| Based on China's traditional Chinese medicine theory and with clinical use as its core,clinical Chinese medicine is a discipline that studies the basic theory and clinical application of Chinese medicine.A clinical pharmacist in Chinese medicine is a bridge between Chinese medicine and Chinese herbal medicine,and should develop scientific clinical thinking in clinical practice,using Chinese medicine theory as a guide and fully applying modern technology to guide the rational clinical use of medicines.During my practice in the Department of Pharmacy,the Department of Integrative Oncology and the Department of Lung Transplantation of China-Japan Friendship Hospital,I completed 36 weeks of routine laboratory work in therapeutic drug monitoring,18 weeks of consultation work in Chinese medicine and 48 weeks of pharmacy practice in specialist clinical herbal medicine.Through the combination of medicine and pharmacy,Chinese and Western medicine,clinical and laboratory studies,she mastered many clinical skills such as pre-treatment of commonly used therapeutic drugs,patient medication education,clinical herbal medicine consultation,individualized medication administration,and establishment of patient medication records.As the technology of solid organ transplantation continues to mature,organ transplantation has become the most desirable means of treating end-stage organ failure.The development of organ transplantation in China has also been combined with the cultural background of Chinese medicine,which has played its unique advantage in the face of numerous post-transplant complications.The immune rejection that accompanies transplantation has an important impact on the long-term survival rate of patients,and therefore the research and rational clinical application of immunosuppressive drugs occupies a very important position.At present,tacrolimus is widely used in clinical practice as a first-line anti-rejection drug after transplantation,but due to the narrow therapeutic window of tacrolimus and the great variation of individual patients,how to achieve the effective blood concentration range becomes the key to its clinical efficacy.In recent years,the effect of pentosidine on the treatment of tacrolimus has become a hot topic of clinical discussion.In this study,we used a combination of evidence-based and clinical studies to analyze the rationality of pentosidine application after organ transplantation,in order to provide reference for clinical use.1 Meta-analysis of the effect of the combination of Wuzhi preparation on tacrolimus treatment after liver and kidney transplantationA systematic search of China Knowledge Network(CNKI),Wanfang database(Wan fang),VIP Chinese journal full-text database(VIP),Chinese Biomedical Literature Database(CBM),PubMed and Cochrane Library was conducted by two investigators to screen,extract,include and evaluate the risk of bias of the literature data after the combination of Wuzhi preparation on the treatment of hepatic and renal transplantation with tacrolimus.tacrolimus after renal transplantation,maintenance dose,incidence of acute rejection,liver and kidney function and occurrence of adverse reactions as outcome indicators,and Meta-analysis was performed using Review manager 5.3 software.Meta-analysis results showed that the blood concentration of tacrolimus was significantly higher in the control group[MD=1.34,95%CI=(1.19,1.49),P<0.00001]and the dose of tacrolimus was significantly lower in the control group[MD=-0.96,95%CI=(0.96),P<0.00001]when combined with Wuzhi capsules.0.96,95%CI=(-1.13,-0.79),P<0.00001],ALT was significantly lower in the liver transplant patients than in the control group[MD=-23.83,95%CI=(-35.00,-12.66),P<0.0001],and the differences in biochemical index levels and incidence of adverse reactions were not The differences in biochemical index levels and incidence of adverse reactions were not statistically significant compared with the control group.2 Systematic evaluation of the efficacy,safety and cost-effectiveness of the treatment with Wuzhi in combination with tacrolimusCNKI,Wan fang,VIP,CBM,PubMed and Cochrane Library were systematically searched,and the literature was screened,extracted,included and evaluated for risk of bias by two investigators before the systematic evaluation of the effectiveness,treatment cost and incidence of adverse effects of Wuzhi capsule combined with tacrolimus treatment as outcome indicators.Twenty-two studies,including 12 randomised controlled trials,7 case-control and 3 case reports,with a total of 1362 patients,were ultimately included.The results showed that tacrolimus combined with Wuzhi was more effective than the control group in the treatment of idiopathic membranous nephropathy and immune glomerular disease,that there was no statistical difference in the effectiveness and incidence of adverse reactions in the prevention of immune rejection after liver and kidney transplantation,and that the cost of treatment and cost-to-effect ratio were better than the control group.3 Effect of combining Wuzhi capsules on tacrolimus treatment after lung transplantationPatients who were given Wuzhi capsules after lung transplantation to increase the blood concentration of tacrolimus were selected as the study subjects.The tacrolimus blood concentration of patients was measured,and the changes of tacrolimus dose,liver and kidney function and blood parameters after the combination of Wuzhi capsules were recorded,and retrospective analysis and discussion were conducted.The tacrolimus blood concentrations of the included lung transplant patients on day 1 of administration of Wuzhi capsules showed an increasing trend,but the difference was not statistically significant(P>0.05);the C/D increased significantly on days 3 and 7 of the combination(P<0.05).The patient's tacrolimus dose on days 1,3 and 7 after the administration of Wuzhi capsules was significantly lower than before the combination(P<0.05).There was no statistically significant difference in the levels of serum creatinine,alanine aminotransferase,aspartate aminotransferase and other biochemical indicators such as white blood cells,neutrophils,lymphocytes,lymphocyte percentage,red blood cells,haemoglobin and red blood cell pressure product(P>0.05).In conclusion,the combination of Wuzhi formulation in liver and kidney transplant recipients after surgery can increase the blood concentration of tacrolimus and reduce the dose of tacrolimus,and protect the liver function of patients.Apart from this,the Wuzhi formulation has a good safety profile and a good economic benefit and is worthy of clinical use. |
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