【摘要】 目的 報道1例靜脈滴注胺碘酮致肝腎功能不全患者。 方法 2010年10月收治1例擴張性心肌病患者，治療過程中使用胺碘酮注射液，導致嚴重的肝腎功能不全。系統查閱中國期刊全文數據庫及外文數據庫Pubmed、Embase建庫至2011年8月關于胺碘酮致肝腎功能不全的相關文獻，進行靜脈胺碘酮致肝腎功能不全的可能性評估，探索胺碘酮靜脈滴注致肝功能不全的的作用機制。 結果 根據查閱文獻結果分析，此患者靜脈注射胺碘酮致肝功不全的可能性高，Naranjo概率評分分別為7分。 結論 提出臨床醫師和臨床藥師應進行胺碘酮靜脈的藥學監護，高度的重視胺碘酮相關的不良反應，從而及時識別和防治胺碘酮所致肝腎功能不全，減少其不良預后。【Abstract】 Objective To report a case of hepatic and renal insufficiency induced by intravenous injection with amiodarone, and to evaluate the possibility of the adverse drug reaction. Methods A patient with dilated cardiomyopathy was admitted in October, 2010. During the procedure, the use of amiodarone hydrochloride injection made the patient suffer from liver and kidney dysfunction. We retrieved the literatures about liver and kidney toxicity of amiodarone from CNKI, Pubmed, and Embase (from the establishment of the databases to November 2011). We also ssessed the possibility of the adverse drug reaction, discussed the mechanism of amiodarone-induced hepatic insufficiency. Results According to the literature, There was a great possibility of hepatic insufficiency induced by amiodarone, and the total score of the Naranjo probability score was 7. Conclusion It is important to pay more attention to the pharmaceutical care of amidarone to timely recognize and effectively prevent or treat hepatic and renal insufficiency induced by intravenous injection with amiodarone.
【摘要】 目的 探討非諾貝特致藥品不良反應（ADRs）的一般規律和特點。 方法 檢索PubMed（1978年-2009年8月）、中國期刊全文數據庫CNKI（1980年-2009年8月）、中國生物醫學文獻數據庫CBMDise（1980年-2009年8月）非諾貝特所致ADRs文獻，進行統計、分析。 結果 非諾貝特致ADRs多發生在gt;40歲年齡段，與性別無顯著關聯；64例ADRs主要涉及骨骼肌肉系統、消化系統、泌尿生殖系統、過敏反應，及時處理者預后良好。 結論 臨床上應重視非諾貝特所致ADRs，及時處理。【Abstract】 Objective To analyse the clinical features, correlation factors, preventions and cures of (adverse drug reactions, ADRs) caused by fenofibrate. Methods The cases of ADRs caused by fenofibrate were collected and analyzed from Pubmed (1978 - August 2009), CNKI (1980 - August 2009) and CBMDise (1980 - August 2009). Results Fenofibrate-induced ADRs were mostly seen in patients over 40 years old, but which was independent for sex. Totally, 64 ADRs were involved in the skeletal musculature system, digestive system, urinogenital system, and allergic response. The prognosis was favorable. Conclusion More attention should be given to patients with fenofibrate and ADRs should be treated as soon as possibile.
【摘要】 目的 了解2007年-2008年成都地區17家醫院抗腫瘤藥物的使用情況。 方法 以銷售金額、用藥頻度（DDDs）對2007年、2008年成都地區17家醫院抗腫瘤藥物消耗數據進行分類統計、綜合分析、對比。 結果 2008年成都地區17家醫院抗腫瘤藥物用藥金額增長幅度較大，各亞類抗腫瘤藥物中其它類抗腫瘤藥物類、植物來源的抗腫瘤藥、抗代謝藥金額排序依次占前3位。銷售金額前100位藥物中，腫瘤藥物占據8位，大多數是其它類抗腫瘤藥物，且其用藥頻度也靠前。 結論 抗腫瘤藥物用藥金額和用藥量都將快速增長，其中其它類抗腫瘤藥物和植物來源的抗腫瘤藥的發展尤被看好。【Abstract】 Objective To evaluate the situation of antineoplastics used in Chengdu area from 2007 to 2008. Methods The consumption data of antineoplastics used in 17 hospitals of Chengdu area in 2007 and 2008 were classified, and the consumption sum and defined daily doses (DDDs) were analyzed. Results The total consumption sum of antineoplastics in 2008 increased sharply. Other antineoplastics, herbal-sourced antineoplastics and antimetabolism drugs ranked in the first three places. Among the top drugs in terms of consumption sum, antineoplastics took 8 places. Conclusion The consumption sum and DDDs of antineoplastics, especially other antineoplastics and herbal-sourced antineoplastics, will increase rapidly.
Objective To assess the effectiveness and safety of cyclosporine A (CsA) for aplastic anemia (AA) in China. Methods Randomized controlled trails (RCTs) of CsA for AA were collected from CBMdisc (1978 to 2008), CNKI (1979 to 2008), and VIP (1989 to 2008). Other relevant journals were also hand searched. The methodological quality of included studies was evaluated, and data analyses were performed with The Cochrane Collaboration’s software RevMan 4.2.0. Results A total of 19 RCTs were included. As for the total effective rate and complete remission rate, significant differences were noted between CsA + androgen vs. androgen alone, CsA + androgen combination vs. androgen combination, as well as CsA + androgen + other drugs vs. androgen + other drugs [total effective rate: RRs and 95%CIs were 1.48 (1.28 to 1.70), 1.67 (1.17 to 2.39), and 1.51 (1.09 to 2.08); complete remission rate: RRs and 95%CIs were 2.06 (1.33 to 3.19), 3.52 (1.19 to 10.39), and 1.54 (1.00 to 2.38)]. Conclusion According to the domestic evidence, treatment with CsA for AA may improve the total effective rate and complete remission rate. However, more high quality clinical trials are expected for further study.
【摘要】 目的 探討二甲雙胍致不良反應的一般規律和特點。 方法 檢索1994年-2011年中國期刊全文數據庫中二甲雙胍所致不良反應個案報道的文獻，得到符合條件的文獻29篇共33例，進行統計分析。 結果 33例不良反應主要表現為內分泌系統（48.5%），皮膚及附件（18.2%），變態反應（15.2%），消化系統（9.1%），神經系統（6.1%）等。 結論 臨床上應重視二甲雙胍引起的不良反應，用藥時應加強對患者的監護，以減少嚴重藥物不良反應的發生。【Abstract】 Objective To investigate the characteristics and the general pattern of the adverse drug reactions (ADR) induced by metformin. Methods The ADR induced by metformin reported in domestic medical journals during 1994-2008 were retrieved by means of CNKI. A total of 29 related literatures involving 33 cases, and a related database was established for statistical analysis. Results The main clinical manifestation represented as endocrine system (48.5%), lesion of skin and its appendants (18.2%), allergic reactions (15.2%), digestive system (9.1%), nervous system (6.1%) and so on. Conclusion It is necessary to pay attention to ADR induced by metformin and strengthen observation during medication in order to reduce serious ADR.
【摘要】 目的 評價腎移植術后他克莫司（TAC）低劑量對比常規劑量干預的療效和安全性。 方法 檢索MEDLINE、EMbase、SCI、CBM、Cochrane圖書館，納入腎移植術后TAC低劑量對比常規劑量免疫抑制治療的隨機對照試驗（RCT）。檢索時間從各個數據庫建庫至2009年12月，對納入研究進行方法學質量評價和Meta分析。 結果 納入3個RCT，其中A級研究2個，B級研究1個。分析結果顯示:兩組急性排斥反應發生率比較，無統計學意義[RR=1.39， 95%CI(0.64， 3.01)]；腎小球濾過率、受者/移植物生存率和納入分析的安全性指標差異均無統計學意義。 結論 基于當前臨床證據，腎移植術后TAC低劑量與常規劑量干預相比，近期療效和安全性相似；遠期結果尚需進一步研究探討。【Abstract】 Objective To evaluate the effect and safety of low-dose versus standard-dose tacrolimus immunosuppressive therapy on kidney transplant recipients. Methods MEDLINE, EMbase, SCI, CBM and the Cochrane library were searched and randomized controlled trials (RCT) of low-dose versus standard-dose tacrolimus immunosuppressive therapy in kidney transplant recipients were gathered. The search was updated in December 2009. Quality assessment and meta-analysis were performed. Results A total of three RCT were identified, two of which were graded A and one was graded B. The analysis results indicated that RR (95%CI) value of the acute rejection rate was 1.39 (0.64, 3.01); glomerular filtration rate, patient/graft survival rate, and safety analysis were not significant different between the two groups. Conclusion Based on the evidence currently, compared to standard-dose TAC, Low-dose TAC has the same effect and safety results, but further study are needed to get the long term results.
【摘要】 目的 系統評價司帕沙星對比氧氟沙星治療耐多藥肺結核的有效性和安全性。 方法 計算機檢索Cochrane圖書館臨床對照試驗資料庫（2010年第2期）和PubMed（1978年-2010年10月）、EMBASE（1974年-2010年10月）、中國學術期刊網絡出版總庫（1978年-2010年10月）、維普（1989年-2010年10月）、中國生物醫學文獻數據庫（1978年-2010年10月）；手工檢索其他相關雜志。檢索語種為中文和英文。納入司帕沙星對比氧氟沙星治療耐多藥肺結核的隨機對照試驗。按Cochrane系統評價的方法評價納入研究質量，用RevMan 5.0軟件對數據進行Meta分析。 結果 共納入8篇研究，Meta分析結果顯示司帕沙星組與氧氟沙星組相比，痰菌轉陰率、病灶顯著吸收率、空洞閉合率均高于對照組，差異具有統計學意義（Plt;0.05）。 結論 現有的證據表明，司帕沙星與其他抗結核藥物聯用治療難治、耐多藥肺結核的療效優于氧氟沙星的聯用方案，但由于納入的文獻數量有限，質量參差不齊，存在潛在的發表偏倚。【Abstract】 Objective To assess the clinical efficacy and safety of sparfloxacin versus ofloxacin in treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB). Methods Literatures were retrieved from PubMed (1978-October, 2010), EMBASE (1974-October 2010), Cochrane library (2nd volume, 2010), China Academic Journal Network Publishing Database (1978-October, 2010), VIP (1989-October, 2010) and CBM (1978 to October, 2010) by computer, and searched some other relevant journals manually. Chinese and English were both used in the search. Randomized controlled trials (RCTs) on sparfloxacin versus ofloxacin in treating pulmonary tuberculosis were included in this study. Meta-analysis was conducted by RevMan 5.0 software. Results The meta-analysis of 8 included RCTs showed that the sputum negative conversion rate, focus absorption rate, cavity closure rate in the sparfloxacin group were significantly higher than the ofloxacin group (P＜0.05). Conclusions The analysis indicates that combined treatment with sparfloxacin has a better effect in treating MDR-TB than with ofloxacin. However, the reliability of this review may be affected by the number and quality of studies included. Large-scale randomized controlled trials of high quality are needed to confirm the conclusions above.
Objective To assess the effectiveness and safety of Tongxinluo Capsule in the treatment of vertebrobasilar artery insufficiency. Methods The Cochrane Library, MEDLINE, VIP and CNKI were searched. Two authors independently collected data, including randomized controlled trials that met the inclusion criteria. They evaluated the quality of these trials and performed meta-analysis using The Cochrane Collaboration’s RevMan 5.0. Results Eleven studies involving 1157 participants were included. All the included studies were inadequate at reporting randomization, concealment of allocation and blinding. Meta-analysis based on the included studies showed that Tongxinluo Capsule with Danshen was better than Danshen alone in vertebrobasilar artery insufficiency (RR= 1.35, 95%CI 1.24 to 1.48) and blood flow velocity of vertebrobasilar artery (WMD=3.60, 95%CI 2.44 to 4.77 and WMD=3.46, 95%CI 1.89 to 5.04). Tongxinluo Capsule with simple basic therapy was better than simple basic therapy alone in vertebrobasilar artery insufficiency (RR=1.21, 95%CI 1.11 to 1.31) and blood flow velocity of vertebrobasilar artery (WMD=3.85, 95%CI 2.19 to 5.51). Conclusion Tongxinluo Capsule is an effective and safe drug for vertebrobasilar artery insufficiency. However, due to the limited quantity and quality of the included studies, we can not draw a firm conclusion about the effectiveness of Tongxinluo Capsule compared to the simple basic therapy or Danshen. The results suggest that further and larger-scale trials using Tongxinluo Capsule for vertebrobasilar artery insufficiency are needed.
【摘要】 目的 采用循證醫學的方法評價硫唑嘌呤（aiathioprine，AZA）治療潰瘍性結腸炎（ulcerative colitis，UC）的有效性和安全性。 方法 計算機檢索PubMed、Cochrane library、Embase、CNKI、維普和CBM數據庫收集國內外關于AZA診療UC的隨機對照試驗（ramdomized controllel trial，RCT）。按Cochrane系統評價的方法評價納入研究質量，并進行Meta分析。 結果 共納入5個RCT，共262例UC患者。Meta分析結果顯示，AZA治療UC在緩解率方面與安慰劑比較，差異無統計學意義[P=1.19，95%CI（0.94，1.49），P=0.14]；在復發率方面，兩者比較差異有統計學意義[P=0.72，95%CI（0.54，0.95），P=0.02]；全部不良反應方面和嚴重不良反應方面，兩者比較差異無統計學意義，Meta分析結果分別為[P=2.52，95%CI（0.82，7.74），P=0.11]和[P=4.03，95%CI（0.88，18.53），P=0.07]。 結論 系統評價結果為AZA在療效方面優于安慰劑，在不良反應發生率方面差異無統計學意義。但由于納入的5個研究中沒有高質量的RCT，且有1個可能產生高度偏倚，使得這一結論受到影響，有必要開展更多設計嚴謹，大樣本、多中心的RCT。【Abstract】 Objective To assess the efficacy and safety of azathio-prine in the treatment of ulcerative colitis through an evidence-based method. Methods We searched the literature from databases like PubMed, Cochrane library, CNKI, VIP, and CBM, and evaluated the quality of studies according to Cochrane systematic review. Finally, Meta-analysis was performed. Results Five randomized controlled trials (RCT) were included in this study with a total of 262 patients. Meta-analysis showed that there was no significant difference in the rate of remission between azathio-prine and placebo in treating ulcerative colitis [P=1.19, 95%CI (0.94, 1.49),P=0.14]. There was significant difference in the relapse rate between the two treating methods [P=0.72, 95%CI (0.54, 0.95),P=0.02]. In addition, there was no statistical difference in all adverse effects [P=2.52, 95%CI (0.82, 7.74),P=0.11] and serious adverse effects [P=4.03, 95%CI (0.88, 18.53),P=0.07] between the two treating methods. Conclusion In the treatment of ulcerative colitis, azathio-prine has a significant advantage in efficacy than placebo, but there is no significant difference in the rate of adverse events between the two groups. However, none of the 5 RCT included in this review has a high quality and one of them even probably has a high bias, which has a big influence on our conclusion. Consequently, multi-center large-scale randomized controlled trials of higher quality are needed to make confirmation.
Objective To assess the efficacy and safety of glimepiride for type 2 diabetes mellitus (T2DM). Methods We searched the literature from PubMed, Ovid (All EBM Reviews), CNKI, Wanfang, VIP, CBM and other databases. Evaluating the quality of the study according to Cochrane systematic reviews, Meta-analysis was performed for the results of homogeneous studies by The Cochrane Collaboration’s software RevMan 5.0, and the heterogeneous data conducted a descriptive qualitative analysis. Results Six RCTs included in the analysis and Meta-analysis was not performed due to the insufficient data (for the median or standard deviation). Six RCTs are multi-center, randomized, double-blind, placebo-controlled trials. The results showed that glimepiride groups to reduce glycosylated hemoglobin, lower fasting and postprandial blood glucose, postprandial plasma insulin enhance the efficacy were statistically significant differences (Plt;0.05) compared to placebo groups. Four studies informed the impact of fasting plasma insulin (FI) and 3 studies showed that the glimepiride groups improving the fasting plasma insulin (FI) were statistically significant differences (Plt;0.05), but 1 study showed the two groups had no significant difference (Pgt;0.05). All studies showed minor adverse reactions of glimepiride. Conclusion Glimepiride can reduce the glycosylated hemoglobin, lower the fasting and postprandial blood glucose, improve fasting and postprandial plasma insulin for type 2 diabetes patients, and have minor adverse reactions. In a word, glimepiride is an effective and security sulfonylureas drug.