作者：
Cao Miao;Deng Fang-fang;Yuan Qun;Zhang Ji-dong;He Qing-hu;...
期刊：
针灸推拿医学：英文版,2018年16(4):236-242 ISSN：1672-3597
通讯作者：
Qing-hu He
作者机构：
Hunan University of Chinese Medicine, Changsha, 410208;The First Hospital of Hunan University of Chinese Medicine, Changsha, 410021;Institute of Basic Medicine, China Academy of Chinese Medical Sciences, Beijing, 100700;[Cao Miao; Yuan Qun; He Qing-hu] Hunan University of Chinese Medicine, Changsha, 410208;[Deng Fang-fang] The First Hospital of Hunan University of Chinese Medicine, Changsha, 410021
通讯机构：
[Qing-hu He] H;Hunan University of Chinese Medicine, Changsha, China
摘要：
Objective: To systematically evaluate the therapeutic efficacy of tuina therapy for primary insomnia. Methods: Nine Chinese and English databases were searched from the inception to May 2017 to identify randomized controlled trials (RCTs) studying tuina therapy for insomnia. The enrolled articles were all RCTs with tuina as the monotherapy or major therapy in the experiment group, with clear diagnostic criteria for primary insomnia well recognized worldwide or in China, and Pittsburgh sleep quality index (PSQI) as one of the outcome measures. Two researchers evaluated the risk of bias and quality of the enrolled studies by following Cochrane Handbook version 5.1.0. The meta-analysis was performed by RevMan version 5.3. Results: Eleven studies were included with a total of 1 076 participants. The Western medication adopted in the control groups were benzodiazepine receptor agonists. The studies were all assessed as high risk of bias for blinding since blinding method was unable to be performed due to the specificity of tuina therapy; no study reported the support of fund or potential interest conflict, so they were all rated unclear for selective reporting. The meta-analysis showed that compared with other traditional Chinese medicine therapies, tuina worked more effectively in reducing the PSQI score (MD=-4.11<0, 95% confidence interval (CI) -6.01 to -2.22, P<0.0001); compared with oral administration of Western medication, tuina showed more significant efficacy in reducing the PSQI score (MD=-3.42<0, 95%CI -5.19 to -1.66, P<0.0001). Subgroup analysis showed that head tuina alone showed no significant difference compared with oral administration of Western medication regarding the change of PSQI score (MD=-4.19<0, 95%CI -8.87 to 0.50, P>0.05); a combination of head and back tuina could more effectively reduce the PSQI score compared with oral administration of Western medication (MD=-2.08<0, 95%CI -3.09 to -1.06, P<0.0001). Conclusion: Tuina can produce more significant efficacy in treating primary insomnia compared with other traditional Chinese medicine therapies and oral administration of Western medication, especially the combination of head and back tuina.
期刊：
IRANIAN JOURNAL OF PUBLIC HEALTH,2017年46(9):1223-1230 ISSN：2251-6085
通讯作者：
He, Guoping
作者机构：
[Zhang, Yinhua] Cent S Univ, Sch Nursing, Dept Community Nursing, Changsha, Hunan, Peoples R China.;[Liu, Honghua; He, Guoping; Zhang, Yinhua; Chen, Yang; Pan, Xiaoyan; Yuan, Qun; Xu, Yi; Yi, Xia] Hunan Univ Tradit Chinese Med, Sch Nursing, Dept Fundamentals Nursing, Changsha, Hunan, Peoples R China.;[Liu, Jingwei] Med Insurance Bur Hunan Prov, Changsha, Hunan, Peoples R China.
通讯机构：
[He, Guoping] H;Hunan Univ Tradit Chinese Med, Sch Nursing, Dept Fundamentals Nursing, Changsha, Hunan, Peoples R China.
关键词：
Antimicrobial;China;Inpatient;Prescription
摘要：
BACKGROUND: China had implemented policies to limit antimicrobials prescription since 2004; we conducted this study to reflect the effect of these national policies by analyzing antimicrobial prescription trends of medical insurance in patients from 2003 to 2014 in Changsha city, China. METHODS: The participants were inpatients of the medical insurance of urban workers (UEBMI). Data were extracted from medical insurance information system of Changsha Medical Insurance Institution, which directly connects with hospitals information systems. RESULTS: Trend analysis showed great changes in antimicrobial prescription and inpatients' cost on antimicrobials over the study period. Antimicrobial prescription rates gradually declined over the study period from 79.0% in 2003 to 43.5% in 2014 (adjusted OR0.205; 95%CI 0.198 to 0.213). There was a quicker decline from 2011 to 2014 (with implementing national antimicrobial stewardship action plan) than the period from 2003 to 2010 (with implementing antimicrobials use education and self-management strategies). The proportion of inpatients used one antimicrobial increased significantly from 25.6% in 2003 to 46.7% in 2014, while the proportion of inpatients used three or more antimicrobials gradually decreased. Bacterial culture rate increased from 20.4% in 2003 to 36.6% in 2014 (adjusted OR 2.248; 95% CI 2.149 to 2.352). The average costs on antimicrobials decreased significantly, from 277.43 US Dollar in 2003 to 91.05 US Dollar in 2014. CONCLUSION: National efforts to promote rational use of antimicrobials in clinical practice have had a positive effect over the past decade in China.
