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1.
Braz. j. oral sci ; 20: e219320, jan.-dez. 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1253013

ABSTRACT

Aim: This study analyzed the effect of whitening mouth rinses on water sorption (WS), solubility (SL), color change, and surface roughness of a nanofilled composite. Whitening perceptibility and acceptability (WID) were also studied. Methods: Forty specimens of Filtek Z350XT, shade EA2 were produced and randomly distributed (n=8) to AS ­ artificial saliva (control); LWE ­ Listerine Whitening Extreme; CLW ­ Colgate Luminous White; LCM ­ Listerine Cool Mint; and CP ­ Colgate Plax. They were immersed in the mouth rinses 2x/day, for one minute, during 28 days. The color was assessed using an Easyshade spectrophotometer (CIE-L*a*b* system). Surface roughness (Ra-µm) was measured with three parallel measures, using an RP-200 roughness meter. The WS and SL (µg/mm-3) were analyzed based on the ISO 4049 recommendations. The data were analyzed using one- and two-way ANOVA/Tukey tests (α=0.05). Results: Surface roughness significantly increased after immersion in AS and LCM, with no significant differences between the groups either before or after immersion. The ΔE* was not significantly different between the groups. All substances produced a ΔWID higher than the 50%:50% perceptibility and acceptability thresholds. The WS and SL were not significantly affected by the mouth rinses. Conclusion: Whitening mouth rinses did not affect WS, SL, surface roughness, and color stability of a nanofilled composite, regardless of the presence of ethanol in the composition


Subject(s)
Color , Composite Resins , Nonprescription Drugs , Tooth Bleaching Agents , Mouthwashes
2.
Article in Chinese | WPRIM | ID: wpr-879196

ABSTRACT

Chinese patent medicine prescriptions containing Jujubea Fructus in 2015 edition of Chinese Pharmacopoeia and the Composition Principles of Chinese Patent Drug were collected, and the characteristics of Chinese patent medicine containing Jujubea Fructus were analyzed by using data mining technology. Statistical software Excel 2019, Clementine 12.0 and SPSS 21.0 were used to conduct statistical analysis of conforming Chinese patent medicine prescriptions by means of frequency statistics, association rule analysis and cluster analysis. Finally, a total of 185 Chinese patent medicine prescriptions containing Jujubea Fructus were included in this study, involving 402 Chinese medicines and 28 kinds of high frequency Chinese medicines, with Jujubea Fructus, Poria, Zingiberis Rhizoma Recens, Glycyrrhizae Radix et Rhizoma, and Codonopsis Radix as the top five. The deficiency-nourishing drugs were in the most common efficacy classification, mainly sweet, bitter and pungent, with most medicine properties of warm and gentle, main meridians of spleen lung and stomach, dosage forms of pills, granules and tablets, and main indications of splenic diseases. Fifteen drug combinations were obtained in association rule analysis. Eleven drug combinations were obtained by association rule analysis of Chinese patent medicine containing Jujubea Fructus in the treatment of splenic diseases, and the drugs were divided into two categories by cluster analysis. According to the above analysis, it is found that the Chinese patent medicine prescriptions containing Jujubea Fructus are mainly composed of deficiency-nourishing drugs, mostly compatible with drugs of sweet, bitter and pungent flavors, warm and gentle properties, and spleen, lung, and stomach meridians in the treatment of splenic diseases, with Sijunzi Decoction as the main drug. This study provides guidance for modern clinical application and development of Jujubea Fructus.


Subject(s)
China , Data Mining , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Nonprescription Drugs
3.
Article in Chinese | WPRIM | ID: wpr-879195

ABSTRACT

Network Meta-analysis was used to evaluate the efficacy and safety of different oral Chinese patent medicines combined with transcatheter arterial chemoembolization(TACE) in the treatment of primary liver cancer. Randomized controlled trials of oral Chinese patent medicines for primary liver cancer were retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, Cochrane Library and EMbase databases from inception to May 2020. According to the Cochrane recommendation standard, the quality of the included articles was evaluated, and the data were analyzed by RevMan, R software and GeMTC software. A total of 10 kinds of oral Chinese patent medicines and 68 RCTs were included. Network Meta-analysis results showed that: as compared with TACE alone, 10 kinds of oral Chinese patent medicines combined with TACE showed advantages in effective rate, 1-year survival rate, 2-year survival rate, KPS score improvement rate and reduced adverse reaction incidence. In the pairwise comparison of oral Chinese patent medicines, the results showed that Cidan Capsules were superior to Jinlong Capsules and Xihuang Pills in 1-year survival rate. According to the probabi-lity ranking results: Shenyi Capsules and Ganfule were more obvious in improving the effective rate; Cidan Capsules and Shenyi Capsules were more effective in improving the 1-year survival rate; Pingxiao Capsules and Shenyi Capsules had better efficacy in improving 2-year survival rate; Huaier Granules and Shenyi Capsules had better efficacy in improving the quality of life; Huisheng Oral Liquid and Ganfule were more effective in reducing the incidence of adverse reactions(such as nausea, vomiting and leukocytosis). The current evidence showed that oral Chinese patent medicine combined with TACE was superior to TACE alone in efficacy and safety. In terms of the effective rate, 1-year survival rate, 2-year survival rate, KPS score improvement rate and reduced adverse reaction incidence, the optimal treatment measures were Shenyi Capsules, Cidan Capsules, Pingxiao Capsules, Huaier Granules and Huisheng Oral Liquid in turn. However, due to the limitations of the research, the current level of evidence is not high, and clear conclusions and evi-dence strength still need to be further verified and improved by high-quality researches.


Subject(s)
Carcinoma, Hepatocellular/drug therapy , Chemoembolization, Therapeutic , China , Drugs, Chinese Herbal , Humans , Liver Neoplasms/drug therapy , Network Meta-Analysis , Nonprescription Drugs , Quality of Life
4.
Article in Chinese | WPRIM | ID: wpr-879121

ABSTRACT

Traditional Chinese medicines(TCMs) have certain limitations in the clinical research design in their post-marketing evaluation, so that randomized controlled programs cannot be strictly implemented in some studies, while the objective performance criteria is a reasonable external controlled research method that has been gradually recognized at home and abroad in recent years in addition to randomized controlled trial(RCT) method. It is more mature in medical devices, surgery and other research fields, but there is no relevant report in the field of post-marketing evaluation of Chinese patent medicines. In this paper, the application prospect of the objective performance criteria and the problems were discussed in the field of post-marketing evaluation of TCM. The characteristics of as TCM are more consistent with the scope of the objective performance criteria, the application of the objective performance criteria in post-marketing evaluation of Chinese patent medicines, especially in single arm research, can break through the limitations of existing conventional clinical research methods, and improve the level of evidence, with good feasibility and advantages. However, in the application process, we should pay attention to the key issues such as the selection of index, research population, follow-up period and the reference selection, to ensure the quality of research. This research group has carried out some exploration and practice in the field of post-marketing evaluation of TCM injections by using single arm combined with the objective performance criteria, hoping to establish the key technology in this field, and provide certain research and design reference for the secondary development of Chinese patent medicines.


Subject(s)
Drugs, Chinese Herbal , Marketing , Medicine, Chinese Traditional , Nonprescription Drugs , Product Surveillance, Postmarketing , Randomized Controlled Trials as Topic
5.
Article in Chinese | WPRIM | ID: wpr-879119

ABSTRACT

Classical Chinese patent medicines(CPMs) are a kind of modern preparation developed from the experience of compatibility and application about ancient prescriptions. Its rich history of human use and reliable clinical efficacy imply the unique theoretical essence and precious value of traditional Chinese medicine(TCM). With the development of evidence-based medicine and the improvement of medical policy, it is particularly urgent to evaluate the clinical values of post-marketing classical CPMs. In this paper, some problems on the clinical value evaluation of CPMs would be described, and it is considered that the simplified evaluation procedures can lead to the lack of evidence for evaluating clinical value of CPMs, causing the difficulty in evaluating the quality of CPM, lack of R&D motivation of enterprises, low content of science and technology, and poor international development. Based on this background, it points out that the clinical value evaluation is the core of the post-marketing evaluation of the classical CPMs, and the eva-luation should be based on the direction of literature research and the latest practice. We should adhere to the research mode of combination disease with syndrome, and select the appropriate type of trials, with clinical efficacy, health economic benefits and safety eva-luation as the main content of the studies, in order to refine the indications and standardize the clinical positioning. Clinical value eva-luation is the basis and main content of post-marketing comprehensive researches on classic and famous CPMs to clarify their clinical value, obtain the conditions for continued marketingand standardize their clinical application, so as to optimize the evidence and quality service of classic and famous CPMs and inherit the core value concept of Chinese medicine.


Subject(s)
China , Drugs, Chinese Herbal , Humans , Marketing , Medicine, Chinese Traditional , Nonprescription Drugs
6.
Article in Chinese | WPRIM | ID: wpr-879118

ABSTRACT

Traditional Chinese medicine(TCM) is an important feature of cancer treatment in China. The methods to tap the advantages of TCM, reasonably evaluate and accurately apply Chinese patent medicines have become current research hotspots and difficulties. TCM takes syndrome differentiation and treatment as the core, with the characteristics of overall regulation and multi-targets efficacy. Therefore, the post-marketing survival benefit evaluation of Chinese patent medicines for cancer is different from that in modern medicine. The primary treatment goals in cancer patients include to improve the disease control rate and prolong their survival time. At present, Chinese patent medicines for cancer patients are lacking indepth studies on survival benefit at the post-marketing stage. In addition, the characteristics of individualized treatment with TCM have also increased the complexity of clinical research on TCM. Therefore, it is of certain practical significance and necessity to evaluate the survival benefit of Chinese patent medicines for cancer after marketing. Based on this, in this paper, we first summarized the technical methodological means of survival benefit evaluation at this stage, and then explored the post-marketing survival benefit evaluation of Chinese patent medicines for cancer from three aspects: the evaluation of cancer treatment effect based on survival time and quality of life, treatment-related toxicity and the auxiliary effect of TCM, and the improvement effect for tumor-related symptoms. Based on the practices of early clinical researches, and according to the insufficient efficacy evaluation of current clinical research on Chinese patent medicines, this paper proposed to improve the evaluation system for clinical researches on Chinese patent medicines, establish the evaluation method with TCM characteristics, clarify the dominant population, lay a theoretical foundation for the evaluation of post-marketing survival benefits of Chinese patent medicines for cancer in the future, and promote the modernization process of TCM.


Subject(s)
China , Drugs, Chinese Herbal/therapeutic use , Humans , Marketing , Medicine, Chinese Traditional , Neoplasms/drug therapy , Nonprescription Drugs/therapeutic use , Quality of Life
7.
Article in Chinese | WPRIM | ID: wpr-879117

ABSTRACT

At present, the value evaluation of Chinese patent medicines is in the exploratory stage, and a clinical value evaluation system that can reflect the characteristics of traditional Chinese medicine has not been established. This article investigates four universal drug value tools from abroad, namely, evidence rating matrix, cancer value label, patient-perspective value framework and multiple criteria decision analysis advance value framework. The evidence rating matrix is used to measure the benefits and risks of different treatment measures, and the net health benefit is used as the best estimate point to evaluate the value of treatment; the cancer value label is mainly used to weigh the economic value and innovative value of drug treatment programs of different anti-tumor drugs by matrix composed the ratio between the expected result and the cost; the patient-perspective value framework emphasizes the evaluation of the value of different healthcare intervention methods from the patient's perspective; multiple criteria decision analysis advance value framework measures the value of drugs or measures from multiple dimensions. Combined with the characteristics of the above universal drug value evaluation tools and the correlation research of domestic drug value evaluation, the paper proposes to analyze the characteristics of Chinese patent medicine value evaluation from the six dimensions of effectiveness, safety, innovation, economy, suitability and accessibility of Chinese patent medicine, and expounds the strategy of constructing Chinese patent medicine value evaluation tool, so as to provide reference for the drug value evaluation and decision-making application of Chinese patent medicine.


Subject(s)
China , Drugs, Chinese Herbal , Humans , Medicine, Chinese Traditional , Nonprescription Drugs
8.
Article in Chinese | WPRIM | ID: wpr-879116

ABSTRACT

The article summarized the relevant researches on the clinical orientation of Chinese patent medicines, and put forward the post-marking principle and strategies of the clinical orientation. The principle could be illustrated by four criteria: overall design, step-by-step implementation, from easiness to hardness, gradual concentration. The strategies were as follows: first carrying out the projects with little cost of money and time, and then the projects requiring much cost of money and time, so that the possibility of fai-lure would be put forward at an early stage to reduce the loss caused by research failure as much as possible by consolidating the research projects with less investment at the early stage and gradually increasing the research projects with more investment at the later stage. On this basis, the "three dimensions and four stages" key technology was proposed for the post-marketing clinical orientation of traditional Chinese medicine. Medicines, diseases and patients were the "three dimensions", so we should understand the features and interaction of the target indications, symptoms and population to establish a three-dimensional clinical positioning coordinate system. "Four stages" were the four steps of clues analyzing, hypothesis orientation, preliminary verification and clinical validation. Each latter stage should be started after full completion of the former one, and the latter stage results shall be used to validate and revise the former clinical orientational hypothesis, continuously forming a feedback circle. Based on the sufficient verification of previous study, prospective clinical trials were implemented at last to get the best evidence-based evidence of clinical orientational hypothesis.


Subject(s)
Drugs, Chinese Herbal , Humans , Marketing , Medicine, Chinese Traditional , Nonprescription Drugs , Prospective Studies
9.
Article in Chinese | WPRIM | ID: wpr-879031

ABSTRACT

It is the core of the development for Chinese patent medicine enterprises to cultivate large varieties of Chinese patent medicine, and the selection of potential "seed" products is the prerequisite for the cultivation strategy. By constructing the evaluation model from multiple dimensions of value and risk, we can conduct specialized evaluation of Chinese patent medicines to effectively, professionally and objectively select the "seed" products with large variety cultivation potential. In this paper, the establishment of a multidimensional evaluation system would be discussed from the aspects of drug naming and prescription composition, safety risk and supply guarantee of raw materials and medicinal materials, competition situation, access to policy catalogue, scientific and technological support, clinical evidence and recognition, systematical and standardized collection of information on product instructions, quality standards, policy catalogue, scientific and technological literature, market competition and clinical application of Chinese patent medicines. Through the objective evaluation index and the range of objective index, the multi-dimensional evaluation model on values and risks of Chinese patent medicine products was discussed. Based on this model, a batch of Chinese patent medicine products can be quickly and comprehensively analyzed, and quantitative comparison can be formed among different types and fields of products. According to the evaluation results of the model and the comprehensive evaluation of experts, high-quality "seed" products can be selec-ted, laying a solid foundation for the next step of large variety cultivation. With use of this model, we can further clarify the external competitive advantages and internal priority levels of each product, and provide support for enterprises to optimize product structure and improve product strategic layout.


Subject(s)
China , Drugs, Chinese Herbal/adverse effects , Medicine, Chinese Traditional , Nonprescription Drugs/adverse effects , Quality Control
10.
Article in Chinese | WPRIM | ID: wpr-878978

ABSTRACT

Single herbs and Chinese patent medicine preparations often have bad taste, such as bitterness and astringency, which is one of the key factors affecting patients' medication compliance, and would affect the therapeutic effect and restrict the extensive application in clinical practice. Therefore, how to make use of taste masking techniques to improve the bad taste of traditional Chinese medicines has become an important project. Through the collection and summarization of Chinese and foreign journals and papers in recent years, this paper discussed the generation mechanism of bitter taste, the new methods of masking bitter taste and the evaluation me-thods of bitter taste, in order to provide references for the taste masking of Chinese patent medicines preparations.


Subject(s)
Astringents , China , Humans , Medicine, Chinese Traditional , Nonprescription Drugs/pharmacology , Taste
11.
Article in Chinese | WPRIM | ID: wpr-878964

ABSTRACT

To evaluate the efficacy and safety of Chinese patent medicine in the treatment of knee osteoarthritis(KOA) with network Meta-analysis, and provide evidence-based medicine evidences for clinical practice. PubMed, Cochrane Library, EMbase, CNKI, Wanfang, VIP and CBM were used to search for clinical randomized controlled trials(RCTs) on Chinese patent medicines for treatment of knee osteoarthritis, with a time limit from the establishment of each database to March 2020. The bias risk assessment tool recommended by Cochrane was used to evaluate the quality of the included RCTs. The network Meta-analysis was performed by Stata 14.0 software. A total of 5 788 patients in 58 RCTs were included, involving 9 kinds of Chinese patent medicines. The results of the network Meta-analysis indicated that in terms of total effective rate, the top three optimal medication regimens were Jinwu Gutong Capsules + Amino Acid Glucose(AAG), Xianling Gubao + AAG and Biqi Capsules; the top three interventions to reduce the VAS score were Panlongqi Tablets > Xianling Gubao + AAG > Xianling Gubao + non steroidal anti-inflammatory drugs(NSAIDs); the top three interventions to reduce the total score of WOMAC were Jintiange Capsules+NSAIDs> Jinwu Gutong Capsules + AAG > Biqi Capsules + NSAIDs; the top three medication schemes with better curative effect to reduce Lequesnse index were Xianling Gubao + NSAIDs > Biqi Capsules + NSAIDs > Jintiange Capsules + NSAIDs; the top three interventions to reduce TNF-α level Xianling Gubao + AAG > Jintiange Capsules > Jintiange Capsules + AAG=Jinwu Gutong Capsules + AAG. In terms of safety, the top five interventions with the least adverse reactions were Biqi Capsules > Jinwu Gutong Capsules > Biqi Capsules + NSAIDs > Xianling Gubao + NSAIDs > Jintiange Capsules. The combined application of Chinese patent medicine and NSADIs or AAG can improve the clinical treatment effect and reduce adverse reactions in KOA patients.


Subject(s)
Biological Products , China , Drugs, Chinese Herbal , Humans , Network Meta-Analysis , Nonprescription Drugs , Osteoarthritis, Knee/drug therapy
12.
Article in Chinese | WPRIM | ID: wpr-878897

ABSTRACT

Network Meta-analysis was used to compare the efficacy and safety of Chinese patent medicines in the treatment of unstable angina pectoris. PubMed, Cochrane Library, CNKI, Wanfang, VIP and other databases were retrieved by computers from the establishment of the databases to June 2020. Randomized controlled trials(RCTs) of Chinese patent medicines for the treatment of unstable angina pectoris were collected. Two investigators independently screened out the literatures, and extracted data according to the inclusion and exclusion criteria. The quality of the included RCTs was evaluated according to the bias risk assessment tool recommended by the Cochrane System Reviewer Manual, and the Stata 13.0 software was used for data analysis and mapping. Through screening, 28 eligible studies were finally included, with the sample size of 2 885 cases, involving 8 Chinese patent medicines. The results of the network Meta-analysis showed that in terms of total effective rate for angina symptom improvement, the order was as follows: Shenshao Capsules > Naoxintong Capsules > Ginkgo Ketone Ester Dripping Pills > Compound Danshen Dripping Pills > Ginkgo Leaf Tablets > Shexiang Baoxin Pills > Tongxinluo Capsules > Yindan Xinnaotong Soft Capsules; in terms of total effective rate for ECG curative effect, the order was as follows: Ginkgo Ketone Ester Dripping Pills>Compound Danshen Dripping Pills > Tongxinluo Capsules > Shenshao Capsules > Shexiang Baoxin Pills > Yindan Xinnaotong Soft Capsules; in terms of hypersensitivity-C-reactive protein curative effect, the order was as follows: Tongxinluo Capsules > Shenshao Capsules > Ginkgo Leaf Tablets>Compound Danshen Dropping Pills> Shexiang Baoxin Pills > Naoxintong Capsules > Yindan Xinnaotong Soft Capsules > Ginkgo Ketone Ester Dropping Pills. Chinese patent medicine combined with conventional therapy can improve the clinical efficacy of unstable angina pectoris. Due to the differences in the quantity and quality of the included studies, the order results of Chinese patent medicines need to be further verified.


Subject(s)
Angina, Unstable/drug therapy , China , Drugs, Chinese Herbal , Humans , Medicine, East Asian Traditional , Network Meta-Analysis , Nonprescription Drugs
13.
Rev. bras. promoç. saúde (Impr.) ; 33: 1-10, 03/01/2020.
Article in English, Portuguese | LILACS | ID: biblio-1099875

ABSTRACT

Objetivo: Analisar o uso de medicamentos por automedicação em pacientes renais crônicos hemodialíticos. Métodos: Estudo quantitativo, descritivo e transversal, realizado em um centro de tratamento hemodialítico, na região Sudoeste da Bahia, em março de 2015, por meio da aplicação de formulário contendo variáveis sociodemográficas, clínicas e farmacoterapêuticas de 170 pacientes. A amostra compôs-se de pacientes em tratamento hemodialítico crônico há mais de um ano, com idade maior ou igual a 18 anos. Utilizou-se o Epidata 3.1 como banco de dados. Realizou-se análise descritiva e empregou-se o método de regressão logística binária, usado para avaliar a associação entre automedicação e variáveis independentes, utilizando o programa SPSS, versão 21.0. Resultados: Dos participantes, 64,1% (109) eram homens, com idade média de 50,5 anos (± 14,9); 57% (98) possuíam renda menor que um salário mínimo; 20% (34) nunca estudaram; 48,2% (82) estavam dialisando em período de um a cinco anos e 92,9% (158) não possuíam plano de saúde. Contabilizaram-se 104 medicamentos utilizados por automedicação, com destaque para o calcitriol (9,6%) e a clonidina (6,7%). Verificou-se que pacientes com maior escolaridade (OR=1,32; IC95%=1,32-28,72) e que usam sobra de medicamentos em casa (OR=22,48; IC95%=6,53-77,38) têm mais chances de se automedicar. Conclusão: Há baixa frequência de automedicação na população de renais crônicos investigada, sendo associada ao uso de medicamentos guardados em casa e à baixa escolaridade.


Objective: To analyze self-medication in chronic kidney disease patients on hemodialysis. Methods: A quantitative descriptive cross-sectional study was conducted at a hemodialysis center in Southwestern Bahia in March 2015 using a form to collect sociodemographic, clinical and drug therapy data from 170 patients in March 2015. The sample comprised patients undergoing chronic hemodialysis treatment for over one year aged 18 years or older. Epidata 3.1 was used as a database. Descriptive analysis was performed and binary logistic regression was used to check for associations between self-medication and independent variables using the SPSS software version 21.0. Results: In all, 64.1% (109) of the participants were men and the mean age was 50.5 years (±14.9). 57% (98) of the participants earned less than one minimum wage, 20% (34) had never studied, 48.2% (82) had been on dialysis for one to five years, and 92.9% (158) had no health insurance. We confirmed self-medication of 104 drugs, particularly calcitriol (9.6%) and clonidine (6.7%). Patients with higher levels of education (OR=1.32; 95%CI=1.32-28.72) and those who use leftover drugs at home (OR=22.48; 95%CI=6.53-77.38) were more likely to self-medicate. Conclusion: The rate of self-medication in chronic kidney disease patients is low and it is associated with the use of drugs stored at home and low levels of education.


Objetivo: Analizar el uso de medicamentos por automedicación de pacientes renales crónicos en hemodiálisis. Métodos: Estudio cuantitativo, descriptivo y transversal realizado en un centro de tratamiento de hemodiálisis de la región Sudoeste de Bahía en marzo de 2015 a través de la aplicación de un formulario con variables sociodemográficas, clínicas y de tratamiento farmacológico de 170 pacientes. La muestra ha sido de pacientes en tratamiento de hemodiálisis desde hace más de un año con edad mayor o igual a 18 años. Se utilizó el Epidata 3.1 para el banco de datos. Se realizó un análisis descriptivo y se utilizó el método de regresión logística binaria para evaluar la asociación entre la automedicación y las variables independientes con el programa SPSS, versión 21.0. Resultados: Entre los participantes, el 64,1% (109) era hombres con edad media de 50,5 años (± 14,9); el 57% (98) tenía renta de menos de un sueldo mínimo; el 20% (34) nunca ha estudiado; el 48,2% (82) realizaba la hemodiálisis desde el periodo entre uno y cinco años y el 92,9% (158) no tenía seguro de salud. Se ha contabilizado 104 medicamentos utilizados por la automedicación con énfasis para el calcitriol (9,6%) y la clonidina (6,7%). Se verificó que los pacientes con mayor escolaridad (OR=1,32; IC95%=1,32-28,72) y los que usan lo que queda de los medicamentos que tienen en casa (OR=22,48; IC95%=6,53-77,38) tienen más oportunidades para la automedicación. Conclusión: Hay baja frecuencia de automedicación en la población de renales crónicos investigados y la misma se asoció con el uso de medicamentos almacenados en casa y las personas de baja escolaridad.


Subject(s)
Outpatients , Renal Dialysis , Pharmacoepidemiology , Drug Utilization , Nonprescription Drugs , Renal Insufficiency, Chronic
14.
Article in Chinese | WPRIM | ID: wpr-878795

ABSTRACT

To systemically assess the clinical efficacy of oral Chinese patent medicine for migraine by using network Meta-analysis. Four Chinese databases(CNKI, VIP, WanFang, CBM), three English databases(Medline, EMbase, Cochrane Library) and ClinicalTrials.gov were systematically and comprehensively retrieved from the establishment of each database to April 24, 2020. Rando-mized controlled trial(RCT) on oral Chinese patent medicine combined with Flunarizine for migraine were screened out according to inclusion criteria and exclusion criteria. Literature screening and data extraction were conducted independently by 2 researchers. The included studies were evaluated with the Cochrane bias risk assessment tool. Data analysis was conducted by using Stata 16.0 software. Finally, a total of 52 RCTs were included, involving 11 kinds of oral Chinese patent medicines. The results of the network Meta-analysis showed that in terms of headache frequency, the order of efficacy was: Flunarizine combined with Tongtian Oral Liquid>combined with Zhengtian Pills>combined with Toutongning Capsules>combined with Yangxue Qingnao Granules>combined with Tianshu Capsules>combined with Xuefu Zhuyu Capsules>combined with Danzhen Toutong Capsules>combined with Chuanxiong Qingnao Granules>combined with Songling Xuemaikang Capsules. In terms of headache intensity, the order of efficacy was: Flunarizine combined with Tongtian Oral Liquid>combined with Zhengtian Pills>combined with Danzhen Toutong Capsules>combined with Tianshu Capsules>combined with Toutongning Capsules>combined with Chuanxiong Qingnao Granules>combined with Yuntongding Capsules>combined with Yang-xue Qingnao Granules>combined with Danqi Soft Capsules. In terms of headache lasting time, the order of efficacy was: Flunarizine combined with Tongtian Oral Liquid>combined with Yangxue Qingnao Granules>combined with Toutongning Capsules>combined with Zhengtian Pills>combined with Danzhen Toutong Capsules>combined with Tianshu Capsules>combined with Xuefu Zhuyu Capsules>combined with Yuntongding Capsules>combined with Chuanxiong Qingnao Granules>combined with Songling Xuemaikang Capsules. The results showed that oral Chinese patent medicines combined with Flunarizine were effective in improving the clinical efficacy for migraine. Due to the differences in the number and quality of studies included in studies of different Chinese patent medicines, and the lack of direct comparison of Chinese patent medicines, the results of the above order of Chinese patent medicines need to be demonstrated in future multi-center, large-sample, and double-blind randomized trial.


Subject(s)
Asian Continental Ancestry Group , Drugs, Chinese Herbal , Humans , Medicine, East Asian Traditional , Migraine Disorders/drug therapy , Network Meta-Analysis , Nonprescription Drugs
15.
Article in Chinese | WPRIM | ID: wpr-828440

ABSTRACT

Traditional Chinese medicine(TCM) syndrome differentiation and treatment has a characteristic and advantageous efficacy in the prevention and treatment of major diseases(no matter for new or sudden infectious diseases or major chronic diseases). At present, the clinical application by Western medicine disease's name, stage, classification and other indications limits the role of TCM syndrome differentiation and treatment, and makes TCM difficult to play its advantages. Therefore, the therapeutic value and social value attribute of Chinese patent medicine after being launched in the market cannot be effectively demonstrated, or even generalized as adjuvants. Under the circumstances, it is difficult to put forward precise positioning different from chemical drugs, with fewer high-level and high-quality evidence-based evidences for precise positioning. The research on the pathological links and therapeutic mechanism of its effect on diseases is also less systematic. The development of biotechnology, such as genomics, has brought medicine into the era of precision, providing ideas and technical support for the exploration of syndrome biomarkers and the analysis of therapeutic mechanism with them as parameters. Digital China Think Tank Forum once mentioned that the development of sequencing technology provides 100% of human genetic code, while only 3% can understand it. Block data 4.0: activation data in the era of artificial intelligence puts forward the concept of activation data, which can be regarded as a theoretical hypothesis for big data, provides a new cognitive thinking and solution for increasingly prominent data paradox between bioinformation explosion and clinical big data, and is a bridge between cross-border data association and fusion. After deeply mining the dominant and recessive value of clinical data and histological data, we can make the pathogenesis of syndrome differentiation and treatment from dark knowledge to clear knowledge. Therefore, with Chinese patent medicine as the guide, the research on the efficacy and mechanism of precise positioning of traditional Chinese medicine after marketing is carried out, and the precise system of "syndrome, disease, function, pathological link and biological connotation" is constructed, which provides a powerful basis and support for increasing the scientific and technological content of varieties.


Subject(s)
Artificial Intelligence , China , Drugs, Chinese Herbal , Humans , Medicine, Chinese Traditional , Nonprescription Drugs
16.
Article in Chinese | WPRIM | ID: wpr-828413

ABSTRACT

Lanqin Oral Liquid is a Chinese patent medicine which contains Isatidis Radix, Scutellariae Radix, Gardeniae Fructus, Phellodendri Chinensis Cordex and Sterculiae Lychophorae Semen. It is known for the pharmaceutical effect on the upper respiratory tract infection as it is beneficial for relieving the swelling of pharyngeal. In terms of Chinese medicine, it offers a clearing action on heat and toxic materials. According to the principle of Chinese medicine, different diseases can be treated by the same therapy as long as they have the same syndrome. Based on this unique diagnosis and treatment approach, Lanqin Oral Liquid was applicable to diseases with syndrome of excessive heat in lung and stomach. It was therefore commonly be used in the therapeutic approach towards hand, foot and mouth disease as well. However, no systematic evaluation had yet been done to verify this Chinese patent medicine on the efficacy and clinical safety for the disease. In order to achieve the manner of evidence-based medicine, this study had adopted a systematic review and Meta-analysis to evaluate the efficacy and safety of Lanqin Oral Liquid in the treatment of hand, foot and mouth disease. All related randomized controlled trials(RCT) were searched in the following data bases: CNKI, WanFang, VIP, SinoMed, Cochrane Library and PubMed. Based on the method provided by the Cochrane collaboration, the study assessed the quality of papers selected and RevMan 5.3 software was used to perform Meta-analysis. Totally 24 studies were included with 3 491 sample size, which 1 826 cases were treatment group and 1 665 cases were control group. From the results of Meta-analysis, the total effective rate of combination of Lanqin Oral Liquid and Western medicines shown better than Western medicine alone in the treatment for hand, foot and mouth di-sease, but mild adverse event were also found(RR=1.20,95%CI[1.16,1.23],P<0.000 01). Incidence of adverse reaction between experimental and control group was statistically insignificant(RR=1.16, 95%CI[0.79, 1.70], P=0.45). No conclusion was able to made in terms of the remission time of clinical symptoms, as the studies included were not qualified for Meta-analysis. As a matter of fact, the number of existing studies related to the Lanqin Oral Liquid were limited with poor quality as well. In other words, high quality studies were essential to further evaluate the efficacy and safety of Lanqin Oral Liquid.


Subject(s)
Drugs, Chinese Herbal , Hand, Foot and Mouth Disease , Humans , Medicine, East Asian Traditional , Nonprescription Drugs , Research Design
17.
Article in Chinese | WPRIM | ID: wpr-828390

ABSTRACT

The consistency of quality on Chinese patent drugs is a hotspot and difficulty in the control of traditional Chinese medicine preparations, and has become one of the bottlenecks restricting its internationalization. Based on the analysis of current studies on quality and problems of Chinese patent drugs, this paper explored relevant methods of quality evaluation on Chinese patent drugs and possible factors affecting the consistency of quality in the pharmaceutical cycle by consulting relevant literatures about quality evaluation methods and consistency control techniques of large-scale Chinese patent drugs. And it put forward the evaluation system on high-quality Chinese patent drugs with "consistency" as the core, so as to promote the overall improvement of the quality of Chinese patent drugs, guide the rational price of Chinese patent drugs of the same species, and provide a new reference model for the quality evaluation of Chinese patent drug.


Subject(s)
Drugs, Chinese Herbal , Medicine, Chinese Traditional , Nonprescription Drugs
18.
Article in Chinese | WPRIM | ID: wpr-828389

ABSTRACT

At present, most of Chinese patent medicines have problems, such as weak scientific basis, unclear clinical value evaluation, etc., which lead to the lack of sufficient evidence for the entry into the essential medicine list, medical insurance catalog and other important health resource allocation tools. This has a negative impact on the development of traditional Chinese medicine. It is urgent to establish a comprehensive evaluation methodology system of Chinese patent medicine in China. There are at least three reasons including producing evidence for clinical rational use scientifically, developing an objective and transparent selecting strategy, eventuating and highlighting its clinical value. The process and method of health technology assessment(HTA) can provide reference for the establishment of comprehensive evaluation method of Chinese patent medicine. However, HTA is rarely carried out in the field of traditional Chinese medicine. The latest domestic and international research showed that HTA combined with multi-criteria decision analysis(MCDA) can increase the transparency of decision-making and improve the quality of decision-making. The combined two formed the EVIDEM framework, which is conducive to drug selection and its clinical use. In this paper, the EVIDEM framework was introduced to establish the methodology framework of the comprehensive clinical evaluation system of Chinese patent medicine. A preliminary research idea has been put forward. In the future, we can establish a set of comprehensive clinical evaluation methods for Chinese patent medicine in cooperation with relevant national drug decision-making departments and management departments. It is believed that such cooperation could promote the full implementation of the re-evaluation for Chinese patent medicine.


Subject(s)
China , Drugs, Essential , Medicine, Chinese Traditional , Nonprescription Drugs , Technology Assessment, Biomedical
19.
Acta Medica Philippina ; : 517-524, 2020.
Article in English | WPRIM | ID: wpr-877289

ABSTRACT

@#Background. Community pharmacists play a central role in the management of minor ailments and their clinical knowledge is vital in improving treatment outcomes of these ailments. The provision of minor ailment service in developed countries has been successful yet the practice in the Philippines has not been documented. Objectives. The aim of this study was to document the involvement of community pharmacists in the management of minor ailments, the practices, and the perceived challenges in the provision of pharmacy service. Methods. This was an exploratory descriptive study. Using qualitative research technique, a guided interview questionnaire was employed for data gathering. The practices employed and perceived challenges encountered by pharmacists were interpreted using conventional content analysis. Results. Colds, cough, skin allergy, diarrhea were the four most common ailments managed by community pharmacists. Pharmacists had underdeveloped roles in consultation. Community pharmacists were knowledgeable on the causes of the minor ailments and the medications dispensed were compliant with approved product indications. The absence of institutional guidelines (66%), lack of ailment-specific training (100%), insufficient clinical skills (76.7%), and a dominant patient self-selection behavior for OTC medicines (73.3%) were perceived as challenges in the provision of minor ailment services. Conclusion. Community pharmacists managed common ailments with non-prescription medicines however consultation roles were found to be underdeveloped.


Subject(s)
Pharmacists , Nonprescription Drugs , Philippines
20.
Article in Chinese | WPRIM | ID: wpr-828034

ABSTRACT

The efficacy of oral Chinese patent medicine in the treatment of acute cerebral infarction was systematically evaluated by network Meta-analysis. The literature search was conducted in three English databases(Medline, EMbase and Cochrane Library) and four Chinese databases(CNKI, VIP, WanFang and SinoMed) from inception to June 2018, and the randomized controlled trials of acute cerebral infarction were screened out according to the pre-set criteria. Two reviewers independently screened out the literature by using pre-specified eligibility criteria, and assessed the quality of included studies according to the risk of bias tool of Cochrane Handbook 5.1.0. Data analysis was conducted by using Stata 13.0 and WinBUGS 1.4.3 software. Finally, 52 RCT were included, involving 11 kinds of oral Chinese patent medicines. The results of the network Meta-analysis showed that in terms of the total effective rate, the order of efficacy was as follows: Naomaitai Capsules>Xiaoshuan Changrong Capsules>Angong Niuhuang Pills>Yangxue Qingnao Granules>Compound Danshen Dripping Pills>Naoxintong Capsules>Tongxinluo Capsules>Naoxueshu Oral Liquid>Zhuyu Tongmai Capsules>Yinxingye Tablets>Compound Danshen Tablets; in terms of neurological deficit scores, the order of efficacy was: Tongxinluo Capsules>Angong Niuhuang Pills>Compound Danshen Dripping Pills>Xiaoshuan Changrong Capsules>Yangxue Qingnao Granules>Zhuyu Tongmai Capsules>Naoxintong Capsules>Naoxueshu Oral Liquid; in terms of Barthel index score, the order of efficacy was: Xiaoshuan Changrong Capsules>Naomaitai Capsules>Naoxueshu Oral Liquid>Angong Niuhuang Pills>Tongxinluo Capsules>Zhuyu Tongmai Capsules. Although different oral Chinese patent medicines can improve these outcomes, the difference in efficacy ranking was relatively large. Because of the small number and low quality of research literature, the conclusion still needs to be proved by multi-center, large-sample, and double-blind randomized trials.


Subject(s)
Brain Ischemia , Cerebral Infarction , Drugs, Chinese Herbal , Humans , Network Meta-Analysis , Nonprescription Drugs , Stroke
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