in re-spects of consumption sum,DDDs,DDC and B/A. RESULTS:The total consumption sum of anti-tumor essential medicine in 39 hospitals from Chongqing area during 2012-2014 increased from 10 083.65 ten thousand yuan to 15 186.65 ten thousand yuan,with annual increase rate of 22.72%. 3-year total consumption sum was 37 952.45 ten thousand yuan,and the sum of consumption sum of top 10 medicines was 36 742.24 ten thousand yuan,accounting for 96.81%;top 3 medicines were paclitaxel,oxaliplatin and flu-orouracil. During 2012-2014,DDDs had changed to certain extent,and the front medicines contained tegafur,paclitaxel and cyclo-phosphamide,etc;the most increment medicine was paclitaxel (oral),whose annual growth rate was 59.63%;that of tamoxifen decreased year by year,with annual decrease rate of 5.14%. DDC of paclitaxel,oxaliplatin and etoposide were the higher others. Annual B/A of oxaliplatin,fluorouracil and cytosine arabinoside were all lower than 1.00. CONCLUSIONS:The lonsumption sum and DDDs of anti-tumor essential medicine had increased reasonably in 39 hospitals from Chongqing area during 2012-2014,while their DDC had kept stable. Main medicines used in the clinic are suitable for numerous indications,and are expensive.
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Objective To understand the clinic usage of TCM decoction pieces in the First Affiliated Hospital of Xi’an Jiaotong University (hereinafter referred to as our hospital).Methods By using Microsoft Office Excel software, the medicine doses, classification of functions and clinic application of the TCM decoction pieces, which were among the top 50 most frequently used TCM decoction pieces were analyzed.Results In 2014, 60% of the top 50 most frequently used TCM decoction pieces in our hospital exceed the medicine dosage inChinese Pharmacopoeia. According to the functions, the top 3 TCM decoction pieces were medicine for reinforcing deficiency, clearing heat and promoting qi, respectively. Medicine for reinforcing deficiency was mainly used in gastroenteropathy, menopathy and nephropathy. Medicine for clearing heat was mainly used in gastroenteropathy, menopathy and infection of the upper respiratory tract. Medicine for promoting qi was mainly used in gastroenteropathy, tumor and disease of cardiovascular system.Conclusion TCM decoction pieces in our hospital exceed the medicine dosage in Chinese Pharmacopoeia, which requires attention. The top 3 TCM decoction pieces are respectively medicine for reinforcing deficiency, clearing heat and promoting qi, whose clinic applications are basically rational.
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Objective:To analyze the medication of one patient with ulcerative colitis to provide pharmaceutical care and support for rational drug use in patients with ulcerative colitis. Methods:During the treatment of the patient with severe ulcerative colitis, clin-ical pharmacists analyzed the drugs used by the patient and provided pharmaceutical care for doctors and the patient according to the ex-amination and diagnosis of the patient. Results:The compliance, therapeutic effect and medication safety of the patient were all im-proved by giving clinical drug rationalization suggestions and targeted medication monitoring and education, which fully embodied the necessity of work of clinical pharmacists in the medication of patients. Conclusion:Through case analysis, clinical thinking of clinical pharmacists can be developed to promote rational drug use, avoid adverse drug reactions and achieve optimal effect of drug treatment.
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OBJECTIVE:To investigate the status of the use of angiotensin Ⅱ receptor blocker(ARB)in the outpatient of our hospital,and provide reference for the clinical rational drug use. METHODS:Totally 2 460 prescriptions of hypertension treated by ARB drugs in the outpatient of our hospital in 2013 were statistically collected,and the use of such drugs were comprehensively an-alyzed. RESULTS:The ratio of ARB in the treatment of hypertension in the outpatient of our hospital in 2013 was 36.22%,and the common ARB drugs were Irbesartan tablets,Irbesartan and hydrochlorothiazide tablets,Valsartan capsules and Telmisartan tab-lets. The prescriptions of hypertension in our hospital were mostly two-drug combination,the common combination of ARB drugs were ARB+calcium channel blocker(CCB)and ARB+potassium-sparing diuretics;the three-drug combination of ARB drugs were ARB+β-receptor blockers (β-RB)+CCB and ARB+CCB+potassium-sparing diuretics. Among 2 460 prescriptions of hypertension treated by ARB drugs,1 103 prescriptions were irrational,accounting for 44.84%;77 prescriptions were ARB combined with po-tassium-sparing diuretics with no clear indication,accounting for 6.98%;39 prescriptions were ARB combined with ACEI with no clear indication,accounting for 3.54%;330 prescriptions were ARB combined with β-RB with no clear indication,accounting for 29.92%;617 prescriptions had inappropriate frequency of ARB use,accounting for 55.94%;and 40 prescriptions were other irra-tional use,accounting for 3.63%. CONCLUSIONS:ARB drugs are commonly used for hypertension patients in outpatient of our hospital. However,there are still many problems of irrational use in clinical treatment. Therefore,hospital should take appropriate interventions to promote the rational drug use through the joint efforts of physicians,pharmacists and hospitals.
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Objective Through the analysis of the 5.12 earthquake relief soldiers medication , to provide a reference for future e-mergency treatment relief workers .Methods May 18, 2008 to August 19, the officers and men of our hospital free treatment for earth-quake relief prescription 161 analysis.Results The skin diseases and accessories were the most reported situations and it′s up to a total of 47 prescriptions ( accounting for 29.19%) , diagnosis of insect bite dermatitis and acute bronchitis prescription , 11 and 9, respective-ly, constitute more than 6.83%and 5.59%.The first factor is the environment in emergency rescue personnel .Conclusion during the emergency relief process , rescue workers targeted prevention is very important .
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Objective:To analyze the drug use in a patient with Crohn’ s disease and provide relevant pharmaceutical service by clinical pharmacists. Methods:Clinical pharmacists participated in the treatment of the patient. The medication was analyzed according to the check results and diagnosis and treatment process, and relevant pharmaceutical service was provided for the patient and nurses. Results: Through the participation in the patient treatment and health education for the patient and nurses performed by clinical pharmacists, the patient was recovered and discharged. Conclusion: Clinical pharmacist participating in pharmaceutical service can promote rational drug use in clinics.
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OBJECTIVE: To provide reference for the rapid enhancement of clinical pharmacists's level in medication.METHODS: An "eight-part essay"style analysis was conducted with the medication orders of typical cases as example to analyze the several important items including patients' condition,drugs,and adverse drug reactions etc.RESULTS: The "eight-part essay"style case analysis sped up pharmacists' acquisition on medication analysis and help them find the start point for clinical medication.CONCLUSION: Medication analysis is very helpful in facilitating pharmacists' work and improving medical corps' drug treatment level.
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OBJECTIVE: To probe into the status quo and the tendency of the application of intravenous infusions. METHODS: Data on the application of intravenous infusions in one of the tertiary Grade A comprehensive hospital in 1996, 1999, 2002 and 2004 were analyzed statistically. RESULTS: The variety of infusion, the total quantity and the total amount of money of infusions increased year by year,the total consumption sum of infusions accounted for 10% of that of the whole year drugs; the majority of which were the consumption of nutritional and dielectric medicines, of which, glucose and sodium chloride injections accounted for 74% of the total; the infusion of treatment type increased fast, much as in cases of anti - infec-tives; the drug expense for each bottle of infusion increased year by year, the amount of money involved in infusion drugs accounted for 60% of the total year round drug consumption sum. CONCLUSION: There is an upward trend in both the quantity and consumption sum of infusions.
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OBJECTIVE:To probe into the status quo and the future tendency of the hematological system drugs used in Guangdong area.METHODS:The hematological system drugs used in over60hospitals of Guangdong area between2000and2004were analyzed statistically with respect to drug variety and amount of money.RESULTS:The amount of money of hematological system drugs increased year by year;that of the joint venture manufactured drugs and the domestic drugs in?creased year by year;filgrastim dominated the first in terms of amount of money.CONCLUSION:The domestic enterprises should strengthen the research and development of drugs and further increase their market share so as to satisfy the needs of more patients.
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OBJECTIVE:To ensure children's medication safety and to promote rational drug use.METHODS:33001ou_ t-patient transfusion prescriptions of12days in2004in our hospital were randomly sampled,in which,the irrational pre?scriptions were classified and analyzed statistically based on clinical pharmacological knowledge and literatures.RESULT:Of the total prescriptions investigated,60.56%of which were about the combined use of drugs;1354(4.10%of the total)involved irrational drug use like repeat drug application,improper combination of drugs,and improper application.CONCLUSION:To reduce the incidence of adverse drug reactions,clinicians should be provided with timely feedbacks on medication information.
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OBJECTIVE:To get to know the preoperative and postoperative medication of patients with cataract.METHODS:The preoperative and postoperative medication of 564 cases with cataract extraction in our hospital from September 2004 to October 2004 was analyzed statistically.RESULTS:Antibacterial eye gutta was mainly used before cataract extraction while compound eye gutta containing antiseptic drugs and glucocorticosteroid were chiefly used after cataract operation.CONCLUSION:The preoperative and postoperative medication for patients with cataract in our hospital was reasonable.
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OBJECTIVE:To evaluate the status quo and tendency of utilization of hypoglycemic drugs in medical insurance inpatients.METHODS:DDD was used to analyze the data of utilization of hypoglycemic drugs in medical insurance inpatients in class A grade three hospital during 2007～2009.RESULTS:The consumption sum of hypoglycemic drug used for medical patients increased year by year.The rates of increase were up to 14.04% for 2008 and 21.65% for 2009.The consumption sum of insulin increased rapidly.The rate of drug combination was 81.57% among which the rate of using two-drug was 68.66%.CONCLUSION:The new type of hypoglycemic drugs have become the main drugs in the hypoglycemics market.Domestic drug manufacturers should develop effective,safe,economical and be benefit for the treatment of complication so as to decrease medical costs and save the resources of medical insurance.
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OBJECTIVE: To investigate the use of antibiotics in our hospital. METHODS: All the prescriptions in Jan., Apr., July and Oct. in 2006 in dispensary for western medicine were reviewed, from which, 6 605 (17.26%) antibiotic prescriptions were selected. The categories and kinds of antibiotics were investigated; meanwhile the administration and dosage, course of treatment and drug combination were analyzed based on diagnosis and patient's age. RESULTS: The antibiotics used in 6 605 prescriptions totaled 7 categories. 87.80% used antibacterial drugs accorded with diagnose; 56.46% of the antibacterial drugs were administered orally; in terms of dosage and administration, more than 95% were up to the standard; the course of treatment in 86.99% ranged from 3 to 7 days; 91.04% of the antibacterial drugs used in single kind, about 8.80% in two kinds, and only 0.17% in three kinds concomitantly. CONCLUSION: The use of antibacterial drugs in our hospital is rational on the whole, yet it is far from perfect. Measures should be taken to further improve the rational drug use level.