30 September 2026, Volume 23 Issue 9
    

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    Special Report
  • Dynamic Decision Making for Rational Drug Use and Coordinated Management of Tumor Control and Host Homeostasis in the Era of Cancer Chronicity
    QU Jin-xiu, YU Shi-jie, GU Xu-yun, RAO Ben-qiang
    Chinese Journal of Rational Drug Use. 2026, 23(9): 1-7. https://doi.org/10.3969/j.issn.2096-3327.2026.09.001
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Advances in cancer diagnosis and treatment have enabled a growing number of patients with malignant tumors to receive long-term therapy with repeated assessments and multi-line management. Accordingly, the evaluation of rational drug use has shifted from individual prescriptions to longitudinal treatment decision-making chains. This article proposes that rational drug use in the era of cancer chronicity should target “coordinated management of tumor control and host homeostasis”. A constrained dynamic decision-making framework termed State-Time-Configuration-Coordination (STCC) is constructed. In this framework, dynamic states are characterized by disease burden, treatment opportunities and host carrying capacity; hard constraints consist of evidence-based principles, safety and implementability. Treatment timing, therapeutic configuration and combination-sequencing strategies are dynamically optimized toward long-term net clinical benefit, with continuous feedback and re-decision-making driven by changes in efficacy, toxicity and host status. Rather than replacing existing clinical guidelines, this framework integrates drug selection, treatment intensity, treatment duration, combination sequencing regimens, and post-resistance re-decision-making into a continuous rational-drug-use workflow. In the future, dynamic multimodal evaluation, artificial intelligence, and precision host-status modulation with traditional Chinese medicine may facilitate the shift of rational cancer pharmacotherapy from static prescription-oriented management toward precise coordinated management of tumor control and host homeostasis.
    • Cancer Medication
  • Real-World Impact of PDCD1 Gene rs2227982 Polymorphism on the Efficacy and Prognosis of Patients with Advanced Lung Adenocarcinoma Undergoing Combination Treatment with Camrelizumab, Carboplatin and Pemetrexed Disodium
    HUANG Yu-han, ZHOU Tao, CHEN Zhi-ling, TAO Yun-xia, LAI Ran
    Chinese Journal of Rational Drug Use. 2026, 23(9): 8-18. https://doi.org/10.3969/j.issn.2096-3327.2026.09.002
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    Objective: To investigate the association between the PDCD1 gene rs2227982 polymorphism and the efficacy and prognosis of camrelizumab combined with carboplatin and pemetrexed disodium chemotherapy in patients with advanced lung adenocarcinoma (LUAD). Methods: A total of 100 patients with advanced LUAD who were treated at our hospital from December 2019 to June 2022 were retrospectively enrolled. All patients received camrelizumab combined with carboplatin and pemetrexed disodium. The SnaPshot method was used to detect rs2227982 genotypes, and changes in hematological indices and tumor markers before and after treatment were compared among patients with different genotypes. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of clinical indices for treatment efficacy. Progression free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method, and independent prognostic factors were identified using a Cox proportional hazards model. Results: The distribution of PDCD1 gene rs2227982 locus was significantly associated with treatment response: the objective response rate (ORR) increased with the number of T alleles (CC, 15.6%; CT, 42.0%; TT, 50.0%). The adjusted odds ratio (OR) of achieving an objective response was significantly higher for the CT genotype (OR=1.560, 95%CI: 1.139~2.137, P=0.012) and TT genotype (OR=2.571, 95%CI: 1.293~5.114, P=0.009) than for the CC genotype. T-allele carriers had greater post-treatment reductions in white blood cell carcinoembryonic antigen (CEA) and cyto-keratin 19 fragment antigen 21-1 (CYFRA21-1) levels than patients with the CC genotype (P<0.05). ROC curve analysis showed that the rate of change in CEA had the highest area under the curve (AUC=0.758, 95%CI: 0.632~0.883). Survival analysis showed that patients with the TT genotype had longer median PFS than those with the CT or CC genotype (P=0.039), whereas the difference in OS was not statistically significant (P=0.085). Multivariable Cox analysis confirmed that the TT genotype was an independent protective factor for PFS. Conclusion: The T allele of PDCD1 gene rs2227982 was associated with a significantly greater treatment response to camrelizumab combined with carboplatin and pemetrexed disodium chemotherapy in patients with advanced LUAD. Dynamic monitoring of CEA and CYFRA21-1 may provide an important basis for predicting treatment efficacy.
  • Clinical Efficacy of Chemotherapy Regimen of Apatinib Combined with Trastuzumab in the Treatment of Advanced Esophageal Cancer
    PEI Shu-fei, ZHAO Xian-qun, ZHANG Xiang-dong, CHU Yan-jun
    Chinese Journal of Rational Drug Use. 2026, 23(9): 19-24. https://doi.org/10.3969/j.issn.2096-3327.2026.09.003
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    Objective: To investigate the clinical efficacy of the chemotherapy regimen of apatinib combined with trastuzumab in the treatment of advanced esophageal cancer patients. Methods: A total of 120 patients with advanced esophageal cancer who were admitted to our hospital from January 2022 to January 2025 were enrolled and divided, using a random number table, into a control group or an observation group, with 60 patients in each group. The control group received treatment with trastuzumab, while the observation group received a chemotherapy regimen of apatinib combined with trastuzumab. Clinical efficacy, tumor marker levels [carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and carbohydrate antigen 72-4 (CA72-4)], 36-Item Short Form Health Survey (SF-36) scores, and the incidence of adverse reactions were compared between the two groups. Results: At the end of the 12th week of treatment, the objective response rate (ORR) and disease control rate (DCR) were higher in the observation group than in the control group. At the end of the 12th week of treatment and after 6 months of follow-up, CEA, CA19-9, and CA72-4 levels were lower and SF-36 scores were higher in the observation group than in the control group (P<0.05). After 6 months of follow-up, there was no statistically significant between-group difference in the overall incidence of adverse reactions (P>0.05). Conclusion: The combination of apatinib and trastuzumab in the treatment of advanced esophageal cancer can improve ORR and DCR, reduce tumor marker levels, and improve quality of life without increasing the risk of adverse reactions.
    • Cardiovascular & Cerebrovascular Medication
  • Efficacy Analysis of Evolocumab Combined with Rosuvastatin in Patients with Unstable Angina after Drug-coated Balloon Intervention
    LIU Wen-shuo, XU Ya-xin, CUI Yan-xia, LI Shan-shan, REN Jia
    Chinese Journal of Rational Drug Use. 2026, 23(9): 25-32. https://doi.org/10.3969/j.issn.2096-3327.2026.09.004
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    Objective: To investigate the efficacy of evolocumab combined with rosuvastatin after drug-coated balloon intervention in patients with unstable angina pectoris (UAP). Methods: A total of 116 patients with UAP who underwent drug-coated balloon intervention at our hospital from March 2019 to March 2024 were prospectively selected and assigned by the envelope method to a control group and an intervention group, with 58 patients in each group. The control group received rosuvastatin, and the intervention group received a in addition to rosuvastatin. Changes in angina symptoms (duration and frequency of angina attacks), myocardial injury markers [N-terminal pro-B-type natriuretic peptide (NT-proBNP) and creatine kinase-isoenzyme (CK-MB)], lipid parameters {total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), lipoprotein(a) [Lp(a)], apolipoprotein A (ApoA), and apolipoprotein B (ApoB)}, clinical efficacy, and major adverse cardiovascular events (MACE) were observed before and after treatment. Results: At 1 month after treatment, both the duration and frequency of angina attacks were superior in the intervention group compared with the control group (P<0.05).NT-proBNP and CK-MB levels were lower in the intervention group than in the control group (P<0.05). At 3, 6, and 12 months after treatment, TC, TG, LDL-C, Lp(a), and ApoB levels were lower in the intervention group than in the control group (P<0.05); HDL-C and ApoA levels were higher in the intervention group than in the control group (P<0.05). The overall clinical efficacy rate was higher in the intervention group (96.55%) than in the control group (84.48%, P<0.05). No statistically significant difference was observed in the overall incidence of MACE between the two groups (P>0.05). Conclusion: Evolocumab combined with rosuvastatin used after drug-coated balloon intervention in patients with UAP have favorable clinical efficacy; they can improve clinical symptoms, reduce myocardial injury markers, and regulate lipid parameters without increasing the risk of adverse reactions.
  • Clinical Efficacy of Ezetimibe Combined with Atorvastatin in Patients with Cerebral Infarction and Hyperlipidemia
    ZHANG Ya-xin, KONG Jun-min, LI Jing-jing
    Chinese Journal of Rational Drug Use. 2026, 23(9): 33-40. https://doi.org/10.3969/j.issn.2096-3327.2026.09.005
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    Objective: To investigate the clinical efficacy of ezetimibe combined with atorvastatin in patients with cerebral infarction and hyperlipidemia. Methods: A total of 76 patients with cerebral infarction and hyperlipidemia who were treated at our hospital between December 2022 and June 2025 were randomly assigned using a random-number table to a control group and an observation group, with 38 patients in each group. Both groups received secondary prevention for cerebral infarction and comprehensive management of underlying diseases. The control group received atorvastatin calcium tablets, while the observation group received ezetimibe tablets in addition to the treatment provided to the control group. Treatment lasted 6 months in both groups. The groups were compared in terms of low-density lipoprotein cholesterol (LDL-C) levels and achievement of lipid-lowering targets, high-sensitivity C reactive protein (hs-CRP) levels, carotid plaque stability (minimum fibrous cap thickness and percentage of lipid core volume), adverse cardiovascular events, and adverse reactions. Results: After treatment, LDL-C and hs-CRP levels were lower in the observation group than in the control group, while the reductions in LDL-C and hs-CRP levels and the lipid goal attainment rate were higher in the observation group (P<0.05). Minimum fibrous cap thickness was greater and the percentage of lipid core volume was lower in the observation group than in the control group (P<0.05). No statistically significant differences were observed between the two groups in the overall incidence of adverse cardiovascular events and adverse reactions (P>0.05). Conclusion: Ezetimibe combined with atorvastatin can effectively reduce LDL-C levels, stabilize carotid plaques, attenuate the inflammatory response, and achieve target LDL-C levels within 6 months in patients with cerebral infarction and hyperlipidemia.
  • Clinical Study of Zhishe Tongluo Capsules Combined with Atorvastatin Calcium Tablets for Acute Cerebral Infarction of Qi-Deficiency and Blood-Stasis Pattern
    XU Yu-hong, DANG Li, YANG Xiao-li, WANG Zhen-zhen
    Chinese Journal of Rational Drug Use. 2026, 23(9): 41-47. https://doi.org/10.3969/j.issn.2096-3327.2026.09.006
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    Objective: To investigate the effects of Zhishe Tongluo Capsules combined with atorvastatin calcium tablets on inflammatory factors and neurological function in patients with acute cerebral infarction (ACI) presenting the qi-deficiency and blood-stasis pattern. Methods: 120 ACI patients of qi deficiency and blood-stasis pattern admitted to our hospital between October 2022 and October 2024 were prospectively enrolled and assigned by the random-number-table method to a control group and a study group, with 60 cases per group. Both groups received standardized background therapy. The control group was treated with atorvastatin calcium tablets alone, while the study group received Zhishe Tongluo Capsules in addition to atorvastatin calcium tablets for 14 consecutive days. Outcomes compared included clinical efficacy, inflammatory factors [interleukin-1β (IL-1β), C reactive protein (CRP)], coagulation parameters [prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D)], neurological function and functional outcome scales [National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS)], and adverse reaction profiles. Results: At 1 day after treatment, the study group achieved a higher total clinical effective rate (91.67% vs 78.33%, P<0.05). At 1 and 7 days after treatment, IL-1β and CRP in the study group were lower than those in the control group (P<0.05). At 1 day after treatment, PT and APTT in the study group were longer than those in the control group, while FIB and D-D were lower than those in the control group (P<0.05). At 1 day after treatment, the NIHSS score in the study group was lower than that in the control group (P<0.05). At 90 days after treatment, the mRS score in the study group was lower than that in the control group (P<0.05). No significant between-group difference was found in the overall incidence of adverse reactions (P>0.05). Conclusion: Zhishe Tongluo Capsules combined with atorvastatin calcium tablets can improve clinical efficacy, reduce inflammatory-factor levels, ameliorate coagulation function and promote neurological recovery in ACI patients with the qi-deficiency and blood-stasis pattern, without elevating adverse reaction risks.
  • Clinical Efficacy of Atorvastatin in Patients with Spontaneous Intracerebral Hemorrhage After Intracranial Hematoma Evacuation
    WANG Yao, WANG Lei, TIAN Jin-jie, HUANG Hao, LU Yong, ZHU Lin-lin, ZHANG Yi
    Chinese Journal of Rational Drug Use. 2026, 23(9): 48-57. https://doi.org/10.3969/j.issn.2096-3327.2026.09.007
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    Objective: To investigate the clinical efficacy of atorvastatin in patients with spontaneous intracerebral hemorrhage (SICH) after intracranial hematoma evacuation and to provide evidence to support optimization of postoperative treatment regimens. Methods: This single-center, exploratory, prospective, randomized controlled study consecutively enrolled 100 patients with SICH who were scheduled to undergo intracranial hematoma evacuation. Using a random number table, the patients were assigned to a control group (intracranial hematoma evacuation+standardized postoperative drug therapy regimen, n=50) and an experimental group (intracranial hematoma evacuation+standardized postoperative drug therapy regimen + atorvastatin calcium tablets, n=50). Hematoma volume and absorption rate, inflammatory markers [interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α)], lipid metabolism parameters [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)], consciousness status and neurological function scores [assessed using the Glasgow Coma Scale (GCS) and the National Institutes of Health Stroke Scale (NIHSS)], 90-day postoperative functional prognosis [assessed using the modified Rankin Scale (mRS)], and the occurrence of adverse reactions and complications were compared between the two groups. Results: The hematoma absorption rates at 7, 14, and 30 days postoperatively were higher in the experimental group than in the control group (P<0.05). The reductions in IL-6 and TNF-α at 14 and 30 days postoperatively were greater in the experimental group than in the control group (P<0.05). At 30 days postoperatively, the reductions in TC, TG, and LDL-C and the increase in HDL-C were greater in the experimental group than in the control group (P<0.05). The improvement rates of NIHSS and GCS scores at 14 and 30 days postoperatively were higher in the experimental group than in the control group (P<0.05). The rate of favorable prognosis at 90 days postoperatively was higher in the experimental group than in the control group (50.00% vs 26.00%, P<0.05). There were no statistically significant differences in the incidence of adverse reactions or complications between the two groups (P>0.05). Conclusion: Atorvastatin can significantly promote hematoma absorption after intracranial hematoma evacuation in patients with SICH, inhibit inflammatory responses, improve lipid metabolism, accelerate neurological functional recovery, and increase the rate of favorable prognosis, with good safety, thereby providing new evidence for clinical treatment.
    • Rational Medication in Older Adults
  • Clinical Observation of Batroxobin Combined with Intratympanic Triamcinolone Acetonide Injection for Sudden Sensorineural Hearing Loss in Older Adults
    MEN Xin-meng, LI Xiao-na, ZHU Xiao-feng, FAN Kai-hui, SUN Zhen-zhen
    Chinese Journal of Rational Drug Use. 2026, 23(9): 58-63. https://doi.org/10.3969/j.issn.2096-3327.2026.09.008
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    Objective: To investigate the clinical efficacy of batroxobin combined with intratympanic triamcinolone acetonide injection for sudden sensorineural hearing loss in older adults. Methods: Clinical data from 98 older adults with sudden sensorineural hearing loss who were treated at our hospital from January 2022 to January 2025 were retrospectively analyzed. According to the treatment regimen, the patients were divided into a control group and a study group, with 49 patients in each group. The control group received intratympanic triamcinolone acetonide injection, whereas the study group received batroxobin injection in addition to the treatment administered to the control group. Both groups received continuous treatment for 10 days. Clinical efficacy, pure tone audiometry (PTA), coagulation indices [thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT)], and adverse reactions were compared between the two groups. Results: The overall clinical response rate was higher in the study group than in the control group (87.76% vs 71.43%, P<0.05). After adjustment for baseline values using analysis of covariance, post-treatment PTA was lower and TT, PT, and APTT were longer in the study group than in the control group (P<0.05). No statistically significant between-group difference was observed in the overall incidence of adverse reactions (P>0.05). Conclusion: Batroxobin combined with intratympanic triamcinolone acetonide injection significantly improves the clinical efficacy of treatment for sudden sensorineural hearing loss in older adults and improves hearing and coagulation function without increasing the risk of adverse reactions.
  • Effects of Nalbuphine Pretreatment on Sedation, Hemodynamics, and Quality of Anesthetic Recovery in Elderly Orthopedic Patients During Induction of Sufentanil-Based General Anesthesia
    HAN Xiao-li, LI Jin-rui, DENG Qun, WEI Jin-ju
    Chinese Journal of Rational Drug Use. 2026, 23(9): 64-70. https://doi.org/10.3969/j.issn.2096-3327.2026.09.009
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    Objective: To investigate the effects of nalbuphine pretreatment on sedation, hemodynamics, and the quality of anesthetic recovery in elderly orthopedic patients during induction of sufentanil-based general anesthesia. Methods: A total of 102 elderly patients treated in the Department of Orthopedics at our hospital from February 2021 to February 2024 were enrolled and randomly assigned to a control group or a study group using simple randomization, with 51 patients in each group. The control group received pretreatment with 0.9% sodium chloride injection, whereas the study group received pretreatment with nalbuphine hydrochloride injection. Both groups received the same general anesthesia regimen. During anesthesia induction, midazolam injection, vecuronium bromide for injection, and sufentanil citrate injection were administered intravenously. After endotracheal intubation, propofol injectable emulsion and remifentanil hydrochloride for injection were continuously infused intravenously via a pump to maintain anesthesia. Pain, assessed using the Visual Analogue Scale (VAS), and sedation, assessed using the Ramsay Sedation Scale, were compared between the two groups. The bispectral index (BIS) and hemodynamic parameters [systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR)] were recorded. Quality indicators for anesthesia recovery and the incidence of adverse reactions were also compared. Results: VAS scores at 1, 6, 12, and 24 h postoperatively were lower in the study group than in the control group (P<0.05). Ramsay Sedation Scale scores at 0.5 and 1 h after pretreatment were higher in the study group than in the control group (P<0.05). At 5 min after pretreatment and immediately after sufentanil administration, BIS, SBP, DBP, and HR were lower in the study group than in the control group (P<0.05). Eye-opening time, time to recovery of spontaneous breathing, time to recovery of verbal response, extubation time, and time to recovery of orientation were all shorter in the study group than in the control group (P<0.05). The incidences of nausea, vomiting, pruritus, respiratory depression, and dizziness did not differ significantly between the two groups (P>0.05). Conclusion: Nalbuphine pretreatment may improve analgesia and sedation during induction of sufentanil-based general anesthesia in elderly orthopedic patients and accelerate postoperative recovery, while having only a limited effect on intraoperative hemodynamics.
    • Pediatric Medication
  • Efficacy of Different Dosing Frequencies of 0.01% Atropine Eye Drops for Myopia in Children Wearing Orthokeratology Lenses and Their Effects on Visual Fatigue
    SHEN Lei, MU Ze-chen, HU Xin-miao, QIN Su-ying, LI Jin-ling
    Chinese Journal of Rational Drug Use. 2026, 23(9): 71-76. https://doi.org/10.3969/j.issn.2096-3327.2026.09.010
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    Objective: To explore the therapeutic efficacy of 0.01% atropine eye drops administered at different dosing frequencies for myopia and their effects on visual fatigue in children wearing orthokeratology lenses. Methods: A total of 147 myopic children fitted with orthokeratology lenses were prospectively enrolled at our hospital from June 2022 to June 2023. Subjects were randomized via the random number table method into group A (n=74, one drop per night daily) and group B (n=73, one drop per night every other day). All participants received 0.01% atropine eye drops together with overnight orthokeratology lens wear (8~10 h per night) for 6 consecutive months. The visual fatigue scores [Convergence Insufficiency Symptom Scale (CISS)], spherical equivalent (SE), objective ocular examination parameters (intraocular pressure, tear film breakup time, and axial length), and clinical efficacy were compared between the two groups of pediatric patients. The incidence of adverse reactions during treatment was also assessed. Results: After 1 month and 6 months of treatment, group B presented lower CISS scores than group A (P<0.05). SE, intraocular pressure, tear-film breakup time and axial length showed no statistical inter-group differences (P>0.05). After 6 months of treatment, the overall clinical effective rate was higher in group B relative to group A (P<0.05). No statistical difference was found in the overall incidence of adverse reactions between groups during treatment (P>0.05). Conclusion: Among children wearing orthokeratology lenses, once-daily and every-other-day administration of 0.01% atropine eye drops yield comparable control effects (SE, axial length, etc.) for myopia in children Once-daily administration does not significantly increase the overall incidence of adverse reactions and is suitable for patients who require regular daily medication and tolerate it well. Every-other-day administration can effectively alleviate the visual fatigue and may improve the overall clinical effective rate based on uncorrected visual acuity improvement, making it suitable for patients with significant visual fatigue or those who need to reduce the dosing frequency.
  • Effects of Acetylcysteine Combined with Ceftizoxime on Inflammatory Responses and Immune Function in Children with Protracted Bacterial Bronchitis
    GAO Hui-li, DUAN Rui-qiang, YANG Ya-qin, WANG Yan-qing, LI Ming-lei
    Chinese Journal of Rational Drug Use. 2026, 23(9): 77-83. https://doi.org/10.3969/j.issn.2096-3327.2026.09.011
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    Objective: To investigate the effects of acetylcysteine combined with ceftizoxime on inflammatory responses and immune function in children with protracted bacterial bronchitis (PBB). Methods: A total of 92 children with PBB who were admitted to our hospital from February 2022 to February 2024 were prospectively enrolled and randomly assigned, using a random number table, to a control group (treated with ceftizoxime) or a study group (treated with acetylcysteine combined with ceftizoxime), with 46 children in each group. Clinical efficacy, time for clinical symptoms to improve, inflammatory response indices [C reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), myeloperoxidase antineutrophil cytoplasmic antibody (MPO-ANCA), proteinase 3 anti-neutrophil cytoplasmic antibody (PR3-ANCA), and tissue inhibitor of metalloproteinases-1 (TIMP-1)], immune function indices (CD3+, CD4+, CD8+, and CD4+/CD8+), and blood gas indices [arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of oxygen (PaO2), and blood pH] were compared between the two groups, and the incidence of adverse reactions was recorded. Results: The overall clinical response rate was higher in the study group than in the control group (91.30% vs 80.43%, P<0.05). The time to resolution of rales, time to cessation of cough, time to resolution of dyspnea, duration of fever, and length of hospital stay were shorter in the study group than in the control group (P<0.05). After 7 days of treatment, CRP, PCT, IL-6, MPO-ANCA, PR3-ANCA, CD8+, and PaCO2 levels decreased in both groups and were lower in the study group than in the control group, whereas TIMP-1, CD3+, CD4+, CD4+/CD8+, PaO2, and pH levels increased in both groups and were higher in the study group than in the control group (P<0.05). No statistically significant between-group differences were observed in the incidence of gastrointestinal reactions, choking cough, allergic reactions, vomiting, and the overall incidence of adverse reactions (P>0.05). Conclusion: Acetylcysteine combined with ceftizoxime significantly improves clinical symptoms in children with PBB, provides more effective control of inflammatory responses, and improves immune function and blood gas parameters without increasing the risk of adverse reactions.
    • Obstetrics & Gynecology Medication
  • Clinical Effects of Atosiban Acetate Combined with Nifedipine on Threatened Preterm Labor in Primiparas Aged ≥35 Years
    HUA Su-li, ZHANG Wen-hui, GAO Wan-li, ZHANG Tian-yuan, YAN Yi-jie
    Chinese Journal of Rational Drug Use. 2026, 23(9): 84-89. https://doi.org/10.3969/j.issn.2096-3327.2026.09.012
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    Objective: To evaluate the clinical efficacy of atosiban acetate combined with nifedipine for threatened preterm labor in primiparas aged ≥35 years. Methods: 92 hospitalized primiparas aged ≥35 years with threatened preterm labor from November 2021 to June 2024 were prospectively recruited and randomly allocated to a control group and a combined group using the random number table method, with 46 patients in each group. The control group received nifedipine monotherapy, whereas the combined group was given add on atosiban acetate besides nifedipine. Inflammatory factors [interleukin-1β (IL-1β), interleukin-8 (IL-8), C reactive protein (CRP), matrix metalloproteinase-9 (MMP-9), prostaglandin E2 (PGE2), nitric oxide (NO)], time to clinical symptom relief, pregnancy related indices, neonatal outcomes and adverse reaction incidence were compared between groups. Results: After 2 week treatment, serum levels of IL-1β, IL-8, CRP, MMP-9, PGE2 and NO decreased in both groups, with significantly lower values observed in the combined group (P<0.05). Compared with the control group, the combined group had shorter time to relief for abdominal pain, lumbago, vaginal bleeding and uterine contraction suppression; longer pregnancy prolongation duration and higher gestational age at delivery; a lower preterm birth rate; and higher neonatal birth weight, 1 min Apgar score and 5 min Apgar score (P<0.05). No significant inter group differences were seen in pregnancy continuation rate and total adverse reaction incidence (P>0.05). Conclusion: For primiparas aged ≥35 years with threatened preterm labor, atosiban acetate combined with nifedipine can reduce inflammatory levels, prolong gestational duration and improve neonatal prognosis, without increasing the risk of adverse reactions.
  • Vitamin D Assisted Letrozole Treatment in Patients with Vitamin D Deficient Polycystic Ovary Syndrome and Infertility
    LI Jin-hua, FU Song-he, LANG Ai-juan, ZHENG Hong-cai, LIU Xiao-yan
    Chinese Journal of Rational Drug Use. 2026, 23(9): 90-97. https://doi.org/10.3969/j.issn.2096-3327.2026.09.013
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    Objective: To investigate the clinical efficacy and effects on pregnancy outcomes of vitamin D-assisted letrozole treatment in patients with vitamin D-deficient polycystic ovary syndrome (PCOS) and infertility. Methods: From March 2022 to January 2025, a total of 88 patients with vitamin D deficiency who had PCOS and infertility were prospectively enrolled at our hospital. Using a random number table, the participants were assigned to either a control group, which received letrozole, or an observation group, which received vitamin D supplementation combined with letrozole. Ultimately, 80 patients were included in the final analysis, with 40 in each group after 4 patients withdrew from each arm. Sex hormone levels, 25-hydroxyvitamin D [25-(OH)D] levels, endometrial thickness, pregnancy-related adverse outcomes, and ovarian hyperstimulation syndrome (OHSS) were assessed before and after treatment. The incidence of adverse reactions was also recorded. Results: The ovulation rate, biochemical pregnancy rate, clinical pregnancy rate, live birth rate and ongoing pregnancy rate were all higher in the observation group than in the control group (P<0.05). After treatment, the levels of luteinizing hormone (LH) and testosterone (T) decreased in both groups and were lower in the observation group than in the control group (P<0.05), whereas 25-(OH)D levels increased in both groups and were higher in the observation group than in the control group (P<0.05). Endometrial thickness increased in both groups and was greater in the observation group than in the control group (P<0.05). There were no statistically significant differences between the two groups in the rates of follicle-stimulating hormone (FSH), early miscarriage, multiple pregnancy, or ectopic pregnancy, or in the incidence of OHSS or adverse reactions (P>0.05). Conclusion: Vitamin D-assisted letrozole treatment can improve sex hormone and 25-(OH)D levels in patients with vitamin D-deficient PCOS and infertility, improve endometrial receptivity, and increase the clinical pregnancy rate without increasing the risk of adverse reactions.
    • Respiratory Medication
  • Therapeutic Efficacy of Shenqi Fuzheng Injection Combined with Ulinastatin for Injection in Patients with Chronic Obstructive Pulmonary Disease and Type Ⅱ Respiratory Failure
    LI Xu, LIU Miao-miao, WANG Ruo-li, CHANG Yin-jiang
    Chinese Journal of Rational Drug Use. 2026, 23(9): 98-104. https://doi.org/10.3969/j.issn.2096-3327.2026.09.014
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    Objective: To investigate the effects of Shenqi Fuzheng injection combined with ulinastatin for injection on pulmonary function and prognosis in patients with chronic obstructive pulmonary disease (COPD) and type Ⅱ respiratory failure. Methods: A total of 112 patients with COPD and type Ⅱ respiratory failure who were admitted to our hospital from January 2019 to January 2021 were enrolled and divided into a control group (n=56; treated with ulinastatin for injection) and an observation group (n=56; treated with Shenqi Fuzheng injection combined with ulinastatin for injection) according to the treatment received. The pulmonary function indices [forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), percent predicted forced expiratory volume in one second (FEV1% pred), and maximal voluntary ventilation (MVV)], blood gas indices [arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), arterial pH, and oxygen saturation (SpO2)], heart rate (HR), respiratory rate (RR), mean arterial pressure (MAP), inflammatory and oxidative stress indices [procalcitonin (PCT), C reactive protein (CRP), superoxide dismutase (SOD), and malondialdehyde (MDA)], clinical efficacy, adverse reactions, and prognosis were compared between the two groups. Results: After treatment, FEV1/FVC, FEV1% pred, MVV, PaO2, arterial pH, SpO2, MAP, and SOD increased, whereas PaCO2, HR, RR, PCT, CRP, and MDA decreased in both groups. The improvements in these indices were greater in the observation group than in the control group (P<0.05). The total clinical response rate was higher in the observation group than in the control group (98.21% vs 85.71%, P<0.05). No significant between-group differences were observed in the overall incidence of adverse reactions or 28-day mortality (P>0.05). Conclusion: Shenqi Fuzheng injection combined with ulinastatin for injection is effective for treating COPD with type Ⅱ respiratory failure. It improves pulmonary function and blood gas indices and reduces inflammation and oxidative stress.
  • Effects of Hemocoagulase Bothrops Atrox Combined with Tranexamic Acid on Clinical Efficacy in Patients with Pulmonary Tuberculosis Complicated with Hemoptysis
    ZHANG Jing, CUI Jun-wei, MA Jun-ke, WANG Yong-liang, ZHANG Bian-fang
    Chinese Journal of Rational Drug Use. 2026, 23(9): 105-110. https://doi.org/10.3969/j.issn.2096-3327.2026.09.015
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    Objective: To analyze the effects of hemocoagulase bothrops atrox combined with tranexamic acid on clinical efficacy in patients with pulmonary tuberculosis complicated with hemoptysis. Methods: A total of 92 patients with pulmonary tuberculosis complicated with hemoptysis admitted to our hospital from April 2021 to May 2023 were selected and randomly divided into control group (treated with tranexamic acid) and observation group (treated with hemocoagulase bothrops atrox combined with tranexamic acid), with 46 cases in each group. Clinical efficacy, coagulation indexes [prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), D-dimer (D-D)], pulmonary function indexes [forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), forced vital capacity (FVC), FEV1/FVC], Generic Quality of Life Inventory-74 (GQOLI-74) score and adverse reactions were compared between the two groups. Results: The total clinical effective rate of the observation group was higher than that of the control group (91.30% vs 73.91%, χ 2=4.842, P=0.028). After treatment, PT and APTT shortened in both groups and were shorter in the observation group (P<0.05); FIB, D-D, FEV1, PEF, FVC, FEV1/FVC and GQOLI-74 scores increased in both groups and were higher in the observation group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (χ 2=0.846, P=0.358). Conclusion: Hemocoagulase bothrops atrox combined with tranexamic acid has good clinical effect for patients with pulmonary tuberculosis complicated with hemoptysis. It can restore coagulation function and pulmonary function and improve patients’ quality of life.
    • Diabetes Medication
  • Effects of Yishen Huashi Granules on Renal Function and Podocyte-Related Proteins in Patients with Diabetic Nephropathy
    SHAO Hai-ying, LI Ming-feng, YOU Jian-li, SHEN Yuan-li, CHEN Kai
    Chinese Journal of Rational Drug Use. 2026, 23(9): 111-116. https://doi.org/10.3969/j.issn.2096-3327.2026.09.016
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    Objective: To investigate the effects of Yishen Huashi Granules on renal function and podocyte-related proteins in patients with diabetic nephropathy (DN). Methods: This was a retrospective cohort study. Data from 98 patients with DN admitted to our hospital between August 2023 and July 2025 were consecutively enrolled. Following propensity score matching (PSM), a total of 54 patients were ultimately included in the analysis and divided into a control group and an observation group, comprising 27 patients each, based on their actual clinical treatment pathways. The control group received conventional treatment, whereas the observation group received Yishen Huashi Granules in addition to the treatment administered to the control group. Renal function parameters [blood urea nitrogen (BUN), serum creatinine (SCr), and glomerular filtration rate (GFR)], urinary protein parameters [24-hour urinary protein excretion (24 h PRO) and albumin-to-creatinine ratio (ACR)], podocyte-related proteins [nephrin and podocin levels], clinical efficacy, and the incidence of adverse reactions were compared between the two groups before and after treatment. Results: After treatment, the levels of BUN, SCr, 24 h PRO, ACR, nephrin, and podocin decreased in both groups and were lower in the observation group than in the control group (P<0.05), whereas GFR increased in both groups and was higher in the observation group than in the control group (P<0.05). The overall clinical response rate was higher in the observation group than in the control group (92.59% vs 70.37%, P<0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (P>0.05). Conclusion: Adding Yishen Huashi Granules to conventional treatment can effectively improve the clinical efficacy of treatment for DN, improve renal function, and reduce proteinuria. It can also significantly downregulate the urinary expression of nephrin and podocin, markers of podocyte injury, thereby alleviating podocyte damage, without a significant increase in short-term adverse reactions.
    • Pain Management & Anesthesia
  • Effects of Celecoxib in Patients Undergoing Total Knee Arthroplasty Based on Latent Profile Analysis of Postoperative Pain
    LIAN Yi-jun, LI Qing-jiang, CUI Ming-xing, ZHAO Bin
    Chinese Journal of Rational Drug Use. 2026, 23(9): 117-124. https://doi.org/10.3969/j.issn.2096-3327.2026.09.017
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    Objective: To explore the effect of celecoxib on postoperative pain in patients undergoing total knee arthroplasty (TKA), and to investigate the heterogeneity of postoperative pain by latent profile analysis. Methods: A retrospective analysis was performed on 108 TKA patients treated in our hospital from January 2024 to August 2025. Patients were divided into control group (conventional intravenous patient-controlled analgesia combined with enoxaparin, n=53) and observation group (celecoxib added on the basis of control group, n=55). Postoperative pain, adverse reactions and deep vein thrombosis (DVT) were compared between the two groups, and latent profile analysis was conducted for postoperative pain. Results: The resting, exercise-related and comprehensive Visual Analogue Scale (VAS) scores at 4 h, 8 h, 12 h, 24 h, 36 h and 48 h after operation in the observation group were lower than those in the control group (P<0.05). There was no significant differences in the total incidence of adverse reactions between the two groups (P>0.05). DVT incidence in the observation group was lower than that in the control group (P<0.05). Patients were classified into low pain group (55.56%) and high pain group (44.44%) by latent profile analysis. Univariate Logistic regression showed that body mass index (BMI) and preoperative cortisol (Cor), catecholamine (CA), C reactive protein (CRP) and interleukin-6 (IL-6) were risk factors for high postoperative pain (P<0.05), while multivariate Logistic regression failed to confirm their independent predictive value (P>0.05). Conclusion: Celecoxib can effectively relieve postoperative pain in TKA patients without increasing the risk of adverse reactions and DVT. Postoperative pain presents obvious heterogeneity. Patients in the high pain group have higher BMI and preoperative stress-inflammatory indicators than those in the low pain group, whereas multivariate analysis does not prove them to be independent predictive factors.
  • Effects of Sevoflurane Combined with Remimazolam in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting
    WU Peng, WU Xi, CUI Kui, LANG Zhi-bin
    Chinese Journal of Rational Drug Use. 2026, 23(9): 125-130. https://doi.org/10.3969/j.issn.2096-3327.2026.09.018
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    Objective: To investigate the effects of sevoflurane combined with remimazolam on postoperative outcomes, quality of emergence, and cognitive function in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods: A retrospective cohort study was conducted in 112 patients who underwent OPCABG at our hospital from January 2020 to December 2024. According to the anesthetic regimen administered, the patients were divided into a control group and an observation group, with 56 patients in each group. The control group received remimazolam for maintenance of anesthesia, whereas the observation group received sevoflurane combined with remimazolam for maintenance of anesthesia. Postoperative outcomes, quality of emergence, cognitive function [assessed using the Mini-Mental State Examination (MMSE)], and adverse reactions were compared between the two groups. Results: Tracheal extubation time, intensive care unit (ICU) length of stay, and postoperative hospital stay were shorter in the observation group than in the control group (P<0.05). The incidence of agitation during emergence was lower in the observation group than in the control group (5.36% vs 17.86%, P<0.05). Repeated-measures analysis of variance showed no statistically significant main effect of group (P>0.05), a statistically significant main effect of time (P<0.05), and a statistically significant group-by-time interaction effect (P<0.05). In both groups, MMSE scores on postoperative day 1 were lower than those on preoperative day 1 (P<0.05), whereas scores on postoperative day 3 were higher than those on postoperative day 1 (P<0.05). There was no statistically significant between-group difference in the overall incidence of adverse reactions (P>0.05). Conclusion: The sevoflurane combined with remimazolam anaesthesia regimen demonstrated a positive effect in improving postoperative outcomes and enhancing the quality of recovery in patients undergoing OPCABG; within the observation period of this study, it did not significantly exacerbate early cognitive impairment in patients.
    • ENT Medication
  • Clinical Study of Flunarizine Hydrochloride Capsules Combined with Extract of Ginkgo Biloba Leaves Injection for the Treatment of Sudden Sensorineural Hearing Loss Accompanied by Vertigo
    MA Qiong-jie, LI Xiao-na, ZHAO Chun-hong, ZHU Xiao-feng, SUN Zhen-zhen, XU Lian-fang, LI Yu-jie
    Chinese Journal of Rational Drug Use. 2026, 23(9): 131-136. https://doi.org/10.3969/j.issn.2096-3327.2026.09.019
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    Objective: To investigate the clinical efficacy and safety of flunarizine hydrochloride capsules combined with extract of ginkgo biloba leaves injection in patients with sudden sensorineural hearing loss (SSNHL) accompanied by vertigo. Methods: A total of 80 patients with SSNHL accompanied by vertigo who were admitted to our hospital from July 2023 to July 2025 were enrolled and randomly assigned to the control group (n=40; treated with extract of ginkgo biloba leaves injection) or the observation group (n=40; additionally treated with flunarizine hydrochloride capsules) using simple randomization. The two groups were compared in terms of improvement in vertigo, pure tone average (PTA), vertigo-related scores [Dizziness Handicap Inventory (DHI) and Dizziness Assessment Rating Scale (DARS)], clinical efficacy, and adverse reactions. Results: After treatment, the total vertigo remission rate was higher in the observation group than in the control group (92.50% vs. 72.50%, P<0.05). PTA, DHI scores, and DARS scores decreased in both groups, with significantly greater reductions in the observation group (P<0.05). The overall clinical response rate was higher in the observation group than in the control group (87.50% vs. 67.50%, P<0.05). No statistically significant difference was observed in the overall incidence of adverse reactions between the two groups (22.50% vs. 20.00%, P>0.05). Conclusion: The combination of flunarizine hydrochloride capsules and extract of ginkgo biloba leaves injection can significantly enhance clinical efficacy in patients with SSNHL accompanied by vertigo, ameliorate vertigo symptoms and improve hearing levels, and reduce vertigo-related dysfunction scores, with a favorable safety profile.
    • Dermatologic Medication
  • Clinical Study of Intense Pulsed Light Combined with 0.03% Tacrolimus Ointment for Facial Steroid-Dependent Dermatitis
    CHEN Jing-li, WANG Wen-jia, PEI Jing-yi
    Chinese Journal of Rational Drug Use. 2026, 23(9): 137-141. https://doi.org/10.3969/j.issn.2096-3327.2026.09.020
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    Objective: To investigate the efficacy of intense pulsed light combined with 0.03% tacrolimus ointment in patients with facial steroid-dependent dermatitis. Methods: A total of 98 patients with facial steroid-dependent dermatitis who visited our hospital from June 2022 to June 2024 were enrolled and randomly assigned, using a random number table, to a control group or a combination-treatment group, with 49 patients in each group. The control group received 0.03% tacrolimus ointment, whereas the combination-treatment group received intense pulsed light in addition to the treatment administered to the control group. Clinical efficacy, skin barrier indices [epidermal sebum content, stratum corneum hydration, and transepidermal water loss (TEWL)], immune function [immunoglobulin A (IgA) and immunoglobulin M (IgM)], and quality of life, assessed using the Dermatology Life Quality Index (DLQI), were compared between the two groups. Results: After 4 weeks of treatment, the overall clinical response rate was higher in the combination-treatment group than in the control group (93.88% vs 73.47%, P<0.05). Epidermal sebum content and stratum corneum hydration were higher, whereas TEWL, IgA, and IgM were lower, in the combination-treatment group than in the control group (P<0.05). DLQI scores at 2 and 4 weeks after treatment were lower in the combination-treatment group than in the control group (P<0.05). Conclusion: Intense pulsed light combined with 0.03% tacrolimus ointment significantly improves treatment efficacy, skin barrier function, immune function, and quality of life in patients with facial steroid-dependent dermatitis.
    • Classical & Empirical Formulations
  • Efficacy Observation of Zhitong Rushen Decoction Encircling Therapy on Patients after Anal Fistula Surgery and Data Mining-Based Analysis of Influencing Factors
    MIAO Ai-feng, CHENG Lu-lu, ZHANG Chuan-ju
    Chinese Journal of Rational Drug Use. 2026, 23(9): 142-148. https://doi.org/10.3969/j.issn.2096-3327.2026.09.021
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    Objective: To explore the application effect of Zhitong Rushen Decoction encircling therapy in pain management and wound healing after anal fistula surgery, and to analyze influencing factors of clinical efficacy based on data mining. Methods: A retrospective analysis was performed on 200 patients after anal fistula surgery treated in our hospital from January 2022 to January 2023. Patients were divided into control group (n=98, conventional treatment) and study group (n=102, conventional treatment plus Zhitong Rushen Decoction encircling therapy) according to therapeutic regimens. Pain degree[Visual Analogue Scale (VAS)], wound healing time, bleeding cessation time during defecation, wound conditions and clinical efficacy were compared between the two groups. Data mining was performed using IBM SPSS Modeler 18.0 software, and a decision tree node was used for modeling to analyze the influencing factors of clinical efficacy. Results: The VAS scores on day 3, day 7 and day 14 after treatment decreased in both groups compared with baseline, and were lower in the study group (P<0.05). The wound healing time and bleeding cessation time during defecation in the study group were shorter than those in the control group (P<0.05). On day 14 of treatment, granulation tissue morphology, wound exudate score, wound area and wound longitudinal diameter decreased in both groups, and these indicators were lower in the study group (P<0.05). The total clinical effective rate on day 14 in the study group was 94.12%, higher than 80.61% in the control group (P<0.05). Data mining results showed that treatment method was the primary factor affecting clinical efficacy (adjusted P=0.004). Pre-treatment granulation tissue morphology score was a predictor for further stratification within the study group (adjusted P=0.017). Conclusion: Zhitong Rushen Decoction encircling therapy can effectively relieve postoperative pain after anal fistula surgery, promote wound healing, improve granulation tissue morphology and wound exudate, and boost clinical efficacy. Data mining further indicates that treatment method is the primary influencing factor for clinical efficacy, and pre-treatment granulation tissue morphology score serves as an important indicator affecting clinical efficacy in the study group.
  • Clinical Study on Chaigui Decoction Combined with Yin Channel Penetrating Acupoint Therapy for Post Ischemic Stroke Cognitive Impairment
    HAN Ke-qing, ZHU Meng-jiao, LI Fei
    Chinese Journal of Rational Drug Use. 2026, 23(9): 149-155. https://doi.org/10.3969/j.issn.2096-3327.2026.09.022
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    Objective: To investigate the effects of Chaigui Decoction combined with yin channel penetrating acupoint therapy on neural repair, cerebral hemodynamics, amyloid β-protein1-42 (Aβ1-42) and phosphorylated tau protein (p-tau) in patients with cognitive impairment after ischemic stroke. Methods: A total of 80 patients with cognitive impairment after ischemic stroke treated in our hospital from October 2021 to October 2023 were enrolled and divided into control group and observation group according to the random number table method, with 40 cases in each group. The control group received conventional Western medicine treatment; the observation group received Chaigui Decoction combined with yin-channel penetrating acupoint therapy on the basis of the control group. Both groups were treated continuously for 4 weeks. Traditional Chinese medicine (TCM) syndrome scores, cognitive function [Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Mini-Mental State Examination (MMSE)], neurological function [China Stroke Scale (CSS)], motor function [Fugl-Meyer Assessment Scale (FMA)], cerebral hemodynamics (cerebral arterial blood flow velocity, peripheral resistance), serum markers related to nerve injury (p-tau, brain-derived neurotrophic factor (BDNF), Aβ1-42), clinical efficacy and adverse reactions were compared between the two groups. Results: After treatment, TCM syndrome scores, CSS score, peripheral resistance and p-tau in the observation group were lower than those in the control group (P<0.05). The LOTCA, MMSE, FMA scores, BDNF and Aβ1-42 in the observation group were higher than those in the control group (P<0.05). Cerebral arterial blood flow velocity in the observation group was faster than that in the control group (P<0.05). The total clinical effective rate of the observation group was 95.00%, which was higher than 75.00% of the control group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Chaigui Decoction combined with yin channel penetrating acupoint therapy can effectively regulate cerebral hemodynamics, promote nerve repair, improve cognitive function and motor function, and enhance clinical efficacy in patients with cognitive impairment after ischemic stroke.
    • Public Education on Rational Drug Use
  • Calcium Chronicles: Bones, Life, and Choices
    ZHENG Xiao-xia
    Chinese Journal of Rational Drug Use. 2026, 23(9): 156-158. https://doi.org/10.3969/j.issn.2096-3327.2026.09.023
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