目的 对糖尿病急性代谢并发症小剂量胰岛素的应用方法及技巧进行探讨和分析。 方法 以2009年1月－2012年2月收治的50例糖尿病急性代谢并发症患者为研究对象,按照数字随机表方法分为对照组和试验组，每组25例患者。对照组患者在小剂量胰岛素的使用上采用常规技巧和方法；试验组患者在小剂量胰岛素的使用上结合实际情况和相关规范进行综合治疗，比较两组患者小剂量胰岛素的应用效果。 结果 经治疗，对照组18例患者的临床症状得到明显改善，显效率为72%；试验组25例患者的临床症状均得到有效缓解，显效率为100%，两组患者的显效率比较，差异有统计学意义（P＜0.05）。 结论 使用小剂量胰岛素治疗糖尿病急性代谢并发症患者时，结合实际情况和相关规范进行综合治疗临床效果满意。
目的：糖尿病周围神经病变是糖尿病最常见的并发症，我们对治疗2型糖尿病周围神经病变的有效方法进行了偿试。方法:将66例2型糖尿病周围神经病变患者随机分为两组。在常规应用口服降糖药或胰岛素治疗的基础上，治疗组加用弥可保500 μg肌注每周3次，前列腺素E1100 μg加入生理盐水250 mL中静脉滴注，每日1次；对照组加用维生素B12500 μg肌注每周3次，复方丹参注射液20 mL加入生理盐水250 mL中静脉滴注，每日1次，疗程均为4周。结果:治疗组总有效率82.3%，与对照组比较差异有显著性（Plt;0.05）。临床症状改善方面，治疗组肢体麻木、肢体疼痛改善率分别达72%和75%，明显高于对照组的37%和44%，感觉减退、多汗、口干、腹泻、便秘、排尿障碍改善也优于对照组（分别为53%比26%、51%比16%、53%比19%、57%比26%、51%比28%、61%比26%）。结论:弥可保与前列腺素E1合用治疗糖尿病周围神经病变是一种有效的方法。
Objective To analyze the substitution mechanism of surrogate endpoints for traditional Chinese medicine (TCM) clinical efficacy evaluation of chronic heart failure (CHF). Methods To obtain data from the occurrence of surrogate endpoints and cardiogenic death of patients with CHF in 7 hospitals. The causal relationship between surrogate endpoints and cardiogenic mortality was inferred by the Bayesian network model, and the interaction among surrogate endpoints was analyzed by non-conditional logistic regression model. Results A total of 2 961 patients with CHF were included. The results of Bayesian network causal inference showed that cardiogenic mortality had a causal relationship with the surrogate endpoints including NYHA classification (P=0.46), amino-terminal pro-B-type natriuretic peptide (NT-proBNP) (P=0.24), left ventricular ejaculation fraction (LVEF) (P=0.19), and hemoglobin (HB) (P=0.11); non-conditional logistic regression analysis showed that NYHA classification had interaction with NT-proBNP, LVEF, and HB prior to and after adjusting confounders. Conclusions The substitution capability of surrogate endpoints for TCM clinical efficacy evaluation of CHF for cardiogenic mortality are NYHA classification, NT-proBNP, LVEF, and HB in turn, and there is a multiplicative interaction between the main surrogate endpoint NYHA classification and the secondary surrogate endpoints including NT-proBNP, LVEF, and HB, suggesting that when the two surrogate endpoints with interaction exist at the same time, it can enhance the substitution capability of surrogate endpoints for cardiogenic mortality.
ObjectiveTo systematically review the application status of Delphi method in clinical research of traditional Chinese medicine (TCM).MethodsPubMed, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect original research and methodological research on Delphi method in TCM from inception to August 30th, 2020. Two reviewers independently screened literature, extracted data, and then, descriptive analysis was performed by using qualitative methods.ResultsA total of 612 articles involving 573 original studies and 39 methodological studies were included, which involved 167 types of diseases. The primary research purposes were disease diagnosis and treatment, syndrome research, scale development, evaluation research, index research, clinical investigation, methodology research, and other 8 categories. 487 papers reported the implementation process and results of Delphi method in varying degrees.ConclusionsDelphi method is widely used in clinical research of TCM, however, there are deficiencies in the specific implementation process.
ObjectiveTo systematically summarize and evaluate the existing evidence of Qishen Yiqi dropping pill (QSYQ) in the treatment of chronic heart failure (CHF), and to evaluate its quality. MethodsThe PubMed, Cochrane Library, EMbase, Web of Science, CNKI, CBM, WanFang Data databases were electronically searched to collect systematic reviews/meta-analyses(SRs/MAs) related to objectives from inception to December 31, 2022. Two researchers independently screened the literature and extracted data, and assessed the methodological quality, risk of bias, reporting quality, and quality of evidence of included SRs/MAs by using Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic(ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis(PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. ResultsThis overview included 17 SRs/MAs. The methodological quality, reporting quality, risk of bias, and quality of evidence for outcome measures of SRs/MAs were all unsatisfactory. All SRs/MAs were of low quality according to the results of the AMSTAR-2 assessment. And only a small number of SRs/MAs were assessed as low risk of bias based on the results of the ROBIS assessment. The evaluation results of the PRISMA checklist showed that the report quality of the 24 studies included was relatively complete. According to the GRADE system evaluation results, 94% of the 84 outcome indicators were low-quality and very low-quality evidence. Limitations were the main factors leading to their degradation, followed by publication bias, inconsistency, imprecision and indirectness. ConclusionAt present, QSYQ has good clinical efficacy in the treatment of CHF, but the standardization and scientificity of clinical research and secondary research reports are insufficient, resulting in low quality of clinical recommendations evidence. In the future, it is necessary to further standardize and improve the quality of clinical and secondary research.