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April 2017, Volume 20, No.10 Abstracts

 Integrating Specialty Care into Primary Care Teams

Matthew E.Bernard1,Eric W.Klavetter2,Jennifer L.Pecina1,Abd Moain Abu Dabrh3,CHI Chun-hua(Translator) 4,5,LI Nan(Translator)6

1.Department of Family Medicine,Rochester Mayo Clinic,Rochester 14624,US

2.Department of Research Administration,Rochester Mayo Clinic,Rochester 14624,US

3.Department of Family Medicine,Jacksonville Mayo Clinic,Jacksonville 32256,US

4.Department of General Practice,Peking University Health Science Center,Beijing 100871,China

5.Health Management Center,Peking University First Hospital,Beijing 100034,China

6.Huimei Healthcare,Beijing 100088,China

    Abstract  Aging populations,increasing numbers of insured patients,and a changing reimbursement model based on value rather than traditional fee for service all necessitate innovation in models of health care delivery.In order to meet the needs of patients with high-quality and low-cost treatment,the medical specialists should be integrated into the primary care team to improve continuity across the spectrum of care and to control costs,and thus achieve the Triple Aim for Populations:improving patient care and experience,improving population health,and decreasing costs of health care.Strategies for integrating specialty care into primary care team include increasing care delivery at point of care,developing primary care with special interest,integrated community specialists(ICS).The paper summarizes the experience and achievement of Mayo Clinic in implementing the above three strategies,and argues that the ICS model is viable for those systems where physician compensation is salary based.

    Key words  Family medicine;Integrated community specialists;Mayo Clinic

 

Navigational Training Model of General Practitioners in China Based on the Milestones of USA

HAN Ting-ting1,LIU Juan-juan1,JIANG Guo-ping2,SHEN Ye2,REN Jing-jing1*

1.Department of General Practice,the First Affiliated Hospital,Zhejiang University,Hangzhou 310003,China

2.Department of Teaching,the First Affiliated Hospital,Zhejiang University,Hangzhou 310003,China

*Corresponding author:REN Jing-jing,Chief physician,Master supervisor;E-mail:lisarjj@126.com

    Abstract  Post-graduate education is an important part of the training of medical talents.Guiding Opinions of the State Council on Establishing the System of General Practitioners points out general practitioners training will be gradually standardized as "5+3" model to improve the clinical and public health practice ability.The establishment of competency-based training model has become the main purpose of post-graduate medical education.The American Accreditation Council for Graduate Medical Education (ACGME) puts forward that physicians need to have 6 competencies (patient service,medical knowledge,practice-based learning and progress,interpersonal skills,professional spirit and system-based practice),and proposed the development and implementation of the specialist competency-based education evaluation framework of resident doctor in all specialties--Milestones.In reference to Milestone scheme of ACGME,Department of General Practice in the First Affiliated Hospital of Zhejiang University builds our unique Milestones of general practitioners--scheme of navigated general practitioner training model (GP-S),and explores how to cultivate outstanding general practice talents in-depth.The paper introduces the composition and content of the GP-S program map and the teaching evaluation system of the operation in guarantee period of Department of General Practice in the First Affiliated Hospital of Zhejiang University,aims to train the general practitioners with different post competencies combining the current general medical characteristics in our country.

    Key words  General practitioners;Education,medical,continuing;Navigational traning model of general practitioners

 

Satisfaction of Incentive System of Community Health Technical Workers Based on Factor Analysis

WANG Juan1,KUANG Shao-hua2,LI Jian3*

1.Traditional Chinese Medical Hospital of Huangdao District,Qingdao 266500,China

2.China Rehabilitation Research Center for Hearing and Speech Impairment,Beijing 100029,China

3.Institute of Medical Information,Chinese Academy of Medical Sciences,Beijing 100020,China

*Corresponding author:LI Jian,Associate researcherE-mail:lijian7636@126.com

    Abstract  Objective  To quantitatively evaluate the incentive system of community health technical workers based on factor analysis.Methods  In September 2014,7 representative cities were selected from eastern,central and western region of China by typical sampling method,and finally QD,YT and SZ cities were selected from the eastern region,and WH and HF from the central region,and YC and ZW from the western region.A simple random sampling method was used to select 4 community health service centers from each city,6 general practitioners,6 nursing staff,5 public health workers and 5 other health technical workers were selected from each community health service center to make a questionnaire survey.The survey included the basic situation of community health technical workers and their satisfaction of the incentive system.On the basis of literature reading and expert consultation,13 indicators were selected to evaluate the incentive system.The main components were extracted by factor analysis,and the satisfaction of community health technical workers in different titles,professional and cities on incentive system was analyzed comprehensively.A total of 591 questionnaires were sent out and 582 valid were collected.The effective response rate was 98.5%.Results  The proportion of community health technical workers being relatively satisfied or very satisfied with the working environment,doctor-patient relationship and self-actualization degree was 41.6% (242/582),44.2% (257/582) and 57.0% (332/582) respectively.The proportion of them being relatively unsatisfied or very dissatisfied with the he income level and the job objectives was 44.0% (256/582).The principal component analysis method was used to extract the three common factors (institutional factors,development factors and workload factors) of the community health technical workers satisfaction on the incentive system.The cumulative variance contribution rate was 63.128%.The overall scores of development factors,workload factors and satisfaction were 0.294,0.172,0.123 respectively among community health technical workers of senior or vice senior titles,the overall score of satisfaction among community health technical workers of primary and intermediate title,no title or unknown titles were -0.014,0.003,-0.048 respectively.The overall score of satisfaction among general practitioners and nursing staff was 0.026 and 0.034 respectively,while that of the public health workers and other technical workers was 0.001 and -0.111 respectively.The overall score of satisfaction among community health technical workers in YT and YC was 0.283 and 0.197 respectively,while that of community health technical workers in WH and ZW was -0.296 and -0.157.Conclusion  The satisfaction of the incentive systems is not high among community health technical workers,the establishment of more incentive compensation system is the core of the reform of community health management system.The allocation of appropriate community health manpower is one of the keys to the development of community health services.We should rely on comprehensive reform,rationalize the management system,and establish more scientific incentive system so as to improve the working enthusiasm of community health technical workers.

    Key words  Community health services;Medical staff;Incentive system;Satisfaction;Factor analysis

 

Empirical Research on the Evaluation Index System of Nursing Quality of Postpartum Family Visits by Community Medical Workers

  FENG Xue,LIU Guo-lian*,MA Nan-nan

School of Nursing,Ningxia Medical University,Yinchuan 750004,China

*Corresponding author:LIU Guo-lian,Professor,Master supervisor;E-mail:13909597076@163.com

    Abstract  Objective  To investigate the implementation and existing problems of the nursing service in the community postnatal family visits,and to provide practical assessment tools and theoretical basis for future improving the evaluation of nursing quality in community postnatal family visits through empirical research on the evaluation index system of nursing quality of postpartum family visits by community medical workers.Methods  From October to December in 2016,18 community health service institutions were randomly selected from three districts in Yinchuan City according to a proportion of 31.Based on the evaluation index system of nursing quality in community postpartum family visits and the combination of the current nursing status of community postpartum family visits,the members of the research group undertook field investigations and evaluations with corresponding designed evaluation scales and questionnaires.Site Inspection Scale of the Quality of Nursing Process in Community Postpartum Family Visits was used to evaluate the process quality evaluation,and Qualitative and Quantitative Evaluation Index Questionnaire of Nursing Service in Community Postpartum Family Visits,Questionnaire of Satisfaction of Nursing Workers in Community Postpartum Family Visits and Questionnaire of Satisfaction and Related Knowledge Status of Delivery Women were applied to assess the quality of the structure and result.The standard scores of each index were obtained after the conversion of the survey data,and then the scores of the nursing quality in the community postpartum family visits of each community health service institutions were calculated by the comprehensive scoring method of weighting and accumulation.Results  Among the 18 community health service institutions,the number of doctors in the personnel of community postpartum family visits was zero,the number of community nurses was one,the annual training rate of the visiting staff,and the annual pass rate of theory and skill assessment were both zero;the constituent ratios of "very good" or "good" evaluations on the preparation before community postpartum family visits,general assessment of newborns in community postpartum family visits and the implementation of maternal physical examination in community postpartum family visits among the 18 community health service institutions were 86.10%,85.54%,and 86.07% respectively,the constituent ratio of "very good" or "good" evaluations on the general assessment of delivery women in the visiting was 22.25%;the average satisfaction rate of medical workers on the existing postpartum visiting conditions was 89.86%,the average satisfaction rate of delivery women on the visiting time,frequency and contents of medical workers was 73.20%.The score of nursing quality in community postpartum family visits of the 18 community health service institutions was between 65.45 and 84.13,with an average score of 70.55 and a score span of 18.68.Conclusion  With scientific and comprehensive covering contents,the evaluation index system of nursing quality in community postpartum family visits has certain operational appropriateness and practical value.However,problems such as insufficient job training of the personnel,lack of specific examination and low satisfaction among delivery women are still exist.

    Key words  Postnatal care;Community health services;Quality assurance,health care;Empirical research

 

Breakthrough of the Two-way Referral in China

LU Yuan1,2,FAN Hui-qin1,WANG Zhao-xin2,SHI Jian-wei2,CHEN Yuan-hong3,ZHANG Bin1,ZHANG Han-zhi1,YU De-hua2*

1.Department of General Practice,Yangpu Hospital,Tongji University,Shanghai 200438,China

2.Department of General Practice,Tongji University School of Medicine,Shanghai 200092,China

3.Daqiao Community Health Service Center,Yangpu District,Shanghai 200090,China

*Corresponding author:YU De-hua,Professor,Chief physician;E-mail:lussy@126.com

    Abstract  Objective  To analyze the recent literatures of two-way referral in China and the breakthrough of research and development under the new situation,so as to provide basis for further improving Chinas two-way referral.Methods  Searching "two-way referral" in the commonly used Chinese databases and network resources,and finally 1 241 journal articles,169 academic papers,23 conference papers were included.Evidence-based analysis was conducted to the time,type,publication,research direction,region and authors specialty of the included literatures.Results  Since 2000,there had been related literature researches on the two-way referral,after that the number of literature increased year by year steadily,and the main research type was review (874,70.43%).The journals with top 4 number of literature publication were Chinese General Practice(278,22.40%),China Hospital CEO(121,9.75%),Chinese Health Economics(96,7.74%),Chinese Primary Health Care(96,7.74%).704(56.72%) papers research direction was model mechanism exploration,221(17.81%) papers were the status and the countermeasures analysis.307(24.74%) papers region was mainly in Shanghai,276 (22.24%) in Beijing.The professional direction of 718(57.86%) first authors concerning the included literature was public health.Conclusion  Based on literature reading and review,the paper summarizes the problems in the two-way referral,puts forward that making breakthroughs in the development dilemma of two-way referral should combine with the current status of medical and health reform,and comprehensive reform practice should be carried out from the perspective of system engineering.Moreover,perfecting guidelines of the two-way referral of single disease;a patient-centered referral should be provided to improve the experience of patients.

    Key words  Two-way referral;Evidence-based analysis;Problem solving

 

"Down-referral Being Difficult" Phenomenon in the Two-way Referral Based on Stakeholder Theory

KONG Ying-wen1,CAO Jie2*,ZHENG Yan-fang1,CHEN Li-sha1,ZHANG Man-jie1,ZOU Zhi-hui1,LIN E1

1.College of Health Management,Guangzhou Medical University,Guangzhou 511436,China

2.The First Affiliated Peoples Hospital of Guangzhou Medical University,Guangzhou 510180,China

*Corresponding author:CAO Jie,Professor,Master supervisor;E-mail:czhongt@126.com

    Abstract  The two-way referral is an important part of the hierarchical diagnosis and treatment,but presently it is hard for China to carry out this system really,especially in the down referral part.Based on stakeholder theory,the paper analyzes the relevant stakeholders of two-way referral,such as interests description,interests related degree,influence,position and influenced degree of policy,finds the root cause of the conflict of interest,that is,the harmony and balance of interests of each stakeholder;and finally puts forward strategies for the harmony of interests,including the establishment of interest coordination mechanism,reasonable optimization of referral links,increasing of community investment,improvement of health insurance payment.

    Key words  Two-way referral;Down-referral;Stakeholder theory

 

Willingness of Down-referral of Community Residents and Its Influencing Factors

GAO Xiang1,ZHANG Xin-yu2,LI Shuo3,CHEN Rui-jun1,ZHAO Shi-hong1*

1.Department of Health Management,School of Public Health,Xuzhou Medical College,Xuzhou 221004,China

2.Faculty of Dentistry,University of Otago,Dunedin 9016,New Zealand

3.School of Nursing,Changsha Medical College,Changsha 410000,China

*Corresponding author:ZHAO Shi-hong,Professor,Master supervisor;E-mail:zhaosh@xzmc.edu.cn

    Abstract  Objective  To study the willingness of down-referral of community residents and discuss its influencing factors.Methods  By simple random sampling method,2 districts were extracted from the 7 districts of Xuzhou City,then 4 communities were selected from each district,and 40 community residents were randomly invested in each community.A self-designed questionnaire was used to conduct a questionnaire survey from July to September 2015.The main contents of the questionnaire included the basic situation of community residents,their cognition,attitude and willingness of two-way referral.A total of 320 questionnaires were sent out and 298 valid questionnaires were collected.The effective response rate was 93.1%.Results  Of the 298 community residents,180 (60.4%) were willing to accept down-referral.Univariate analysis showed that the willingness of down-referral among community residents with different age,educational level,average monthly income,hospitals of usual visits and whether worried about the community health care technology,and whether believed that down-referral will affect the continuity of treatment was significantly different (P0.05).Multivariate Logistic regression analysis showed that the average monthly income,whether worried about the community health care technology,and whether believed that down-referral will affect the continuity of treatment was the influencing factors of the willingness of down-referral of community residents (P0.05).Conclusion  The average monthly income,whether worry about the community health care technology,and whether believed that down-referral will affect the continuity of treatment influence community residents willingness of down-referral.The implementation of two-way referral should be promoted from the aspects of building information platform of two-way referral and improving medical technology of community health.

    Key words  Two-way referral;Down-referral;Roots cause analysis;Community residents

 

Impact of Glucose Variability on Left Ventricular Function of Patients with Acute Myocardial Infarction

YANG Hong-xia,MI Shu-hua*,SU Gong,TIAN Lei,ZHOU Yun,ZHANG Tao

Department of Special Medical Needs,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China

*Corresponding author:MI Shu-hua,Professor,Chief physician,Master supervisor;E-mail:mishuhua@hotmail.com

    Abstract  Objective  To explore the impact of glucose variability on the left ventricular function of patients with acute myocardial infarction (AMI).Methods  A total of 207 patients who were diagnosed with AMI for the first time and underwent elective coronary angiography in Beijing Anzhen Hospital,Capital Medical University from October 2014 to December 2015,were enrolled.The daily the mean amplitude of glycemic excursions (MAGE) was measured by continuous glucose monitoring system (CGMS).According to MAGE level,the subjects were divided into low MAGE group (n=132) and high MAGE group (n=75).The general data gender,age,past medical history,duration of diabetes,BMI,systolic blood pressure (SBP),diastolic blood pressure (DBP),heart rate (HR),incidence of ST-segment elevation myocardial infarction,Killip classification,laboratory test results fasting plasma glucose (FPG),glycosylated hemoglobin (HbA1c),and echocardiographic findings left ventricular ejection fraction (LVEF),left ventricular end-diastolic diameter (LVEDD) of patients were collected.Results  There was no significant difference in the percentage of men,age,BMI,SBP,DBP,incidence of hypertension and ST-segment elevation myocardial infarction between the two groups (P0.05),while there was significant difference in HR,incidence of diabetes mellitus and duration of diabetes (P0.05).There were significant differences in the FPG and HbA1c levels,Killip classification,LVEF and LVEDD between the two groups (P0.05).LVEF was linearly negatively correlated with the levels of FPG,HbA1c and MAGE (r=-0.34,-0.33,-0.41 respectively;P0.05).Killip classification was positively correlated with the levels of FPG,HbA1c and MAGE(rs=0.29,0.28,0.29 respectively;P0.05).Multivariate linear regression analysis showed that the level of MAGE was an independent risk factor of LVEF (P0.05).Multivariate Logistic regression analysis showed that the level of MAGE was an independent risk factor of Killip classification (P0.05).Conclusion  The relatively high amplitude of glucose variability is significantly correlated with the worsening of left ventricular function of patients with AMI.

    Key words  Myocardial infarction;Blood glucose;Ventricular function,left

 

Influencing Factors of Coagulation Function in Patients with Chronic Kidney Disease

CHANG Li-xin,YU Qi-yao,ZHANG Dong-xue,CUI Li-wen*

Department of Nephrology,Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China

*Corresponding author:CUI Li-wen,Associate chief physician;E-mail:cuiliwen_914@163.com

    Abstract  Objective  To investigate the influencing factors of coagulation function in patients with chronic kidney disease(CKD).Methods  The participants enrolled in this study were 340 CKD patients who received inpatient treatment without dialysis in Department of Nephrology,Fourth Hospital of Hebei Medical University from February 2015 to July 2016.All the patients underwent thrombelastography(TEG),covering reaction time(R),coagulation time(K),Angle,maximum amplitude(MA),coagulation index(CI),and measured routine coagulation parameters levels,such as fibrinogen(Fib),prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),and determined the levels of some common clinical parameters,including platelet count(PLT),plateletcrit(PCT),albumin(ALB),total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein(LDL),high-density lipoprotein(HDL),creatinine(Cr),24 h urine total protein(UTP),and urine protein to creatinine ratio(UPr/Cr).The results of the above examinations were recorded.We analyzed the influencing factors of coagulation function in patients with CKD by the multiple linear regression analysis.Results  Pearson correlation coefficient and Spearmans rank correlation coefficient analyses revealed that,R was linearly and positively associated with APTT(P0.05);K was linearly and negatively correlated with Fib(P0.05),but linearly and positively correlated with APTT(P0.05);Angle presented a linear and positive correlation with Fib(P0.05),but a linear and negative correlation with TT(P0.05);MA had a linear and positive correlation with Fib(P0.05),whereas it had a linear and negative correlation with TT(P0.05);CI was negatively associated with APTT(P0.05),but positively associated with Fib(P0.05);CI was negatively related with R and K(P0.05),but positively related with Angle and MA(P0.05).Multiple liner regression analysis found that,APTT was the influencing factor for R(P0.05);Fib and APTT were the influencing factors for K,Angle,MA and CI(P0.05);R,K,Angle and MA were the influencing factors of CI(P0.05).Spearmans rank correlation coefficient analysis demonstrated that,CI was positively associated with PLT,PCT and UPr/Cr,but negatively associated with ALB(P0.05).Multiple liner regression analysis also displayed that PCT and ALB affected CI significantly(P0.05).Conclusion  Compared with the routine coagulation test,TEG is more sensitive for determining the blood coagulation state of CKD patients.ALB and PCT are the influencing factors of blood coagulation state.

 

    Key words  Kidney diseases;Thrombelastography;Blood coagulation;Root cause analysis

 

Influencing Factors of Patients with Rheumatoid Arthritis Combined with Interstitial Lung Disease

ZHOU Hao-tong,WANG You-lian*

Department of Rheumatism and Immunology,Jiangxi Provincial Peoples Hospital,Nanchang 330006,China

*Corresponding author:WANG You-lian,Chief physician,Master supervisor;E-mail:wyl5639@sina.com

    Abstract  Objective  To explore influencing factors of patients with rheumatoid arthritis(RA) combined with interstitial lung disease(ILD).Methods  A total of 349 patients with RA treated in Department of Rheumatism and Immunology of Jiangxi Provincial Peoples Hospital from June 2013 to February 2016 were selected and divided into RA group and RA combined with ILD group(RA-ILD group) according to the detected results of high-resolution CT(HRCT).The general data,related laboratory testing indicators and pulmonary function indicators were recorded and compared between the two groups.Results  Among the 349 patients with RA,69(19.8%) were combined with ILD.The main respiratory symptoms of RA-ILD patients were dry cough and dyspnea after the event,and the main abnormal performance of HRCT were groupd-glass opacity and reticular and nodular shadows.The proportion of males,mean age,smoking rate and RA disease activity score(DAS28) in RA-ILD group were significantly higher than those in RA group(P0.05).There was no significant difference in the course of disease between two groups(P0.05).The levels of rheumatoid factor(RF),anti-cyclic citrullinated peptide antibody(anti-CCP antibody) and glucose-6-phosphate isomerase(GPI) in RA-ILD group were significantly higher than those in RA group(P0.05);the erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),fibrinogen,D-dimer,immunoglobulin G(IgG),immunoglobulin A(IgA),and immunoglobulin M(IgM) were not significantly different between two groups(P0.05).A total of 68 patients received pulmonary function tests.The carbon monoxide diffusing capacity(DLCO),vital capacity(VC),forced vital capacity(FVC),first-second forced expiratory volume(FEV1) in RA-ILD group were significantly lower than those in RA group(P<0.05);the incidence of ventilatory dysfunction and diffuse dysfunction in RA-ILD group were significantly higher than those in RA group(P0.05);there was no significant difference in the incidence of FEV1/FVC ratio and small airway dysfunction between the two groups(P0.05).Multivariate Logistic regression analysis showed that age,DAS28 and GPI were the influencing factors of RA combined with ILD(P0.05).Pearson correlation analysis showed that DLCO had no linear correlation with age,DAS28 and GPI(P0.05).Conclusion  ILD is a common complication of patients with RA,and advanced age,high disease activity,high-titer GPI are its risk factors.Early HRCT examination is helpful for the early diagnosis and treatment of the disease and early DLCO diagnosis of lung function is also valuable for early diagnosis of ILD.

    Key words  Arthritis,rheumatoid;Lung diseases,interstitial;Root cause analysis

 

Mortality Risk Factors for Acute Stanford A Aortic Dissection with Surgical Treatment

HE Ji-gang1,LI Hong-rong1,LI Yong-wu1,YAN Dan2,WANG Ping1,GUI Long-sheng1*

1.Department of Cardiovascular Surgery,First Peoples Hospital of Yunnan Province,Kunming 650032,China

2.Department of Intensive Care Unit,First Peoples Hospital of Yunnan Province,Kunming 650032,China

*Corresponding author:GUI Long-sheng,Chief physician,Master supervisor;E-mail:jiganghe@sina.com

    Abstract  Objective  To investigate the mortality risk factors for acute Stanford A aortic dissection with surgical treatment.Methods  A retrospective method was used in this study.We selected 167 consecutive patients with acute Stanford type A aortic dissection treated with surgery in First Peoples Hospital of Yunnan Province from October 2009 to January 2016 as the participants and divided them into the survival group (n=131) and non-survival group (n=36) based on the treatment outcome.We collected the baseline data of the participants for comparison and analysis,which included sex,age,smoking history,previous treatment histories of percutaneous coronary intervention(PCI),thoracic surgery,chronic obstructive pulmonary disease(COPD),peripheral vascular disease,chest pain,nausea/vomiting,abdominal pain and hypotension,status of laboratory markers(hemoglobin and platelet),intraoperative duration of deep hypothermic circulatory arrest(DHCA) and aortic arch treatment approaches.Results  Age,proportions of patients with previous treatment histories of thoracic surgery,COPD,chest pain,abdominal pain,and hypotension differed significantly between the groups(P0.05),while sex ratio,percentage of patients with smoking history,proportions of patients with previous treatment histories of PCI,peripheral vascular disease,and nausea/vomiting did not(P0.05).The differences in platelet count and distribution width existed between the groups(P0.05),while the difference in hemoglobin levels did not(P0.05).The differences in both the intraoperative duration of DHCA and aortic arch treatment approaches were noted between the groups(P0.05).Multivariate Logistic regression analysis showed that older age,previous treatment histories of thoracic surgery,chest pain,abdominal pain and hypotension,decreased platelet count before surgery,prolonged intraoperative duration of DHCA and intraoperative aortic arch treatment approaches were the mortality risk factors for acute Stanford A aortic dissection with surgical treatment(P0.05).Conclusion  Older age,previous treatment histories of thoracic surgery,chest pain,abdominal pain and hypotension,decreased platelet count before surgery,prolonged intraoperative duration of DHCA,and aortic arch reconstruction with triple-branched stent graft placement can increase the mortality risk of acute Stanford A aortic dissection with surgical treatment.

    Key words  Aorta;Aneurysm,dissecting;Surgical procedures,operative;Death;Risk factors

 

Efficacy and Safety of Ozoned Autohemotherapy in Adjuvant Therapy of Men with Primary Hypertension

CAO Guo-qing1,DAI Xin-yu1,ZHAO Na1,ZUO Xin-lu2,NI Jia-xiang1*

1.Department of Pain,Xuanwu Hospital Capital Medical University,Beijing 100053,China

2.Chengde Nursing Vocational College,Chengde 067000,China

*Corresponding author:NI Jia-xiang,Professor,Doctoral surpervisor;E-mail:nijiaxiang@263.net

    Abstract  Objective  To evaluate the efficacy and safety of ozoned autohemotherapy(O3-AHT)in adjuvant therapy of men with primary hypertension.Methods  Sixty male patients with primary hypertension treated at Xuanwu Hospital Capital Medical University from January 2014 to January 2015 were randomly divided into experiment group and control group by random number table method,each group had 30 cases.The control group orally took levamlodipine at a dose of 5 mg,once per day.Based on that of the control group,adjuvant therapy of O3-AHT(concentration:20 mg/L,once per two days,ten times a course of treatment courses) was given to the experiment group.The systolic blood pressure(SBP) and heart rate(HR) before treatment(T0),3 months after the first course of treatment(T1),3 months after the second course of treatment(T2),3 months after the third course of treatment(T3) were recorded;the oral status and grades of satisfaction index(PSI) scores of T3 were recorded.The incidence of adverse events during the treatment was recorded.Results  There was no significant difference in age and course of disease(P0.05).There was significant difference in SBP between two groups(P

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