目的 观察非洛地平缓释片联合百令胶囊治疗慢性肾脏病的临床疗效.方法 选取2021年1月—2022年6月中国人民解放军联勤保障部队第九一〇医院收治的慢性肾脏病患者98例,按照随机数字表法分为甲组与乙组,各49例.甲组予以非洛地平缓释片,乙组予以非洛地平缓释片联合百令胶囊,2组均治疗3个月.比较2组治疗前、治疗3个月后肾功能指标[包括血肌酐(SCr)、血尿酸(UA)、尿素氮(BUN)、24 h尿蛋白定量]、炎性反应指标[包括超敏C反应蛋白(hs-CRP)、白细胞诱素1(Lkn-1)、肿瘤坏死因子-α(TNF-α)以及尿转化生长因子 β1(TGF-β1)]、血压[舒张压(DBP)与收缩压(SBP)]、血管内皮功能指标[包括内皮素-1(ET-1)、一氧化氮(NO)、血管内皮生长因子(VEGF)以及可溶性血管细胞黏附分子-1(sVCAM-1)].结果 治疗3个月后,2组SCr、UA、BUN、24 h尿蛋白定量较治疗前降低,且乙组低于甲组(P<0.01).治疗3个月后,2组hs-CRP、Lkn-1、TNF-α及尿TGF-β1较治疗前降低,且乙组低于甲组(P<0.01).治疗3个月后,2组DBP、SBP、ET-1、VEGF及sVCAM-1较治疗前降低,且乙组低于甲组(P<0.05或P<0.01);治疗3个月后,2组NO较治疗前升高,且乙组高于甲组(P<0.05或P<0.01).结论 非洛地平缓释片联合百令胶囊治疗慢性肾脏病的疗效确切,可以有效改善肾功能,减轻炎症,控制血压并改善血管内皮功能.

目的 观察二甲双胍联合尼美舒利治疗老年类风湿关节炎患者的临床疗效.方法 选取2019—2020年中国人民解放军联勤保障部队第九一〇医院收治的老年类风湿关节炎患者90例,采用奇偶数分组法分为对照组与联合组,各45例.对照组予以尼美舒利片治疗,联合组予以尼美舒利片联合二甲双胍片治疗,2组均连续治疗3个月.比较2组临床疗效,治疗前及治疗3个月后临床症状改善情况[晨僵时间、肿胀关节数(SJC)、压痛关节数(TJC)]、类风湿因子(RF)、红细胞沉降率(ESR)、炎性因子[C反应蛋白(CRP)、白介素1(IL-1)、白介素6(IL-6)及肿瘤坏死因子α(TNF-α)]、T淋巴细胞亚群[CD3、CD4、CD8表面B、T淋巴细胞衰减子(BTLA)表达水平]、简明健康调查量表(SF-36)评分,不良反应.结果 联合组治疗总有效率为95.56％,高于对照组的80.00％(χ2=5.075,P=0.024).2组在治疗3个月后晨僵时间短于治疗前,SJC、TJC分别少于治疗前(P<0.01);治疗3个月后,联合组晨僵时间较对照组更短,SJC、TJC较对照组更少(P<0.01).2组在治疗3个月后RF、ESR、CRP、IL-1、IL-6、TNF-α水平低于治疗前,且联合组更低(P<0.05或P<0.01).2组在治疗3个月后CD3、CD4、CD8表面BTLA表达水平分别高于治疗前(P<0.01),且联合组较对照组更高(P<0.05或P<0.01).2组在治疗3个月后SF-36评分高于治疗前(P<0.01),且联合组更高(P<0.05或P<0.01).2组不良反应总发生率比较,差异无统计学意义(P>0.05).结论 与单一应用尼美舒利相比,二甲双胍联合尼美舒利治疗老年类风湿关节炎患者的临床疗效更好,可更有效地缓解患者临床症状,改善患者机体免疫功能,减轻炎性反应,且安全性较高.

Objective To analyze the drug consultation situation in the outpatient department of our hospital for improving the quality and efficiency of drug consultation and further promoting the development of hospital pharmacy. Methods The medication counseling contents were collected from the outpatient department of our hospital from Jan . 2012 to Dec. 2013 and performed the analysis and summary in the aspects of consulting drugs and consulting contents. Results In the aspect of categories in the drug consultation, the consultation of cardiovascular system drugs accounted for 20. 76%, which of anti-infection drugs accounted for 19. 83%, which of di-gestive system drugs accounted for 15. 29%, etc.;in the aspect of the consulting contents, the consultation of drug usage and dosage ac-counted for 24. 28%, which of the basic drug information accounted for 19. 01%, which of drug return accounted for 10. 12%, which of drug ' s ingredients, function and use accounted for 9. 30%, etc. Conclusion The drug counseling is one of the important contents of clinical pharmacy service, is an important link for improving the level of pharmaceutical care and promoting rational drug use and is a necessary measure of patients at the center in hospital.

患者1，男，52岁，主诉为肾区、腹部剧痛，伴有恶心、呕吐、膀胱刺激征、血尿等入住医院泌尿外科。体格检查示体温36.4℃，脉搏80次/ min,血压130/70 mmHg。无既往病史，无药物过敏史。为明确诊断，于2013年3月20日8：48在 CT 室行全腹部 CT平扫+增强扫描。行 CT 增强检查时使用碘普罗胺注射液（商品名优维显370，拜耳医药保健有限公司广州分公司，批号为966A2，规格为每瓶100 mL），2 min 后出现呕吐，立即报告医生，嘱患者呕吐时头偏向一侧，及时清除呕吐物，以免误吸，给予静脉注射地塞米松注射液5 mg、吸氧等对症处理。8：51患者仍诉头晕、全身乏力、冒冷汗，平车保暖，送往急诊科观察，上心电监护，测得血压79/49 mmHg，脉搏96次/ min，给予10%葡萄糖注射液500 mL +多巴胺60 mg 静脉滴注、补充血容量等对症治疗。9：05患者自觉症状有所好转，测得血压107/50 mmHg，脉搏82次/ min，仍继续密切观察病情及其他变化，脱离危险后转入病房观察治疗。次日生命体征平稳，不适症状完全消失而出院。

Objective To evaluate the clinical effect of entecavir combined with Fuzheng Huayu Capsule in treating hepatic fibrosis of chronic hepatitis B.Methods A hundred patients with hepatic fibrosis of chronic hepatitis B were randomly divided into 2 groups.The control group(50 cases)was given oral entecavir 0.5 mg,once daily.The treatment group(50 cases)was given oral entecavir 0.5 mg,once daily,combined with Fuzheng Huayu Capsule 1.5 g,3 times daily.The treatment course was 1 year in the two groups.The main symptoms before and after treatment were compared between the two groups.The liver function,serum markers of hepatic fibrosis and ultrasonographic image were performed.Results After 1-year treatment,the liver function,liver fibrosis indexes and ultrasonographic images in the two groups were improved in different degrees;but the improvement of liver fibrosis indexes(HA,LN,PC-Ⅲ,Ⅳ-C)and the ultrasonographic image(thickness of spleen)in the treatment group were more significantly than those in the control group(P < 0.05).Conclusion Entecavir combined with Fuzheng Huayu Capsule has better antifibrosis effect on hepatic fibrosis in chronic hepatitis B.

Objective To reduce the drug-patient disputes for increasing the quality of pharmaceutical service and the pharmacist' s ability to handle the drug-patient disputes.Methods The whole drug-patients disputes registered in the pharmacy department in the recent 2 years were collected and analyzed on the work nature of the outpatient pharmacy and the causes leading to the drug-patients disputes.The pertinent resolve methods were provided.Results and Conclusion The drug-patient disputes are caused by various factors.But establishing strict management system and the operating specification,continuously increasing the pharmacist' s professional level and improving the service attitude can prevent and reduce the drug-patient disputes.

通过介绍白芨的药用价值,概述了白芨目前的已知化学成分、药理作用及临床用途,为进一步研究白芨有效部位的有效成分提取、鉴定及作用机制的研究提供参考。

<正>药学服务是一种以药学为基础的服务理念,以患者为中心的实践服务,主要包括门诊患者药学服务与住院患者药学服务两大方面,目的在于通过对患者疾病诊断和治疗提供技术指导,促进合理用药,达到患者安全、有效、经济、适当的用药效果。

<正>我国在当前及未来医院药学的发展的重点应该是临床药学和药学服务(Pharmaceutical care)。药学服务是以服务患者为宗旨,全程化药学服务模式也是医院药学发展的主要方向。