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Objective To evaluate the effect for stroke(cerebral infarction)at acute stage intervened by traditional Chinese medicine(TCM) clinical pathway. Methods A retrospective analysis was carried out in the patients before and after intervention by TCM clinical pathway during the year of 2013-2016. The outcomes included the entrance rate,completion percentage,aberration rate,severity,hospitalization time,and hospitalization fee as well as functional prognosis 30 d after discharge. Results A total of 792 cases was included,241 cases admitted in the year of 2013, 191 in the year of 2014, 135 in the year of 2015, and 225 in the year of 2016. In the year of 2014-2016,the entrance rate,completion percentage,hospitalization time,hospitalization fee,critical case percentage,and gender constituent ratio were steadily(P > 0.05). Modified Rankin Scale(mRS)for short-term functional prognosis mRS 0 ~ 2 percentage and aberration rate in the year of 2016 were superior to those in the year of 2014 and 2015(P < 0.05). Functional improvement on discharge day 30 in the year of 2014-2016 was superior to that in the year of 2013(P < 0.05). The hospitalization time and hospitalization fee in the year of 2014-2016 were a liffle higher than those in the year of 2013(P < 0.05), showing no obvious increase. Conclusion The application of TCM clinical pathway can make the diagnosis and treatment procedure of stroke at acute stage standardized,enhance the therapeutic effect,achieve or even exceed the goal of manage scheme.
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Objective:To explore the effects of Chinese medicine clinical pharmacists participating in the formulation and imple-mentation of traditional Chinese medicine clinical pathway in orthopaedics department. Methods: Totally 60 cases of radius fracture patients were selected from 2009 to 2011 as the control group, and 54 cases of radius fracture patients were selected as the observation group in our hospital during 2015 and 2016. The observation group was instructed by both Chinese medicine clinical pharmacists and doctors;meanwhile, Chinese medicine clinical pharmacists were responsible for the entire pharmaceutical care. The clinical curative effect of the two groups, the rational use rate of traditional Chinese medicines, the average length of stay, the average cost of traditional Chinese medicines and the incidence of ADR between the groups were compared. The effect of Chinese medicine clinical pharmacists participating in the formulation and implementation of clinical pathway was evaluated. Results:After the formulation and implementa-tion of clinical pathway, the total effective rate was improved from 80. 0% to 92. 6%, the rational use rate of traditional Chinese medi-cines increased significantly from 60. 0% to 85. 2%, and the differences were statistically significant (P<0. 05). The average length of stay decreased significantly from (14.0 ±2.3) d to (11.0 ±3.1) d and the difference was statistically significant (P<0.05). Meanwhile, the average cost of traditional Chinese medicines decreased from (887. 07 ± 186. 44) yuan to (437. 14 ± 127. 32) yuan and the difference was statistically significant (P<0. 05). Moreover, the incidence of ADR decreased from 16. 7% to 11. 1%. Con-clusion:Chinese medicine clinical pharmacists should participate in the whole process of clinical pathway, which can play an important role in ensuring the implementation of clinical pathway and standardizing the rational drug use. It can significantly make the clinical medication safer,and more effective and economical. It can shorten the hospital stay and reduce the hospitalization costs as well.
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This study was aimed to evaluate the feasibility of wind-warm lung-heat disease (non-severe community-acquired pneumonia, CAP) from the clinical curative effect, hospitalization days, medical expenses and other aspects. This study selected 198 wind-warm lung-heat disease (non-severe CAP) inpatients from January, 2012 to December, 2012 with the conventional therapy in the Respiratory Department, Wuhan Integrated Traditional Chinese Medicine (TCM) & Western Medicine Hospital as the control group. And another 179 wind-warm lung-heat disease (non-severe CAP) inpatients were selected from January, 2013 to December, 2013 with the TCM clinical pathway treatment in the Respiratory Department of the same hospital as the treatment group. Retrospective analysis was used to compare the clinical curative effects, hospitalization days, and medical cost differences. The results showed that TCM clinical pathway for wind-warm lung-heat disease (non-severe CAP) can shorten the hospitalization days and reduce patients’ medical costs, and ensure the clinical curative effects. It was concluded that the standardized TCM clinical pathway had positive effect on wind-warm lung-heat disease (non-severe CAP). Therefore, the formulation and implementation of TCM clinical pathway was of great significance in the treatment of wind-warm lung-heat disease (non-severe CAP).
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Objective To investigate the effect of treating cervical spondylotic radiculopathy with traditional Chinese medicine. Methods 110 patients with cervical spondylotic radiculopathy were treated with traditional Chinese medical pathway: Chinese herbal medicine soaking (incised notoptetygium rhizome, Chinese angelica, divaricate saposhnikovia root, safflower, dahurian angelica root, myrrh, common floweringqince fruit, and tuberculate speranskia herb, etc.)-Acupuncture-cervical traction-massage, once daily, 10 times as a course of treatment. After two courses, therapeutic effect score was analyzed. Results Of all 110 cases, 35 cases(31.82%)were cured; 53 cases(48.18%)had obvious effectiveness; 17 cases(15.45%)had effectiveness; 5 cases(4.55%)had no effectiveness. The total efficiency was 95.45%. The patient's age(χ2=0.296), sex(U=0.023), and duration of disease(χ2=0.577)had no significant effect on the efficacy(P>0.05);After the treatment, neck pain, upper extremity pain, upper extremity numbness, neck tenderness, intervertebral foramina compression test, sensory disturbances limbs, myodynamia of upper limbs, and tendon reflexes were significantly improved compared with before treatment, with significant difference(t=16.355、11.958、7.755、4.927、11.780、8.647、10.485、3.190、3.873、3.367,P<0.05). Conclusion The use of traditional Chinese medicine clinical pathway in treating cervical spondylotic radiculopathy was effective and it could improve the quality of medical care.
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Objective To analyze the effect of implementing traditional Chinese medicine (TCM) clinical pathway on family sickbed patients.Methods Those family sickbed patients with herpes zoster or facial neuritis were involved in this study.Their medical records and data of ‘Family sickbed quality control scale’ were collected,in which there are methods of TCM clinical pathway,decoction of the Chinese Medicine,ingredients and treatment procedures of the topically used TCMs,and acupuncture treatment procedures were documented.The family sickbed days,prognosis,informed rate and satisfaction rate were analyzed before and after TCM clinical pathway treatment.Results In the treatment group,the family sickbed days (11.67± 1.91)d and referral rate 12.20％ (10/82) were significantly lower (P＜ 0.01) than those in the control group [(1 3.88 ± 2.61) d,50.00％ (41/82) respectively].The rate of cure87.80％ (72/82),the rate of informed patient 97.56％ (80/82) and the rate of satisfaction91.46％ (75/82) were significantly higher(P＜ 0.01)than those in the control group [50.00％ (41/82)、65.85％ (54/82)、50.00％ (41/82) respectively].Conclusion The clinical pathways for family sickbed patients with herpes zoster or facial neuritis were effective.