乐鱼体育app颈椎脱位不大意 专业治疗麻痹省中医院治疗复杂陈旧颈椎骨折脱位患者

　　今年jin年nian1月yue，患有huan的zhe修xiu剪jian自ziaiaping果实guo树shurzhishishien不小心shen掉shuailuo，当dang时，shi感觉gan觉jue颈bo子zi痛teng痛tong，右you手shou拇指zhi、食yi指zhi发fama，在zai当dang地di医yi医院yuan检查jian查zha发fa现xian颈jingzhui滑hua脱tuo。因为yin为wei当di医yi医院yuan医yiao条款jian有you限xian，家jian人ren将jiang患者zhe转zhuan到zhi省xing级jimou医yi医院yuan就jiu诊zhen，给ji患者zhe颈jingzhui佩戴dai颈jing托tuo固g定ding后，hou建jian议yi回hui家jia休xu养yang，就jiu这zheyang而言，刘liu某mou带dai带着zhuo颈jing托tuo回到dao家jiazhong。

　　近jin日ri，甘gan肃su省xing中zhong医院yuan骨gu肿zhong瘤liu科ke李li红hong专zhuan主zhu任ren团tuan队dui治疗liaoliao一yi位wei患huan病bing4ge多duo月yuede复fu杂za陈chen旧jiu性xing颈jing椎zhui骨gu折zhe脱tuo位wei患huanzhe。gai患huanzhe因yin病bing情qing被pidang搁置、手shou手术zhu很难、风feng险xian高gao，xia已yi康kang复fu出chu医院yuan，在zai团tuan队dui专业学习xue的de治zhi疗liao下。

　　患有huan的zhe前qian来到lai省xing中zhong医院yuan进行jiu诊断zhen。通过guo仔细xi查zha体titiong通过guo、阅读yue片pian、查zha阅读yue文wen提供xian资料liao，李li红hong专zhuan团tuan队dui决定jue决定ding为wei患huanzhe进入jing手shou技术zhu治zhiliao，5月yue8日ri为wei患huanzhishiangzhuihua脱tuo前qian-后hou-前qian路lusong解xie复fu位，手shou手术zhu历li时shi6小xiao时shi，手术zhu后hou患huanzhe恢复hui复fu良liang好hao，临lin床chuangzhengzhengzhuang时shiao，、运yun动donggong能neng正zheng常chang。乐鱼体育app

　　5月份yue份fen，复fu查zhaCT显示xian显示shi，患有huan的zhezhui体ti滑hua脱tuo比bi之zhi之前的qian更严格，而且qie病bing人ren也觉得gan觉jue手shou指zhima木mudezheng状zhuang加jia重zhong。医yi生sheng建jian议yi患huan的zhe尽jin快kuai到dao大da医yi医院yuan治zhi治疗liao，否则ze会有you瘫痪tan瘫痪huan的de危险xian。

　　来lai源yuan： zhou新xin网络 罗兰州zhou日ri　　罗兰州zhou日ri社she全quan媒mei体ti记ji者zhe 刘liu小xiao芳fan

　　一yi个ge关guan于yu干gan细xi胞bao和yu免疫yi细xi胞baode健jian康kang公gongyi科kepu平pingtai

　　yi下xia文wen章zhanglai源yuanyuan细xibaozhe说shuo ，zuozheyang Jiayin

　　suisuishshang（Spinal cord injury），通tong常chang是指zhi脊ji髓sui受shou到dao外wai部bu影ying的影响，制造zao成cheng损伤sung部bu位wei和ji其qi以yi下xia部bu分fen瘫痪huan或huo全quan部bu瘫痪huan，使shi患huang的zhong最终zhong身体shen残疾ji。脊ji髓sui损伤sun伤shang是shi一yi种zhong比bi更jiao经常chang见xiang的de外wai伤shang。

　　关guan注zhu我的women，获得huo获取qu更geng多duo相xiang关guan资zi讯xun

　　shang(源yuan自zibing)

　　长zhang期qi以yi来lai，治疗zhi治疗liao脊ji髓sui损sun伤shang主zhu要yao通tong通过guo手shou术zhu脊ji髓sui减jian压ya恢复fu其qi稳wen定dingxing，通过guo药yaowuo、高gao压ya氧yang等deng治疗zhiliao来lai抑yi制zhi或huo减jian轻qing其qi继ji发fa性xing损伤sun伤shang。在zai一yiding程cheng度duo上shang减jiang轻qingliao患huang的zhengzhengzheng状zhuang，但dan和bing没有wei在zai神shen通过jing功gong可以neng方fang面miang取qu。因为yin这ci，当dang今jin急ji需要xu一yi种zhong高gao效xiao安an全quandezhi治疗liaofang案an来lai改gai变bian这zhongzhong状zhang状况kuang。乐鱼官网

　　黎shu光guang初chu现xiande干gan细xi胞bao治疗liao法fao

　　于yu是shi，干gan细xi胞bao治zhiliao应ying运yun而er生sheng。脊髓sui损sun伤shang治疗zhi治疗liaode难nuo点dian在zai于yui。：神shen通过jing传导zhuandao重zhong建jian和ji运yun动dong功gong可以neng的de恢hui复fu。免mian疫yi系xi统tong一yi方fang面miang是shi可ke推动cu进入jin神shen通过jing系xi统tong再zai生sheng，而er另ling一yifang面mian则que产chan生sheng瘢bang痕hen阻止zu止zhi神shen通过jing再zai生sheng连lian接jie。一yi般ban认ren，wei治zhi，liao窗口chuang口kou期qi， 6 个ge月yue。

　　关guan于yu机ji理li，越yue来lai越yueduodezheng，ju表biao显示ming可以neng有you两liangzhong：

　　干gan细xibao由you于yu具ju有you强qiang大dade自zi我wo复fu制zhi可以neng力li和he旁pang分fen泌mi作zuoyong，科ke学习xue家jia和he医yi生sheng在zaizhi治疗liao“脊ji髓suisuisuisun伤shang”方fang表面mian送ji给yu。

　　移yi植zhi细xi胞bao替ti代替daishou损sun细xi胞bao，将cu推入jin脊ji髓sui损sun伤shang空kong洞dong区qu形xing形成cheng桥qiao接jie，引导dao神shen通过jing再zai生sheng、调zhou节jie免疫yi微wei环境jing、在修xiu复fuji髓sui中，zhong非fei神shen经jing组zu织zhi等deng促使cu进入jin神shen经jing受伤sung恢复huifu。

　　移植zhi后，hou的de细xi胞bao通过guo提ti为gong修复xiu复fun伤shang的de细xi胞bao因yin子zi，将cu推入jin原yuan受shou损sun组zhi从zinran修复xiu复fu，或huo防fang止zhi损伤sun伤shang进入jin一yi步bu加jia重zhong。

　　表biao1. 用yong治疗zhiliaoji髓suisuisuisun伤shang细胞bao种zhongleilai来lai源yuan

　　目mu前qian全quan球qiu在zai研究yande干gan细xi胞bao治疗zhiliao脊ji髓suisuisun伤shang临lin床chuang试shi验yan项xiang目mu，使shi使用yongliao骨gu髓sui间jian充chongzhi干gan细胞baog、脂zhifang、在dai之间的jian充chonghi干、shen经jin细xibaooo、shao突tiao质量zhian体tibaooobaooo、自zi体ti施shi旺wang细xibaooo、自zi体ti嗅xiu鞘shao细xi胞bao。按ju美mei国guo国guoli卫生sheng研究yuan研究yuan（NIH）全quan球qiu最zuidade临lin床chuang研yan研究jiu数shu根据ju库kuclinicaltrialssshang注明zhuicedexinixi统tong计ji，细xi胞bao治疗zhi疗法liao脊ji髓sui损sun伤shang临lin床chuang试验shi验yan项xiang目mu有you57项xiang，其qi中zhong大da部bu分fen处chu在zai1期qi，zai2期qi中有youxie处chu。

　　临lin床chuang试shi验yanzhong，最zui经常chang看到xian用yong在yu治疗zhi，liaoji髓suisuisuisun伤shangdexibao来lai源yuan主zhu要yao是shi间jian充chongzhi干gan细胞bao、神shen经jing干gan细xi胞bao和heshao突tu胶jiao质zhi前qian体ti细xi胞bao。

　　用yong治疗zhiliao脊髓suisuisuisuisuisuisuishangdexibao治疗liaofao法fao

　　jian充chonghi干gan细胞

　　表biao2。干gan细xi胞bao治疗zhiliao脊髓suisuishshang临lin床chuang试shingzhan[1]

　　临lin床chuang试验shiong，最zui常chang用yong在yu治疗zhi，liao脊ji髓sui损伤shang的de细xi胞bao来lai源yuan，当dang属于zhu间jian，当dang属于zhu间jian。根据ju统tong计ji，间jian充chongzhi干gan细胞bao治zhiliao脊ji髓suisuisuishang，临lin床chuang结jie果guo显xian显示shi没有wu明ming显xiang副pi作zuoyong，并且bing有you一yi定ding的de治疗zhiliao效果xiao果guo[2-4]。

　　jian充chonghi干gan细胞（Mesenchymal Stem Cells, MSCs），lai源yuan骨髓sui、zhifang组织zhiz、带dai的脐qi、胎tai盘pan等deng组zu织zhi。间jian充chongzhi干gan细xi胞bao易yi于yu分fen离li和he扩kuo增zeng，具有you免疫yi调zhou节jie、抗kang凋亡diao、血xue管guan生sheng、抗kang瘢ban痕hen和heng养yang支zhi持chi等deng多duo种zhong生sheng物wu学习xue功gong。

　　2017年nian，中zhong山shan大da学xue附fu属zhu第di三san医yi院yuan戎rong利li民min团tuan队dui开kai展zhan间jian充chongzhi干gan细胞bao治zhiang。前qian，对zerong利li民队tuan队dui负责 “鞘shao内nei注zhu射yi人ren与tongzhong异yi体ti脐qi带dai间jian充chongzhi干gan细胞bao治zhi治zhiliao脊ji髓suisuisuisun伤shangde临lin床chuang试shiang，ji机ji制zhi研yan研究jiu”项xiang目mu。他们men发fanbuliao干gan细xi胞bao治zhiao早zao慢性xingji髓suisun伤shangde临lin床chuang研究yanjiu方fang案an[5-6]，并且bing开kai展zhan，liao超chao通过guo百bai例li的de临lin床chuang试shi验yan。

　　2015年nian，中zhong科ke院yuan遗yi传zhuansuo戴dai建jian武wu团tuan队dui，开kai展zhan世shi界jie首shou例li神shen通过jing再zai生sheng胶jiao原yuan支zhi架jia结jie结合he骨guisuisui单shan个ge核hu细胞bao(里li面mian含hanbmsc)移植zhi治zhisuisuisuisuisuisuisuisuin个gelian。先xian后，hou在zai3家jia临lin床chuang医院yuan进入jin行xingliao5例liji髓suisuisun伤shang修xiu复fu手shou技术zhu，安an全quan性xing得到dei到dao肯ken。除了chuliao干gan细xibao作zuo使用yong外，神shen通过jing再zai生sheng胶jiao原yuan支zhi架jiaogong不buke没有mo，避免biao细xibaode扩kuo散san，提ti高gaoliao干gan细xi胞bao治zhiliao效果xiao果guo。

　　神shen经jin干gan细xibaoo（Neural Stem Cells，NSC），是shi神shen经jingxi统tong内nei的de干gan细xi胞bao，可ke自zi我wo更geng新xin并bing演yan变bian为wei分fenhua的de前qian体ti细胞bao，从conger生sheng到cheng神shen，从conger生sheng到jing元yuan和ji胶jiao质zhi细胞bao，Ru星xing形状xing胶jiao质zhi细胞bao和heshao突tu胶jiao质zhi细胞bao等bi。

　　2019年nian，日ri本ben有you条tiao件jian地di批准pi准zhun上shangshiliao一yikuan治zhiliansuisuisuisuishangdiangliangliangliangliao方法fao——Stemirac。首先，xian抽chou取qu患者zhe约yue500 sui血液xue，并且bing获得huo间jian充chongzhi干gan细xibao，然后zaiti外wai扩kuo增zeng到zhi5千qian万wan到dao2亿yishu量liang，zai损伤sun伤shang发送fa生sheng后，houde3-8周zhou内nei将jiang其qi静jing脉mo注zhu射yi到dao患huangzhe体tinei，以yi期qi达da到dao治zhiliao效果xiao果guo。

　　Stem Cells Inc.是shi国guo际ji上shang首shouge开kai展zhan神shen经jing干gan细xi胞bao(来lai自zi流liu产chan胎tai脑nao组zu织zhi)治疗zhi治疗liao脊ji髓sui损sun伤shangdegong司si，部bu分fen病bing人ren的de感gan觉jue功gong可以neng有yousuo改gai好shan。然ran和er，Stem Cells Inc.2016年nian5月yueyou于yu某mou点xieyuan因yin终zhong止zhiliao干gan细xi胞bao治zhiliao脊jisuisuisuishangshang 2 期qi临lin床chuang试shi验yan。

　　1992年nian，Reynolds和heweiss等deng首shou先xian从cong小xiaoshuwen状zhuangti中zhong分fen离li得到huo得到deishen。bao。神shen经jing干gan细xi胞baode发fa现xian为wei脊ji髓suisuisuisuisuishang治zhishangliao带dai来lai新xindexi望wang，移yi植zhi的de神shen通过jing干gan细xibaoke填zhen充chongji髓sui损伤shang后hou残can留liu的de空kongqiang，在zai体ti内nei分fen化hua出chushen通过jing、星xing形xing胶jiao质zhi细xi胞bao和he少shao突tu胶jiao质zhi细xi胞bao，提供ti供gong再zai髓sui鞘shao化hua和ji新xinde神shen通过jing连接jie，保bao持chi神shen通过jing纤xian维weide完成wan整zheng性xing。

　　shao突tiao质量zhian体tibaooobaooo

　　神shen经jing干gan细xi胞bao，ye可ke以yi通tong通过guo诱导youdao多duo可以neng干gan细xi胞bao（iPSCs）分fen化hua得到huo得到dei。目mu前qian，日ri本ben庆qing应ying大da学习xue正zheng在zai开kai展zhaniPSC来lai源yuande神shen，通过jing干gan细胞bao治疗zhing，观看guan观察cha其qi安an全quan性xing和he有you效xiao性xing，为wei期qi一yi年nian。与yu天tian然ran得到huo得到dei的de神shen经jing干gan细xibao相xiang比bi，iPSCs来lai源yuandeshen经jing干gan细xibao具ju有you可以批pi量liang生shen。chan，自zi体ti移yi植zhi的de优you势shi[7]。

　　移动dong物wu实shi验yan表biao明ming，移动yi植物zhi的deopc可以ke推动cu进入jin白bai质zhi存cun留liu，增加zeng加jianei源yuan性xing少shao突tu胶jiao质zhi细胞bao数shing，减jian小xiao空kong腔qiang容rong积ji，从cong和er提ti高gao运yun动dong恢复hui复fu。OPC其qi潜qian在zaide治zhiliao机ji制zhikeneng是shi，然后zai髓sui鞘shaohua，调zhou节jie局ju部bu免mian疫yi微wei环huanjing，分fen泌mi神shen通过jing营ying养yang，提ti供gong物wu理li支zhi架jia用yi支zhi支撑cheng生sheng长zhang的de轴zhou突tu。OPC可以用yi分割fen泌mi一yi系列lie物wu质量zhi，包bao包括kuo生sheng长zhang因yin子zi，神shen通过jing营ying养yang因yin子zi，趋qu化hua因yin子zi和yu细xi胞bao因yin子zi。

　　少shao突tiao质zhixibaoobaooo（Oligodendrocyte，OL），是shi中zhong枢shushen经jingde成chengsuishao神shen经jing胶jiao质zhi细胞bao，而eroPC是shi少shao突tu胶jiao质zhi细胞bao系xi发fa育yude起qishi细胞bao，是shi不wei成cheng熟悉shu的deol，有you比jiao强qiangde增zeng能neng力li。OPC可以ke以yi在zai体ti内添加zengzhi、迁qian移yi、分fen化hua为wei成cheng熟悉shu的de少shao突tu胶jiao质zhi细xibao，bing形xing成chengsui鞘shao发fa挥hui功gong可neng。适用于shi的yongyuji髓suisuisuisuishangshangzhi疗法liao，对dui损伤sun伤shang反fan应ying快xun速su，能neng自zi我wo更geng新xin，是shi损伤sung修xiu复fu的de重zhong要yao组zu成cheng部bufen。

　　多duo可以nengan细xibao（PSC），包bao包括kuo胚胎tai干gan细胞baooo（ESC）和he诱you导dao性xing多duo可以nengan细xibao（ iPSC），通过guo定ding通过guo定ding到xiang分fen化hua可ke得到huodei大da量liang的deopc。多duo可以neng干gan细xi胞bao可ke在zai体ti之外wai无wu限xian扩展kuo增加zeng，具有ju具有you非常hen强qiang的de分fen化hua潜qian可以neng，理li论lun上shang可ke形xing可以在cheng体ti中使用ren何he一yi种zhong细xi胞。bao。2009年nian，美国guofda批pi准zhun一yi项xiang临lin床chuang试shi验yan，利li用yong胚pei胎tai干gan细胞bao分fenhua获得huodei的deoPC细xi胞bao治疗zhi。后hou期qi因yin为wei财cai务wu原yuan因yin这个gai项xiang目mu终zhong止zhi。

　　OPC治疗zhi疗liao脊ji髓suisuisun伤shang，jing是shi因yin为wei分fen泌mi功gongneng，还huan是shi因yin为wei髓suishao再zai生sheng功gong可以neng，至zhi今jin尚shang未weiming确认que。you在yu原yuan代daiopc取huo取qu比jiao为wei困kun难nuo，其qi来lai源yuan问wen问题ti还是shi其qi应ying用yong在yu临lin床chuang需要xu解xie决juede问wen问题tizhi一yi。

　　2020年nian，国guo内nei干gan细xibao企业qi业ye三san启qi生sheng物wu和ji其qi全quan资zizi公gongsi三san启qi药yao物wu开kai发faliao一yizhong转zhuan分fang法fan（PCT/CN2014/087828)可ke利li用yong小xiao分为fen子zi化hua合he物wu，将jiang人ren变成chengxian维wei细胞bao为weioPCs。其qi优you势shi在zai于yu自zi体ti无wu排pai异yi，转zhuan化huao效xiao率shuai高gao，也ye具ju有you一yidingde成cheng本ben优you势shi。可惜hande是shi，目前qian还huan不bu可以neng规gui模mu化hua生sheng生chan。这种zhongzhong方fang法fa有you希望wang打开kai发送fa一yizhong基ji于yu自zi体tiOPC的de脊ji髓suisuisuisungshang新xin治疗liao法fa。

　　Asterias biotherapeutics公gongsi继续ji续xu开kai展zhan进入jin行xing一yi项xiang针zhen对duijisuisuisun伤shangdengdixibao治zhiang临lin床chuang试shi验yan。这zhe个ge治疗liao法fa的de核hu心xin部bu分fen是shiast-OPC1，一yizhong是you人ren胚胎tai干gan细胞bao分fenhua，er来lai的deOPC。1/2a临lin床chuang试shi验yan表biao明ming，AST-OPC1具ju有you良liang好haode安an全quan性xing，qie可ke以yi提ti升shengbing人ren运yun动dong可以nengli。不bu过guooPC1 zuo为wei胚pei胎tai干gan细xi胞baodelai源yuandexi细胞bao，需要xu要yao考kao考虑lv免mianyi排pai骂chi问wen题ti。

　　干gan细xi胞bao治zhi治liao脊ji髓suisuisun伤shangde探tan索suo脚jiao步bu从cong未wei停ting止zhi，如何ru何he让rang干gan细xibao疗liao法fa更geng安an全quan有you效xiao应ying用yong对yuji髓suisuisuisunshang，这zhe是shi科kexue家jiamen和he细xibao治疗liao法fa开kai发fa企qi业ye正zheng在zai做zuodeshing。

　　表biao3. 在yuoPC中，基jideji髓sui损伤sungshang创建chuang新xin疗liao法fai

　　[1] Ahuja, C.S., etal., The leading edge: Emergingneuroprotective and neuroregenerative cell-based therapies for spinal cordinjury. Stem Cells Transl Med, 2020. 9(12):p. 1509-1530.

　　对于dui在yusuo中有you脊ji髓suisuisuisuisuisunshang患huang的zhe来lai说shuo，每个mei一yi项xiang都有you意yiyiyi的de临lin床chuang试shisuang，不bu管guan是shi一yi小xiao步bu还huan是shi一yi大da步bu，du将jiang改为gai变bian，他们的men人ren生sheng。

　　[3] Lee, S.H., et al.,Impact of local injection ofbrain-derived neurotrophic factor-expressing mesenchymal stromal cells (MSCs)combined with intravenous MSC delivery in a canine model of chronic spinal cordinjury. Cytotherapy, 2016.

　　[2] Park, J.H., etal., Long-term results of spinal cordinjury therapy using mesenchymal stem cells derived from bone marrow in humans. Neurosurgery, 2012. 70(5): p.1238-47; discussion 1247.

　　[5] Yang, Y., et al., Subarachnoid transplantation of humanumbilical cord mesenchymal stem cell in rodent model with subacute incompletespinal cord injury: Preclinical safety and efficacy study. Exp Cell Res,2020. 395(2): p. 112184.

　　[4]Jarocha, D., etal., Continuous improvement aftermultiple mesenchymal stem cell transplantations in a patient with completespinal cord injury. Cell Transplant, 2015. 24(4): p. 661-72.

　　[7] Yamanaka, S., Pluripotent Stem Cell-Based CellTherapy-Promise and Challenges. Cell Stem Cell, 2020. 27(4): p. 523-531.

　　[6] Yang, Y., et al., Human umbilical cord mesenchymal stem cellsto treat spinal cord injury in the early chronic phase: study protocol for aprospective, multicenter, randomized, placebo-controlled, single-blindedclinical trial. Neural Regen Res, 2020. 15(8): p. 1532-1538.

　　来lai源yuan：干gan细xi胞baoozhe说shuoo

　　写zhuan文wen：Yang Jiayin

　　原yuan标biao题提示：【科ke学xue普pu及ji】用yong在yu拯救zheng救jiu脊jisuisuisuisuisuishangzhedexibao疗liao法fao：黎shu光guang初期chu现xian

　　国guo家jia医yi治疗 国guo家jia中zhong医yi药yao管guan理li局ju关guan于yu医yi保bao支zhi持chi中zhong医yi药yao传zhuan承担cheng创chuang新xin发送fangzhandedao意见

　　12月yue31日ri，国guo家jia医yi治疗、国guo家jia中zhong医yiao管guan理li局ju30日ri印yin发送fa关guan于yu医yi保bao支zhi持chi中zhong医yiao传zhuan承担cheng创chuang新xin发送fande指zhi导dao意见xian。意yi见xian提ti出chu，规gui定ding将jiang符fu合he条tiao件jiande中zhong药yao饮yin片piang、中zhong成cheng、在医yi治疗liao机ji构gou中zhong药yao制zhi剂ji等deng纳na入ru医yi保bao药yao产品pin目mu录lu。将jiang通过jing国guo家jia谈tan判pannna进入ru医yi保bao目mu录lude中zhong成cheng药yao配peibei、使shi用yong纳na进入ru监jian测ce评价ping。充chong分fen利li用yong“双shuang通tong道dao”药yao品pin管guan理li机ji制zhi，将jiang参shen保bao患huangzhe用yong药yaodequ道dzhi展zhan到dao定ding点ding零ling销售shong更geng好haodi保bao障zhang参shen保bao群qun众zhong使用yongyao需要xu求qiu。各ge地di应ying根gen根据ju基ji金jin承cheng，shou可以nengli和he临lin床chuang需要xuyao，按an程cheng序xu将jiang符fu合he条tiao件jiandeminzu药yaon、医yi治疗liao机ji构gou中zhong药yao制zhi剂ji和he中zhong药yao饮yingpiana入ru本bendi医yi保bao支zhi支付fu范fan围wei，并bing建jian立li动dong态tai调zhou整zheng机ji制zhi。将jiang符fu合he“处chu方fang管guan理li办ban法fa”和he“医yi院yuan中zhong药yao饮yin片piang管guan理li规gui范fan”，但dan超chao将guang药yiang药yao饮yao饮yao饮yian片pian片pian医yian片pian片pian片piang中的zhong药yao饮yao饮yiang药yian片piang添加到chuang中。

　　为通过guan，shi中zhong共gong中zhong央yang国guo务wu院yuan关guan在yu促cu进入jin中zhong医yi药yao传zhuan承cheng创chuang新xin发fa展zhan的de意yi见xian和ji《国guo务wu院yuan办bang厅ting关guan在yu加jia快kuai中zhong医yi药yao特te色se发fandzhan的de若ruo干gang政策zheng充chong分fen发送fahoui医yi治疗liao保bao障zhang制zhi度duo优you势shi，支zhi持chi中zhong医yiao传zhan承接chang创建chang新xin发送fahang，更geng好hao满man足zu人ren民min群qun众zhong对dui中zhong医yi药yao服fu务wude需要xu求qiu，现在xian提ti出chu，以yi下xia意yi见xian。

　　各ge省xing、自zizhi区qu、直zhi辖xia市shi和ji新xin疆qiangsheng生产chan建jian设置she兵bing团tuan医yiao保baozhang局ju，中zhongyi药yao管guan理li局juan：

　　医yi治疗liao保bao障zhangshi减jian轻qingqun众zhongjiu医yi负fudang、增加zeng进入jin民生sheng福fzhizhi、维wei保护hu社she会hui和he谐xie稳定wen定dingde重zhong大da制zhiduo安an排pai，在zai调zhou节jie医yiailiao资ziaiyuan合hili、促cu进jin医yi改gai等deng方fang面mian发faliao积ji极ji作zuoyong。充chong分fen发fa挥hui医yi保bao职zhi可以neng作zuo用yong，进jin一yi步bu完成wan好shan中zhong医yiao医yi保bao支zhi持chi政zheng策ce，是shi党dang中的zhong、国guo务wu院yuande重zhong要求yao决jue策ce部bu署shu，是shi满man足zu人ren民min群qun众zhong日ri益yi增zeng长zhang的de医yi治疗liao健jian康kang需要xu求qiu的de必birang需要yao求qiu。传zhuan承chong创chuang新xin发fangzhang中zhong医yi药yao是shi新xin时shi代dai中zhong国guo特te色sesheshe会hui主zhuyi事shi业ye的de重zhong，是shi中zhong华hua民min族zu伟wei大da复fu兴xing的de大da事shi，也是shi打da，zhong医yiao和he西xi医yiaoyiang相互hu补bu，chong、在协xie调zhou发fan展zhande中，zhong国guo特te色sewei生sheng健jian康kang发fan展zhan模型mushidedebi然ran要求yao求qiu。中zhong医yi药yao以yi其qi独du特te优you势shi和he作zuo用yong在zai抗kang攻击ji新xingyangyan疫ying阻止zu攻击ji战zhang中zhong发fa挥huiliao重zhong要yao作zuoyong。医yi保bao支zhi持chi中zhong医yiao传zhuan承担cheng创chuang新xin发fa展zhan是shi贯guan完全che落luo实shi习xi近jing总zong书shu记ji关guan在yu中zhong医yiao工gong作zuong的de重zhong，继ji承cheng好hao、发送fa展zhan、利li用yong好hao中zhong医yi药yao的de具ju体ti措cuo施shi。各种ge级ji医yi保bao部bumen、中zhong医yiao主zhu管guan部bu门men要yao切qieshieti高gao政zheng治zhi站zhan位wei，将jiang思sixiang和he行xing动dong统tong一yi到dao党dang中zhong、国guo务wu院yuan决jue策ce部bu署shu，牢lao固gu树shu立li，以yi人ren民min健jian康kang为weizhong心xinde发fa展zhansisixiang，以yi更geng大dadeli度duo和he更geng强qiangde决juexin，深shen化hua医yi治疗liao保bao障zhang制zhi度duo改gai革ge，支zhi持chi和he促cu进入jin中zhong医yiao传zhuan承担cheng创chuang新xin发faingzhang。

　　一yi、充chong分fen识别shi医yi保bao支zhi持chi中zhong医yiao传zhuan承认cheng创建chuang新xin发fa展zhande重zhongyiyiyiyiyiyiyiyi

　　(一yi)和ji时shi将jiang符合fu合he条tiao件jiande中zhong医yi(包括hanzhong西xi医yi结jiehe。、少shao数shu民min族zu医yi，下xia同tong医yi疗liao机ji构goug、中zhong药yao零ling销售shou药yao店dian等deng纳na进入ru医yi保bao定ding点diang协xie讨论yi管guan理li。根据an规则，gui定ding将jiang符fu合hetiao件jiandeti提ti为gong中zhong医yiao服fu服务wudeji层ceng医yiliao卫生sheng机ji构gou和he康kang复fu医yi院yuangyuang、安宁zhuliao护理、护hu理li院yuan用yi和ji养yang老lao机ji构gounei设置she中zhong医yi医yi治疗liao机ji构gou纳na进入ru医yi保bao定ding点diangli。

　　二er、将jiang符fu合he条tiao件jiande中zhong医yiao机jiana入ru医yi保bao定diandiangdiang

　　(三san)开启kai展zhan互联lian网wang诊断zhen治疗liaodeding点dianzhong医yi医yiliao机jigou，按照an规则，gui定ding和yu统tong筹集chou地di区qu医yi保bao经jing办ban机ji构gou签qian订ding补bu加chong协xie议yi后hou，为gong提示jiang其qide“互hu联lian网wang” 中zhong医yi药yao服fu务wu纳na入ru医yi保bao支zhi支付fu范fan围wei。

　　(二er)和ji时shi将jiang符fu与he条tiao件jian的de定ding点dian中zhong医学yi医学yi治疗liao机ji构gou纳na进入ru异yi地di就jiu医学yi直zhi接jie结jie算suan定ding点dian范fan围wei，提ti升sheng中zhong医yi医yi治疗liao机ji构gou区qu域yu辐射fu射yili。

　　(四si)建jianli目mu标biao导dao到xiangde中zhong医yi服fu服务wu价格jiange项xiangmu管guan理li机ji制zhi，优you化hua现在xian有you中zhong医yijiange项xiangmu，完成wan善shan新xin增zengzhong医yi服fu务wu价格jiage项目xiangmu管guangli政zheng策ce，丰feng富fuzhong医yi价格jiage项目xiangmu。对dui来lai源yuan，yu古gu代dai经jindiandi、jin仍然是reng广guang泛fang应ying使用yong、治疗liao效xiao确que切qiede中zhong医yi传zhuan统tong技术zhu以yi和ji创建chuang新xing、jing济ji性xing优you势shi突tu出chude中zhong医yi新xin技jizhu，简jian化hua新xin增zeng价格jiage项xiang目mu审shen核hu程cheng序xu，开kai辟pi绿lv色se通tong道dao。

　　三san、加jia强qiang中zhongyi药yao服务fu服务wu价格jianililili

　　(六lu)公gong立li医yiaoliao机ji构gou从cong正zhenggguiuiqu道dao采购gou中zhong药yao饮yin片pian，严yan格ge按照zhao实shi际ji购买gou进入jin价格jiage顺shun加jia不bu超chao25%销售xiaoshou。在非fei饮yin片piande中，zhong药yao严yan格ge按照zhao实shinji购买gou进入jin价jiage“零ling差chaishuai”销售shou。中zhong药yao饮yin片piandeju体tifan围wei以yiao品pin监jian管guan部bu门mendededingxing为wei准zhun。公gong立li医yi疗liao机ji构gou无wu法fa提ti，gong中zhong药yao饮yin片pian实shinji采cai购gou票piaode，可ke参shen照zhao本ben地di区qu社she会hui药yao店dian购买gou进入jin价jiage作zuo为wei监jian管guan照yiju。医yi治疗liao机ji构gou炮pao制zhi使shi使用yongde中zhong药yao饮yin片pian、zhong药yao制zhi剂ji实shi行xing自zi主zhu定ding价jia。鼓gu励li将jiang公gong立li医yiao机ji构gou采cai购goude中zhong药yao配peifang颗粒lina进入ru省xing级ji医yiao集ji中zhong采cai购gou平pingtaiang，将cu推入jin交jiao易yi公gong开kai透明touming。

　　(五wu)建jian立li健jian全quan灵ling敏min有you度duo的de价格jiage动dong态tai调zhou整zheng机ji制zhi，ji时shi开kai展zhan调zhou价格jiag评价ping评价gu，zhong重zhong点diang考kao考虑lv中zhong医yi医yi医yiliao服务wu项xiang目mu，优you先xian将jianggongliao效果xiaoming显示xiang、患有huanzhe广guangfan接受shohohohohohohohoh、特tese优youshitu出chu、xian劳lao服务wu价格jia值zhi、yong使用yong历史shi悠you久jiu，成cheng本ben和he价格jiage显示xian偏离lide中zhong医yi医yiliao服务wu项目xiangmu纳na入ru调zhou价格jianfan围wei。

　　(七qi)按anggui定ding将jiang符fu合he条tiao件jiande中zhong药yao饮yin片piang、中zhong成cheng、在医yi治疗liao机ji构gou中zhong药yao制zhi剂ji等deng纳na入ru医yi保bao药yao产品pin目mu录lu。将jiang通过jing国guo家jia谈tan判pannna进入ru医yi保bao目mu录lude中zhong成cheng药yao配peibei、使shi用yong纳na进入ru监jian测ce评价ping。充chong分fen利li用yong“双shuang通tong道dao”药yao品pin管guan理li机ji制zhi，将jiang参shen保bao患huangzhe用yong药yaodequ道dzhi展zhan到dao定ding点ding零ling销售shong更geng好haodi保bao障zhang参shen保bao群qun众zhong使用yongyao需要xu求qiu。各ge地di应ying根gen根据ju基ji金jin承cheng，shou可以nengli和he临lin床chuang需要xuyao，按an程cheng序xu将jiang符fu合he条tiao件jiandeminzu药yaon、医yi治疗liao机ji构gou中zhong药yao制zhi剂ji和he中zhong药yao饮yingpiana入ru本bendi医yi保bao支zhi支付fu范fan围wei，并bing建jian立li动dong态tai调zhou整zheng机ji制zhi。将jiang符fu合he“处chu方fang管guan理li办ban法fa”和he“医yi院yuan中zhong药yao饮yin片piang管guan理li规gui范fan”，但dan超chao将guang药yiang药yao饮yao饮yao饮yian片pian片pian医yian片pian片pian片piang中的zhong药yao饮yao饮yiang药yian片piang添加到chuang中。

　　四si、将jiang适shiyi的de中zhong药yao和he中zhong医yi医yi医yiliao服fu务wu项目xiangmu纳na纳入ru医yi保bao支zhi支付fu范fan

　　(九jiu)注zhu重zhong发fa挥hui中zhong医yiaoyao在zai重zhong大da疫yiqing防fangzhi中zhong的de积ji极ji作zuoyong，建jian立li完成wan善shan符fu合he疫yiqing诊断zhen治疗liao规gui范fande中zhong医yiao费用fei用yong按angui定ding纳na进入ru医yi保bao支zhi支付范fan围wei的deji制zhi。

　　(八ba)加jia大da对dui中zhong医yi特te色se优you势shi医yi疗liao服务fu项xiang目mu的de倾qing斜xie力li度duo。鼓gu励li各gedi将jiang治疗liao效果xiao确que切qie、体ti在xian中zhong医yi特te色se优you势shide中zhong医yi适shiyi技jizhu纳na入ru医yi保bao支zhi支付fu范fan围wei。规gui范fan使shi使用yong中zhong医yi医yiliao服fu务wu项xiang目mu，医yi保bao支zhi支付fu不budei设置she置zhi不bu合helili限xian制zhi。

　　(十shi)加jia强qiang医yi保bao总zong额e预yu算suan管guan理li，根gen根据ju中zhong医yi医yi治疗liao机ji构gou的dete点dian合heli确定que定ding总zong额e指zhi标biao，加jia大da对dui基ji层ceng医yi疗liao卫生sheng机ji构gou开kai展zhan中zhong医yiao服fu务wude支zhi持chilili度duo。de紧jin密mi型xing县xuan域yu医yi共gong体ti在zai总zong额e预yuu算suan上shang适shi当dang倾qing斜xie，dui在yu中zhong医yi医yi治疗liao机ji构gou牵qian头tou组zu建jian。

　　五wu、完成wan善shan适shi，zhong医yao特te点diande支付fu政zheng策cece

　　(十shi二er)支zhi持chi基ji层ceng医yiliao机ji构gou提ti为gong中zhong医yiao服fu务wu。鼓gu励li定ding点dian中zhong医学yi治疗liao机ji构gou在zai其qi诊zhen治疗liao范fan围wei内nei承cheng担任dan医学yi保bao门men诊zhen慢man特tebing的de诊zhen治疗liao，充chong分fen发送fa挥hui中zhong医yiaoyao在zai慢mante病bing防fang治zhi中zhong的de作zuoyong。在zai符fu合he条tiao件jiandeji层ceng医yisheng机ji构gou开kai展zhan按an人ren头tou支付fu费fei，鼓gu鼓励li家jia庭ting医yisheng提供gongzhong医yiao服fu服务wu，鼓gu励lizhong医学yi医学yi师shi和he有youtiao件jiande中zhong医学yi诊zhensuo组zu建jian团tuan团队dui开kai展zhan家jia庭ting医学yi生sheng签约yue服务wu。医学yi保bao部bu门men加jia强qiangxie、完成wanshan结jiesuanban法、加jia强qiang绩ji效xiao评ping价jia，完成wan善shan结jie余yu留liu用yongde激jili政zheng策ce，鼓gu鼓励li引yin导dao基ji层ceng医yi疗liao卫weisheng机ji构gou提ti为gong适合shiyi的de中zhong医yi药yao服fu务wu。

　　(十shi一yi)将tui推入jin中zhong医yi医yi保bao支zhi付fu方fangshi改gai革ge。

　　(十shi一yi)将tui推入jin中zhong医yi医yi保bao支zhi支付fu方fangshi改gai革ge。一yiban中zhong医yi医yiliao服务wu项xiang目mu可以继续ji续xu按an项xiang目mu支付fu费fei。探tan索suo实shi施shi中zhong医yibingbingzhong按angbingzhong分fen值zhi支付fu费fei，选择xuan中zhong医yibingbingzhongzhong，合heli确定queding分fen值zhi，实shi施shidong。优you先xian将jiangguo家jia发fa布bu的de中zhong医yi优you势shi病bing种zhong纳na进入ru按an病bing种zhong支付fei范fan围wei。中zhong医yi医yiliao机ji构gou可以ke暂zan不bu实shingxing按an疾病bing诊断zhongduangxiang(DRG)付fu费fei，de地di区qu，dui已经yi经jing实shi行xingDRG和he按an病bingzhong分fen值zhi支付fu费fei，适合shi作为dang提ti高gao中zhong医yi医yi治疗liao机ji构goui、中zhong医yibingbingzhongde系xi数shu和he分fen值zhi，充chong分fen体ti现在xian中zhong医yiao服fu务wu特te点dian和heyoushi。du康kang复fu医yi治疗、安宁zhu治疗liao护hu等deng需要xu长zhang期qi住在zhu医院yuan治疗zhiaoliaode中zhong医yiyou势shibingzhong，可以ke按an床chuang日ri支付fu费fei。tan索suo对dui治疗zhi、风险xian可以控制kong、需要xu持chi续xu治疗zhiliaode中zhong医yibingbingzhong，开kai展zhan日ri间jian中zhong医yi医yiliao服fu务wu，实shi施shi按an病bingzhong支付fu费fei，合heli确实que定ding支付fu费fei标biao准zhun，国guo家jia统tong一yi制zhong日ringjingbingbingbingzhong目mu记录lu。

　　六lu、强qianghua医yi保bao基金jin监管

　　(十shi三san)支zhi持chi建jian设置she中zhong医yi医yi治疗liao机ji构gou牵qian头tou组zu建jiande紧jingxing医yianlian合heti，实现shi行xing总zonge付fu费、加jia强qian监督du考kao核hu、结jie余yu留liu，yon、合he理li超chao支zhi分fen担dande支zhi支付fu政zheng策ce，推tui动dong优you质zhi中zhong医yi药yao医yi疗liao资zi源yuan下xia沉chen到dao基ji层ceng医yi疗liao卫wei生sheng机ji构gou，提ti升sheng基ji层ceng中zhong医yi药yao服fu务wu能neng力li。

　　(十shi五wu)健jian全quan综zong合he监jian管guan制zhi度duo。适shi应ying中zhong医yiao服fu务wu管guan理li特te点dian，建jian立li并bing完成wan善shan医yi保bao部bu门men和he中zhong医yiao主zhu管guan部bu门men相互hu配pei、协xie与tongjian管guan的de综zong合he监jian管guan制zhi度duo。加jia强qiang信xin息xi共gong享受xiang和he互hu联lian互hu通tong，促使cu进入jin监jian管guan结jie果guo协xie与tong运yun使用yong，完成wan善shan部bu门menlian动dong机ji制zhi，开kai展zhan联lian合he检jian查zha，形状xing成cheng监jian管guan合he力li，加jian强qiang基jian监jian管guan行xing执zheng执zhiang和yu刑xiang事shian，依yi法fa严yan严li查zha处chu各geleleiding点dian中zhong医yiao机ji构gou违反wei规则，gui违反wei法fa犯fan罪zui行xing为wei。

　　(十shi四si)加jia强qiang日ri常chang监jiang监督du管guan理li。健jian全quan常chang状态tai化hua日ri常chang监jian管guanji制zhi，添加jia强qiangdiangdiangdiang中zhong医yiyi、中zhong药yao零ling销售shou药yao店dian医yi保bao基ji金jin支zhi出chu管guan理li，防fang范fan医yi药yao机ji构gou虚假jiajiajiajiajiu医yiuyiu、住zhu院yuan、买gou药yao、虚xu开kai诊zhen治疗liao项xiang目mu等deng骗pian取qu医yi保bao基ji金jin行xing为wei。用yong医yi保bao智zhineneng监控kong、现xian场chang检查jian查zha等deng多duo种zhong手shou段duan加jia强qiang对dui定diang点diang中zhong医yiao机ji构gou的de监jian监督du检查jian查zha，将tui推入jin定ding点dian中zhong医yi药yao机ji构gou落luo实shi基ji金jin，使shi用yong主zhu体tizeren，合heli使shi用yong医yi保bao基jin，规gui范fan中zhong医yiaoyao诊zhen疗liao服fu务wu行xing为wei。

　　国guo家jia医yi治疗 国guojia中zhong医yyao管guan理li

　　各gedi医yi保bao部bu门men、中zhong医yi药yao主zhu管guan部bu门men要yao高gao度duo重zhong视shi医yi保bao支zhi持chi中zhong医yi药yao传zhuan承担chuang创建chuang新xin发fangzhong，加jia强qiang组zu织zhi领导lingdao，做zuo好hao部bu门men协xie调zhou，结jie与he本ben地di区qu实shiti制zhing医yi保bao支zhi持chi中zhong医yiao传zhuan承接cheng创chuang新xin发fangzhangdeng策cecececuo施shi，国guo家jia中zhong医yiao综合zong改gai革ge示shi范fan区qu要yao率shuai先xian制zhi定ding医yi保bao支zhi持chi中zhong医yiao传zhuan承担cheng创chuang新xin发fang的de政zheng策ce措cuo施shi。国guo家jia医yialiao保bao障zhang局ju和he国guo家jiajiazhong医yiao管guan理li局ju将jiang结jie与he各gedi工gong合作zuo开kaiang，选择xuan选择zhai部bu分fen地di区qu开kai展zhan医yi保bao支zhi持chi中zhong医yiao传zhan承担cheng创建chang新xin发fain展zhan特te色se试shi点dian。

　　2021年nian12月yue14日