中成药临床综合评价是当前中医药评价领域内的一个重要方向,对中医药行业的发展有着积极推动作用。中成药临床综合评价体系的建立,有助于在证据和价值基础上对同类别不同中成药、不同剂型和规格中成药,以及不同生产厂家中成药的“临床...中成药临床综合评价是当前中医药评价领域内的一个重要方向,对中医药行业的发展有着积极推动作用。中成药临床综合评价体系的建立,有助于在证据和价值基础上对同类别不同中成药、不同剂型和规格中成药,以及不同生产厂家中成药的“临床综合价值”进行综合评估。建立科学合理的中成药综合评价指标体系是保证其发挥临床价值的重要前提。然而目前,尚未见到对中成药临床综合评价公认的系统论述以及可借鉴的方法学体系。由国际研究团队研发的证据与价值:对决策的影响(the evidence and value:impact on decision-making,EVIDEM)框架被用于评估医疗干预措施的综合价值。EVIDEM框架围绕证据与价值观,基于多准则决策分析(multi-criteria decision analysis,MCDA)模型和卫生技术评估(health technology assessment,HTA),为科学决策提供了方法学工具。该文在团队目前正在开展的EVIDEM实证研究基础上,提出基于EVIDEM框架的中成药临床综合评价主要包括4个环节、7个模块、10个步骤。通过该研究的应用探索,期望为未来中医药领域开展中成药临床综合评价提供方法借鉴和实践经验。展开更多
Objective:To evaluate the effect and safety of foot baths with Tangbi Waixi Decoction(TW)in treating patients with diabetic peripheral neuropathy(DPN).Methods:It is a multicenter double-blinded randomized controlled t...Objective:To evaluate the effect and safety of foot baths with Tangbi Waixi Decoction(TW)in treating patients with diabetic peripheral neuropathy(DPN).Methods:It is a multicenter double-blinded randomized controlled trial.Participants with DPN were recruited between November 18,2016 and May 30,2018 from 8 hospitals in China.All patients received basic treatments for glycemic management.Patients received foot baths with TW herbal granules either 66.9 g(intervention group)or 6.69 g(control group)for 30 min once a day for 2 weeks and followed by a 2-week rest,as a therapeutic course.If the Toronto Clinical Scoring System total score(TCSS-TS)6 points,the patients received a total of 3 therapeutic courses(for 12 weeks)and were followed up for 12 weeks.The primary outcome was change in TCSS-TS score at 12 and 24 weeks.Secondary outcomes included changes in bilateral motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the median and common peroneal nerve.Safety was also assessed.Results:Totally 632 patients were enrolled,and 317 and 315 were randomized to the intervention and control groups,respectively.After the 12-week intervention,patients in both groups showed significant declines in TCSSTS scores,and significant increases in MNCV and SNCV of the median and common peroneal nerves compared with pre-treatment(P<0.05).The reduction of TCSS-TS score at 12 weeks and the increase of SNCV of median nerve at 24 weeks in the control group were greater than those in the intervention group(P<0.05).The number of adverse events did not differ significantly between groups(P>0.05),and no serious adverse event was related with treatment.Conclusion:Treatment of TW foot baths was safe and significantly benefitted patients with DPN.A low dose of TW appeared to be more effective than a high dose.(Registry No.Chi CTR-IOR-16009331)展开更多
Material exchange frequently occurs in gullies,and thus the relationship between a gullynetwork structure and sediment transport potential has attracted considerable interest.However,previous researches ignored the di...Material exchange frequently occurs in gullies,and thus the relationship between a gullynetwork structure and sediment transport potential has attracted considerable interest.However,previous researches ignored the difficulty of material transport from sources to sinks,and did not quantify the connectivity of a network structure.In this study,we used a graph model structure to model gully networks of six typical sample areas in the Loess Plateau of China and quantified gully network connectivity using four indexes:average node strength,accessibility from sources to sinks,potential flow,and network structural connectivity index.Results show that:(1)Reflected by different quantitative indexes,the trends of gully network connectivity in different regions are similar.From north to south,the connectivity of a sample area first increases and then decreases.(2)The more mature gullies have stronger network connectivity.Small resistance is conducive to material transport in the gullies.(3)The node connectivity index of the gully network shows a significant aggregation distribution in space,and node connectivity on the main channel is often stronger than that on the branch trench.These results not only deepen the understanding of the process and mechanism of loess gully geomorphic development and evolution but also provide a reference for geomorphic studies.展开更多
文摘中成药临床综合评价是当前中医药评价领域内的一个重要方向,对中医药行业的发展有着积极推动作用。中成药临床综合评价体系的建立,有助于在证据和价值基础上对同类别不同中成药、不同剂型和规格中成药,以及不同生产厂家中成药的“临床综合价值”进行综合评估。建立科学合理的中成药综合评价指标体系是保证其发挥临床价值的重要前提。然而目前,尚未见到对中成药临床综合评价公认的系统论述以及可借鉴的方法学体系。由国际研究团队研发的证据与价值:对决策的影响(the evidence and value:impact on decision-making,EVIDEM)框架被用于评估医疗干预措施的综合价值。EVIDEM框架围绕证据与价值观,基于多准则决策分析(multi-criteria decision analysis,MCDA)模型和卫生技术评估(health technology assessment,HTA),为科学决策提供了方法学工具。该文在团队目前正在开展的EVIDEM实证研究基础上,提出基于EVIDEM框架的中成药临床综合评价主要包括4个环节、7个模块、10个步骤。通过该研究的应用探索,期望为未来中医药领域开展中成药临床综合评价提供方法借鉴和实践经验。
基金Supported by the National Science and Technology Support Program(No.2015BAI04B09)。
文摘Objective:To evaluate the effect and safety of foot baths with Tangbi Waixi Decoction(TW)in treating patients with diabetic peripheral neuropathy(DPN).Methods:It is a multicenter double-blinded randomized controlled trial.Participants with DPN were recruited between November 18,2016 and May 30,2018 from 8 hospitals in China.All patients received basic treatments for glycemic management.Patients received foot baths with TW herbal granules either 66.9 g(intervention group)or 6.69 g(control group)for 30 min once a day for 2 weeks and followed by a 2-week rest,as a therapeutic course.If the Toronto Clinical Scoring System total score(TCSS-TS)6 points,the patients received a total of 3 therapeutic courses(for 12 weeks)and were followed up for 12 weeks.The primary outcome was change in TCSS-TS score at 12 and 24 weeks.Secondary outcomes included changes in bilateral motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the median and common peroneal nerve.Safety was also assessed.Results:Totally 632 patients were enrolled,and 317 and 315 were randomized to the intervention and control groups,respectively.After the 12-week intervention,patients in both groups showed significant declines in TCSSTS scores,and significant increases in MNCV and SNCV of the median and common peroneal nerves compared with pre-treatment(P<0.05).The reduction of TCSS-TS score at 12 weeks and the increase of SNCV of median nerve at 24 weeks in the control group were greater than those in the intervention group(P<0.05).The number of adverse events did not differ significantly between groups(P>0.05),and no serious adverse event was related with treatment.Conclusion:Treatment of TW foot baths was safe and significantly benefitted patients with DPN.A low dose of TW appeared to be more effective than a high dose.(Registry No.Chi CTR-IOR-16009331)
基金supported by the National Natural Science Foundation of China(Grant Nos.42271421 and 41930102)。
文摘Material exchange frequently occurs in gullies,and thus the relationship between a gullynetwork structure and sediment transport potential has attracted considerable interest.However,previous researches ignored the difficulty of material transport from sources to sinks,and did not quantify the connectivity of a network structure.In this study,we used a graph model structure to model gully networks of six typical sample areas in the Loess Plateau of China and quantified gully network connectivity using four indexes:average node strength,accessibility from sources to sinks,potential flow,and network structural connectivity index.Results show that:(1)Reflected by different quantitative indexes,the trends of gully network connectivity in different regions are similar.From north to south,the connectivity of a sample area first increases and then decreases.(2)The more mature gullies have stronger network connectivity.Small resistance is conducive to material transport in the gullies.(3)The node connectivity index of the gully network shows a significant aggregation distribution in space,and node connectivity on the main channel is often stronger than that on the branch trench.These results not only deepen the understanding of the process and mechanism of loess gully geomorphic development and evolution but also provide a reference for geomorphic studies.
