目的 探讨中医药治疗小儿腺样体肥大（AH）的研究现状、研究热点及趋势，为本领域研究者提供借鉴。方法 检索中国知网（CNKI）数据库从2005年1月1日至2024年1月31日中医药治疗小儿腺样体肥大的相关文献。运用Excel 2019分析其发文量，运用CiteSpace 6.2.R6软件分析其作者、机构、关键词。结果 共纳入文献395篇，年发文量整体呈现波动上升的趋势；发文量最多的作者为姜之炎；发文量最多的研究机构为山东中医药大学。初步形成了以姜之炎、俞景茂、阎兆君为核心的研究团队；研究机构以中医类院校及其附属医院为主。高频关键词提示当前研究热点前三位为中医药治疗方法、临床疗效。结论 AH领域研究内容主要以内治法、外治法、作用机制为主；研究热点逐渐从临床研究转向作用机制等实验研究；应用“数据挖掘”“网络药理学”等计算机技术研究AH会成为趋势。
Objective To explore the research status，research hotspots，and trends of traditional Chinese medicine in the treatment of adenoid hypertrophy in children，to provide a reference for researchers in this field．Methods The relevant literature on the treatment of adenoid hypertrophy in children with traditional Chinese medicine was searched in the CNKI database from January 1，2005，to January 31，2024．Excel 2019 was applied to analyze the number of published papers，and CiteSpace 6.2.R6 software was applied to analyze its authors，institutions，and keywords．Results A total of 395 papers were included，and the annual number of papers showed a fluctuating upward trend．The author with the largest number of papers was JIANG Zhiyan．Shandong University of Traditional Chinese Medicine was the research institution with the largest number of papers．The core research teams including JIANG Zhiyan，YU Jingmao，and YAN Zhaojun were initially formed．The research institutions were mainly Chinese medicine colleges and their affiliated hospitals．High-frequency keywords suggest that the current top three research hotspots were traditional Chinese medicine treatment methods，clinical efficacy．Conclusions The research content in this field is mainly based on internal treatment，external treatment，and mechanism．The focus has gradually shifted from clinical research to experimental research such as mechanism．The application of computer technologies such as “data mining” and “network pharmacology” for this disease will become a trend．
目的 分析广州市中医优势病种按病种分值付费政策实施效果，以期为完善广州市中医病种付费方式改革提供参考思路。方法 以广州市某三甲中医医院住院患者在政策实施前（n=6 057）及实施后（n=7 208）住院病历为研究样本，对医院次均住院医疗费用、中医综合治疗费占比、平均住院日进行两独立样本非参数检验等描述性统计分析。结果 政策实施后，住院人次增长19%，患者次均住院医疗费用下降7.02%（P＜0.001），中医综合治疗费用占比提升0.8%（P＞0.05），医疗机构平均住院日缩短0.63 d（P＜0.001），入组中医优势病种患者自费率较非入组的低，医疗机构总体病例组合指数下降，中医优势病种结算有盈余。结论 中医优势病种按病种分值付费政策有利于医保-患者-医院三方共赢；但中医优势病种入组率有待提高，建议加大对中医医疗机构的支持与助力；中医综合治疗费用占比提升不显著，建议完善中医治疗项目医疗服务价格动态调整机制；中医优势病种仅局限在住院，建议实现诊疗单元全覆盖。
Objective To discuss the correlation analysis of the hospitalization expenses of TCM dominant diseases under the DIP payment mode，and provide a reference for further promoting the reform of the payment mode of TCM dominant diseases in Guangzhou．Methods The nonparametric test was used to analyze the number of inpatients，the average hospitalization cost，and the proportion of TCM comprehensive treatment on the data of inpatient records before and after the implementation of the TCM dominant diseases policy，the sample sizes were 6 057 and 7 028 respectively．Results After the implementation of the TCM dominant diseases policy，there was a slight fluctuation in the number of inpatients from 6 057 to 7 208，the average hospitalization cost was decreased by 7.02%（P＜0.001），the proportion of TCM comprehensive treatment costs had an increase of 0.8%（P＞0.05），the average length of hospital stay was shorten by 0.63 days（P＜0.001），the self-expense rate of the patients with the TCM dominant diseases of in the group was lower than that of the patients without the group，the total case mix index value of the hospital decreased，but there was a surplus on the group of TCM dominant diseases settlement．Conclusios The policy is conducive to the tripartite win-win of medical insurance，patients and hospitals．However，the enrollment rate of TCM dominant diseases need to be improved，which is suggested to increase the support for TCM hospitals．The proportion of TCM comprehensive treatment has not increased significantly，so it is suggested to improve the dynamic adjustment mechanism of medical service price of TCM treatment items．The TCM dominant diseases are only limited to hospitalization，and it is recommended to achieve full coverage of diagnosis and treatment units．
目的 提示临床在使用解郁化痰安神颗粒过程中，予以关注其发生的药物不良反应，同时进一步重视中成药及中药制剂带来的药物不良反应，并与中医药当中的瞑眩反应予以区分。方法 通过分析1例解郁化痰安神颗粒致失眠不良反应，基于中国知网、万方数据知识服务平台等国内数据库，对不良反应发生机制予以分析、讨论。结果 本次解郁化痰安神颗粒致失眠不良反应1例，不良反应相关性评价为“可能”，根据临床观察，可能为中药中典型的“瞑眩反应”。结论 临床当发现基于中成药的不良反应，应予以分析辨别，及时处置药物不良反应，进一步观察研究瞑眩反应。
Objective To suggest that during the clinical use of Jieyu Huatan Anshen Granules，attention should be paid to its adverse drug reactions，and further attention should be paid to the adverse drug reactions caused by traditional Chinese patent medicines and simple preparations and traditional Chinese medicine preparations，and it should be distinguished from the insomnia and dizziness reactions in traditional Chinese medicine．Methods A case of insomnia adverse reaction caused by Jieyu Huatan Anshen Granules was analyzed based on domestic databases such as CNKI and Wanfang data to investigate and discuss the mechanism of adverse reactions．Results One case of insomnia adverse reaction caused by Jieyu Huatan Anshen Granules was reported，and the correlation evaluation of the adverse reaction was “possible”．According to clinical observations，it may be a typical “dizziness reaction” in traditional Chinese medicine．Conclusions When adverse reactions based on traditional Chinese medicine decoction，traditional Chinese patent medicines and simple preparations and other traditional Chinese medicine preparations are found in clinical practice，they should be analyzed and identified，and the adverse reactions should be handled in time and be further observed and studied．
