OBJECTIVE To explore the efficacy of Jiaotai pill(JTW)and JTW modified prescriptions(JTW^(+))plus benzodiazepines(BDZ)for insomnia in China by systematic review and network meta-analysis,especially optimization ratio(_(m:n))between Coptis chinensis and Cinnamo.METHODS Randomized controlled trials(RCTs)regarding JTW and JTW^(+)+BDZ for insomina were comprehensively searched in CNKI,VIP,Wanfang,and PubMed,Cochrane Library,OVID,Embase databases from their inception to December 2017.The risk of bias was assessed by the Cochrane collaboration′s tool and Jadad scale.Systematic review and network meta-analysis were performed to evaluate the relative risk(RR)plus 95%confidence interval(95%CI)or prediction interval(95%PrI),and draw surface under the cumulative ranking curves(SUCRA)by Stata 14.0 and RevMan 5.0 software.RESULTS A total of 13 RCTs(1 RCT was omitted by sensitivity analysis)with 1040 patients were included.Overall heterogeneity was acceptable,except publication bias.Based on classical meta-analysis,JTW and JTW_(m:n)^(+)+BDZ,such as JTW_(2:1)^(+)+BDZ,JTW_(5:1)^(+)+BDZ,JTW_(6:1)^(+)+BDZ,JTW_(10:1)^(+)+BDZ,had more efficacy than BDZ.Based on network meta-analysis,JTW and JTW_(m:n)^(+)+BDZ,such as JTW_(2:1)^(+)+BDZ,JTW_(6:1)^(+)+BDZ,JTW_(10:1)^(+)+BDZ,had more efficacy than BDZ;meanwhile,SUCRA showed the best rank of JTW/JTW+(BDZ
目的:探讨药物利用指数(d DUI/c DUI)与药品说明书评价结果相关性。方法:以6种中药注射剂为例,分层随机抽取某医院使用该品种中药注射剂病例120例,采用d DUI/c DUI与药品说明书(给药剂量/给药浓度合理性百分率)评价中药注射剂临床使用合理性与安全性,并探讨两者评价结果相关性与一致性。结果:相关分析提示,除注射用丹参(冻干)外,其他5种中药注射剂药物利用指数c DUI与药品说明书(给药浓度)评价尚具有较好相关性(热毒宁注射液:Spearman=-0.7507,P<0.05;疏血通注射液:Spearman=-0.7723,P<0.05;血塞通注射液:Spearman=-0.8911,P<0.05;银杏内酯注射液:Spearman=0.7283,P<0.05;灯盏细辛注射液:S p e a r m a n=-0.5854,P<0.05);κ参数提示,c DUI与给药浓度仅银杏内酯注射液尚具有较好一致性(κ=0.613,P<0.05)。结论:药物利用指数与药品说明书评价相关性受多因素影响,其中从给药浓度角度评价中药注射剂临床使用合理性与安全性尚可接受,但应注意临床严重超剂量、超浓度使用等实际因素的影响。
