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题名实施临床路径的意义和方法
被引量：411
- 1
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作者
张正华
高居中
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机构
北京医院协会
北京红十字朝阳医院
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出处
《中华医院管理杂志》
2002年第9期513-515,共3页
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文摘
作者就临床路径的概念和内涵、由来和作用进行了描述 ;并介绍了临床路径的病种 /病例选择和制定的方法、过程 ;阐述了改革对医院支付方式是实施临床路径的动力 ,转变医师的服务理念是推行临床路径的关键 。
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关键词
临床路径
病种选择
医疗费用
医疗质量
支付方式
医疗制度
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Keywords
Clinical pathway
selection of disease group
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分类号
R197.1
[医药卫生—卫生事业管理]
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题名中医药治疗帕金森病近况
被引量：3
- 2
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作者
张琳
刘树民
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机构
黑龙江中医药大学中医药研究院
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出处
《中国临床康复》
CSCD
北大核心
2006年第3期152-154,共3页
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基金
黑龙江中医药大学科研基金项目(200504)~~
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文摘
目的:系统总结帕金森病的中医药临床应用与基础研究进展,归纳帕金森病临床治疗以及中医药作用机制研究的方法和规律。资料来源:检索中国期刊全文数据库和维普中文期刊全文数据库1994-01/2005-08关于帕金森病的中医药治疗及实验研究的相关文章,限定文章语言种类为中文,检索词“帕金森,中医药”。资料选择:对资料进行初审,选取中医药治疗帕金森病的临床及实验研究文献,文献包括处理组和对照组的,筛除明显不随机的研究,对剩余的文献开始查找全文。纳入标准为①随机对照研究;②实验或临床研究包含平行对照组。③处理组为中药复方、中西药并用,或单一中药组。排除标准:重复性研究。资料提炼:共收集到78篇关于中医药治疗帕金森病的随机和未随机研究文章,25篇动物实验或临床研究符合纳入标准。排除的53篇文章,39篇为未随机研究或重复性研究,14篇为综述类文章。资料综合:通过25个实验包括约620例患者和810只实验动物,证实了中医药治疗帕金森病效果明确、良好,药性平和,毒副作用小。中药在保护神经细胞,抑制氧化应激反应,抗兴奋性毒性等方面研究取得了一定进展。从辨证论治、专方论治、中西医结合治疗以及单味药和复方的实验研究4个方面系统总结帕金森病的中医药治疗近况,归纳临床治疗以及中医药作用机制研究的方法和规律。结论:目前帕金森病的治疗仍然是针对其症状的控制,尚无有效延缓疾病进程的手段。大量的临床和实验资料显示,中医药治疗帕金森病效果明确、良好。中药在保护神经细胞、抑制氧化应激反应、抗兴奋性毒性等方面研究取得了一定进展。
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关键词
帕金森病
综述文献
中医疗法
中医药治疗
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Keywords
were 'Parkinson, Chinese medicine'.STUDY selection: All documents are examines to select the clinical and experimental study documents of TCM treatment on Parkinson disease, which includes treatment group and control group, and non-random studies are rejected. Whole test of the rest documents is selected. Inclusion criteria: ① randomized controlled study
② experimental or clinical research including parallel control group
③ combination of Chinese medicine with Western medicine or the single Chinese medicine group. Exclusion criteria: duplicated studies. DATA EXTRACTION: There are 78 random and non-random articles about TCM therapy on Parkinson disease, and 25 experimental and clinical studies are in coincidence with conclusion criteria. Among 53 excluded articles, there are 39 titles because of non-random or duplicated studies and 14 review articles.DATA SYNTHESIS: According to 25 experiments including 620 patients and 810 experimental animals, it is manifested that TCM can be used to treat Parkinson disease with clear, good, mild effect and no topical or side effects. Chinese medicine can preserve cellular nervosa
restrain oxidative stress reaction, rivalry excitability toxicity. The text summarizes the recently status of the TCM treatment of Parkinson disease, from four aspects, which includes the treatment based on syndrome differentiation, treatment with specific prescriptions, combination of Chinese and western medicine treatment, experimental study on unit medicine and prescriptions, and the method and rule of the clinical treatment and the study on pharmacological mechanisms of TCM.CONCLUSION: Parkinson disease is the refractoriness disease. At present, major reports are concentrated in summarizing the clinical experience, but the reports of large-scale random and double-blind clinical research are scarce. And preliminary experiments are less. Developing the central pharmacology research on Chinese medicine and identify effect mechanism of medicine, which will be the development trend in future.
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分类号
R277.725
[医药卫生—中医学]
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题名针药结合治疗疑难杂症
- 3
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作者
张秋娟
周爽
赵虹
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机构
上海中医药大学附属岳阳中西医结合医院心脑血管专科
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出处
《中国临床康复》
CSCD
北大核心
2006年第3期143-145,共3页
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基金
上海市重点学科建设项目资助(T0302)~~
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文摘
目的:综合探讨近几年针药结合治疗疑难杂症的干预效果和前景。资料来源:应用计算机检索CBM,CBMdisc系统及万方数据库2000-01/2005-02有关针药结合治疗疑难杂症的文献,限定文章语言种类为中文,检索词“针药结合,帕金森病,糖尿病,血管性痴呆”,观察对象为帕金森病、糖尿病及血管性痴呆患者。资料选择:选取实验包括针药结合治疗并和对照组相比较的文献,进行初审,删除明显非随机临床实验的文章,然后查找余下的文献全文,进一步判断是否为随机临床实验。质量评价主要考察资料的真实性,调查设计是否严密,实施过程是否严格,统计学处理是否合理。资料提炼:共检索到32篇有关针灸治疗帕金森病、糖尿病及其神经病变、血管性痴呆的随机和非随机实验,16篇文献符合纳入标准,排除16篇重复研究文献。资料综合:16个实验共包括582例患者,分别对针药结合组和对照组进行分析比较。①针药结合治疗帕金森病的干预效果:有学者应用眼针结合内服定风胶囊治疗,经3个疗程治疗后总有效率88.90%。②针药结合治疗糖尿病及其神经病变的干预效果:有人采用针刺配合中药治疗2型糖尿病周围性面瘫患者,有效率为93.55%,明显优于特定电磁波照射配合西药对照组60.00%。③针药结合治疗血管性痴呆的干预效果:有人应用针刺配合药物治疗血管性痴呆患者,并与单用药物作对照,结果提示治疗组总有效率95.00%;对照组总有效率88.90%。结论:针药结合治疗疑难杂病疗效肯定,尤其是对帕金森病、糖尿病及其神经病变、血管性痴呆具有特有优势,其干预效果显著优于单纯药物治疗。
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关键词
针药并用
中医疗法
综述文献
疑难杂症
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Keywords
of'combination of acupuncture and drug, Parkinson disease, diabetes mellitus, vascular dementia'in Chinese, and the subjects were patients with Parkinson disease, diabetes and vascular dementia. STUDY selection: Articles including combination of acupuncture and drug and compared with control group were selected into primary selection. Significant non-randomized clinical experimental articles were deleted, and then full-texts of the leftover articles were retrieved in order to judge further whether randomized clinical experiment or not. Quality evaluation mainly inspected data'validity, exact inventory design, strict practice procedure and whether statistics are reasonable.DATA EXTRACTION: A total of 32 articles on randomized or non-randomized experiment of acupuncture in the treatment of Parkinson disease, diabetes, neural lesion and vascular dementia. Sixteen accorded with the inclusion criterion, and 16 repetitive research literatures were excluded. DATA SYNTHESIS: Sixteen trials included 582 patients. Analysis comparison was done between the combination of acupuncture and drug group and the control group, respectively. ①Interventional effect of combination of acupuncture and drug for Parkinson disease: Some scholars combined eye-acupuncture and Dingfeng capsule. After 3 months, total efficiency was 88.90%. ②Interventional effect of combination of acupuncture and drug for diabetes and neural lesion: Some one combined acupuncture and traditional Chinese medicine in the treatment of type 2 diabetes peripheral facial paralysis, and its efficiency was 93.55%, which was better significantly than 60.00% efficiency with special electromagnetic wave combining western medicine in the control group. ③Interventional effect of combination of acupuncture and drug for vascular dementia: Some one used acupuncture and drug for vascular dementia, and took pure drug as control. The result indicated that the total efficiency was 95.00% in the treatment group and 88.90% in the control group. CONCLUSION: Curative effect of co
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分类号
R245
[医药卫生—针灸推拿学]
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