[鍘熶功p87-108]
1銆佸鍚庡弽鎬濆叴涓氶』闈犺嚜寮?/span>
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铏界劧锛屼笌WHO鍜岀編鍥藉崕灏旂壒閲屽痉鐮旂┒闄㈠悎浣滅爺绌堕潚钂跨惀閰繘灞曞緱涓嶅椤哄埄锛岀粨灞€涔熶笉灏戒汉鎰忥紝浣嗙敱浜庨潚钂跨礌鎸囧濮斿憳浼氬湪鍚堜綔璋堝垽鍒濇湡锛屽挨鍏舵槸鍦ㄨ嵂鍘?/span>GMP妫€鏌ラ伃閬?ldquo;绾㈢伅”涔嬪悗锛屽繁棰勬枡鍒板湪鏈潵鍚堜綔涓殑澶嶆潅鎬у拰涓嶅彲棰勬祴鎬э紝鏋滄柇閲囧彇浜?ldquo;涓ゆ潯鑵胯蛋璺?rdquo;鐨勬柟閽堬紝渚濋潬鍏ㄥ浗澶у崗浣滅殑浼樺娍锛岃鐪熷涔犳帉鎻?/span>WHO鎻愪緵鐨勫浗闄呮爣鍑嗕笌鎶€鏈柟娉曪紝鍔犱笂寰楀埌鍥藉璐㈡斂閮ㄧ殑涓撴鏀寔锛屾渶缁堣繕鏄鏈熷湴瀹屾垚浜嗛潚钂跨惀閰拰钂跨敳閱氱殑寮€鍙戠爺绌讹紝骞堕『鍒╁湴閫氳繃浜嗗浗瀹惰嵂鏀块儴闂ㄧ殑瀹℃煡鎵瑰噯銆傝繖鏄垜鍥芥寜鐓у浗闄呮爣鍑嗗紑鍙戞柊鑽殑涓€娆″皾璇曪紝涔熸槸瀵规垜鍥芥柊鑽紑鍙戠鎶€鍔涢噺鐨勪竴娆¤€冮獙銆?/span>
鎴戝浗鏂拌嵂璇勪环涓庡鎵圭鐞嗗埗搴︼紝鍦?/span>20涓栫邯80骞翠唬鍒濇湡灏氫笉鍋ュ叏銆傚綋鏃讹紝鎴戝浗灏氭棤涓撻棬浠庝簨涓村簥鑽悊鐮旂┒鐨勬満鏋勶紝涓村簥鑽悊绉戞妧浜哄憳鍔涢噺钖勫急锛屼复搴婂墠鑽悊姣掓€э紝鐗瑰埆鏄壒娈婃瘨鎬х殑鐮旂┒鍑犱箮鏄┖鐧姐€傛垜鍥藉埗鑽巶鐢熶骇鐨勯潚钂跨礌绫绘姉鐤熻嵂涓嶈兘涓哄浗闄呮墍鍏銆?/span>
鍏充簬闈掕捒绱犳姉鐤熻嵂鐨勫畨鍏ㄦ€ч棶棰橈紝鍏ㄥ浗523棰嗗灏忕粍鍜屽悗鏉ョ殑闈掕捒绱犳寚瀵煎鍛樹細閮介潪甯搁噸瑙?/span>[50]銆?/span>1981骞达紝鎴戝浗杩樻病鏈夊疄鏂?/span>GLP绠＄悊瑙勮寖锛屾病鏈変竴涓悎鏍肩殑GLP瀹為獙瀹わ紝浣嗘槸宸茬粡浜嗚В鍒板浗闄呬笂瀵硅嵂鐗╁畨鍏ㄦ€ц瘎浠风殑姣掓€ц瘯楠岋紝蹇呴』鍦?/span>GLP瑙勮寖绠＄悊鐨勫疄楠屽鍐呰繘琛岋紱鍥犳灏辨寜鐓?/span>GLP鎰忚瘑鍜岃姹傛瘮杈冪郴缁熷湴杩涜浜嗛潚钂跨礌娌规贩鎮墏瀵瑰ぇ鍔ㄧ墿锛堢尨锛夌殑14澶╅暱鏈熸瘨鎬ц瘯楠屻€傜粨鏋滆〃鏄庯紝3鍊嶄复搴婃不鐤楀墏閲忕粍鐨勭尨瀛愭棤浠讳綍姣掓€у弽搴旓紝6鍊嶅墏閲忕粍锛?/span>48MKD锛夌殑鍔ㄧ墿鍑虹幇涓€杩囨€х殑缃戠粐绾㈢粏鑳炲噺灏戯紝瓒呰繃12鍊嶅墏閲忕粍锛?/span>96MKD锛夌殑鍔ㄧ墿鎵嶅嚭鐜版槑鏄炬瘨鎬у弽搴斻€傛瘨鎬ц〃鐜颁负閫犺鍔熻兘涓ラ噸鎶戝埗锛屽績鑲屽彈鎹燂紝鍑虹幇浜嗙缁忔瘨鎬э紝1/6鍔ㄧ墿姝讳骸浜庡績鍔涜“绔€傛寜鐓т笂杩版瘨鎬у墏閲忚璁℃柟妗堬紝鍙堢敤鐙楀仛浜?/span>14澶╃殑闀挎瘨璇曢獙锛屽叾缁撴灉涓庣尨瀛愮殑姣掓€у弽搴旂被鍚岋紝浣嗙棁鐘惰緝杞伙紝鏃犲姩鐗╂浜°€傚洜姝わ紝鍙互璁や负锛岄潚钂跨礌瀵规不鐤楁姉鑽€ф伓鎬х枱鐤惧拰浣滀负閲嶇棁鐤熺柧鐨勬€ユ晳鑽槸鏈€瀹夊叏鐨勩€?/span>
姝ゅ悗锛岄潚钂跨礌鎸囧濮斿憳浼氫究鍊熷姪WHO鐤熺柧鍖栫枟绉戝宸ヤ綔缁勬彁渚涚殑鐮旂┒璁捐鏂规鍜屾潵鍗庝笓瀹剁殑鎸囧锛屼簬20涓栫邯80骞翠唬鍒濇湡锛屽湪鍥藉唴鐜囧厛鎸夌収鍥介檯鏍囧噯瀵归潚钂跨礌绫绘姉鐤熻嵂杩涜鐮旂┒锛屽紑鍒涗簡鎴戝浗鎸夌収鍥介檯鏍囧噯鐮斿彂鏂拌嵂鐨勫厛娌炽€傚湪涓€浜涢鍩熷～琛ヤ簡绌虹櫧銆?/span>
涓尰鐮旂┒闄腑鑽墍鑽悊鐮旂┒瀹ょ敱鏉庢辰鐞虫暀鎺堜富鎸侊紝寮€灞曚簡闈掕捒绱犵被鎶楃枱鑽嚧绐佸彉鍜岀敓娈栨瘨鎬ц瘯楠岀爺绌讹紝娑堥櫎浜嗕汉浠闈掕捒绱犵被鑽墿鍙兘鍙戠敓绫讳技20涓栫邯60骞翠唬鍦ㄥ痉鍥藉彂鐢熺殑“鍙嶅簲鍋滀簨浠?rdquo;鎮插墽閲嶆紨鐨勬媴蹇冦€?/span>1983骞存浘缇庢€℃暀鎺堥槓鏄庝簡绱鍒嗗厜鍏夊害娉曟祴瀹氶潚钂跨礌鍖栧鍙嶅簲鏈虹悊锛?/span>1986骞磋档涓栧杽鍦?/span>姝ゅ熀纭€涓?/span>锛屽湪鍥藉唴棣栧厛寤虹珛浜嗛潚钂跨礌楂樻晥娑茬浉鑹茶氨娉曪紝鎴愬姛鍦扮敤浜庡姩鐗╁拰浜轰綋琛€娴嗗拰鍞炬恫浠ュ強妞嶇墿涓潚钂跨礌鐨勬祴瀹氾紱鍛?/span>閽?/span>楦ｆ暀鎺堢巼鍏堝湪鍥藉唴涓村簥涓婂鐤熺柧鎮ｈ€呯敤闈掕捒绱犳爴鍚庣殑鑽墿浠ｈ阿鍔ㄥ姏瀛︾殑鐮旂┒銆?/span>1986骞存浘缇庢€℃暀鎺堝缓绔嬩簡鏈姶閱囩殑楂樻晥娑茬浉鑹茶氨娉曪紝涓轰互鍚庝汉浣撹娴嗘祿搴︽祴瀹氬瀹氫簡鍩虹銆?/span>
鍐涗簨鍖诲绉戝闄㈠井鐢熺墿娴佽鐥呯爺绌舵墍鑽悊姣掔悊鐮旂┒瀹わ紝鐢辨粫缈曞拰鏁欐巿涓绘寔寮€灞曠殑闈掕捒绱犵被鎶楃枱鑽暱鏈熸瘨鎬ц瘯楠岀爺绌讹紝涓哄姏姹傝揪鍒?/span>GLP瑙勮寖鍖栬姹傦紝鍦ㄧ粍缁囩鎶€浜哄憳鎶€鏈粌鍏电殑鍚屾椂锛岃崏鎷熶簡姣掓€у疄楠屻€佹楠岄」鐩悇绉嶆爣鍑嗗寲鎿嶄綔瑙勭▼锛?/span>SOP)锛屼负鏈€鍚庡疄楠岀爺绌跺伐浣滄€荤粨鎻愪緵浜嗗畬鏁淬€佺瀛﹁€屼笖鏈夎鏈嶅姏鐨勬暟鎹祫鏂欙紝鍙楀埌鑽墿璇勫閮ㄩ棬鐨勯珮搴﹁瘎浠枫€傝繖涔熸槸鍥藉唴棣栨鎸?/span>GLP瑙勮寖鐨勮姹傚鑽墿杩涜涓村簥鍓嶅畨鍏ㄦ€ц瘎浠枫€?/span>
鍐涗簨鍖诲绉戝闄㈡斁灏勫尰瀛︾爺绌舵墍瀹嬩功鍏冩暀鎺堝湪鍔ㄧ墿鐨勬瘨鐞嗚瘯楠岀爺绌朵腑锛岀粡杩囦粩缁嗙殑瑙傚療锛屽彂鐜板ぇ鍓傞噺闈掕捒绱犲彲浣垮疄楠屽姩鐗╃殑鏃╂湡缃戠粐绾㈢粏鑳炴暟涓嬮檷銆傝繖涓€鍙戠幇鎴愪负鍚庢潵闈掕捒绱犵被鑽复搴婄敤鑽瘨鎬х洃娴嬬殑閲嶈鎸囨爣鏂规硶涔嬩竴銆?/span>
涓浗鍖诲绉戝闄㈣嵂鐗╃爺绌舵墍锛岀敱瀹嬫尟鐜夊拰鏉ㄦ爲寰锋暀鎺堜富鎸佸紑灞曚簡闈掕捒绱犵被鎶楃枱鑽复搴婅嵂浠ｅ姩鍔涘鐨勭爺绌讹紝寤虹珛鐨勬斁灏勫厤鐤祴瀹氭硶鍜岃繕鍘熷瀷鐢靛寲瀛︽瀬璋辨娴嬮珮鏁堟恫鐩歌壊璋辨硶锛?/span>HPLC-Ee)锛屼负鍒跺畾涓村簥缁欒嵂鏂规鎻愪緵浜嗙瀛︿緷鎹€?/span>
骞垮窞涓尰瀛﹂櫌鐤熺柧鐮旂┒瀹わ紝鐢辨潕鍥芥ˉ鏁欐巿涓绘寔寮€灞曠殑闈掕捒绱犵被鎶楃枱鑽?/span>I鏈熶复搴婅瘯楠岋紝浠ュ仴搴蜂汉涓鸿瘯楠屽璞★紝瑙傚療浜嗚В鑽墿涓村簥鐨勪笉鑹弽搴斿拰鑰愬彈鎬с€傝繖鍦ㄦ垜鍥借繃鍘荤殑涓村簥鐮旂┒鏄棤鍏堜緥鐨勩€備负浜嗕笌鍥介檯鎺ヨ建锛屽浗瀹跺崼鐢熼儴鑽斂灞€鎵瑰噯鐢卞箍宸炰腑鍖诲闄㈣礋璐ｇ粍缁囧疄鏂姐€傝瘯楠岀洃鐫ｄ汉锛?/span>monitor)鐢卞崼鐢熼儴鑽鎵€鏈辩嚂鎷呬换銆傝繖鏄垜鍥介娆℃寜鐓?/span>WHO 鎻愪緵鐨勯潚钂跨惀閰€佽捒鐢查啔I鏈熶复搴婅瘯楠岃璁℃柟妗堬紝瀵瑰仴搴锋垚浜哄織鎰胯€呰繘琛岃€愬彈鎬у拰鑽唬鍔ㄥ姏瀛︾殑鍙岀洸璇曢獙銆?/span>
涓鸿繘涓€姝ユ帉鎻″浗闄呰嵂鐗╂敞鍐屽鐢虫姤鏂囦欢璧勬枡鐨勮姹傦紝鍦ㄥ浗瀹跺尰鑽鐞嗗眬娌堝绁ユ暀鎺堟寚瀵间笅锛岄潚钂跨礌鎸囧濮斿憳浼氱粍缁囨粫缈曞拰銆侀倱钃変粰銆佽档绉€鏂囥€佹浘缇庢€℃暀鎺堢瓑锛屾寜鐓у浗闄呰嵂鐗╂敞鍐岃鏍间笌瑕佹眰锛屽闈掕捒鐞ラ叝銆佽捒鐢查啔鐨勭敵鎶ユ敞鍐屾潗鏂欒繘琛屼簡鍏ㄩ潰淇敼鍜岄€氱瘒缈昏瘧锛岃WHO鐤熺柧鍖栫枟绉戝宸ヤ綔缁勭殑鐭ュ悕涓撳鍜岄【闂崗鍔╁鏌ャ€備粬浠彁鍑轰簡寰堝鏈夌泭鐨勬剰瑙佸拰寤鸿銆?/span>
缁忚繃10澶氬勾鐨勬帰绱㈢爺绌跺拰鍚勬湁鍏冲崟浣嶉€氬姏鍚堜綔锛屼粠闈掕捒绱犳敼閫犺鐢熷嚭鏉ョ殑钂跨敳閱氱殑娌归拡鍓傚拰闈掕捒鐞ラ叝鐨勬按閽堝墏锛屼簬1987 骞磋鍥藉鍗敓閮ㄦ壒鍑嗙敓浜с€?/span>1987 骞?/span>9鏈?/span>11鏃ワ紝鍥藉鍗敓閮ㄤ负姝ゅ彫寮€鏂伴椈鍙戝竷浼氾紝瀹ｅ憡钂跨敳閱氥€侀潚钂跨惀閰拡鍓傚拰闈掕捒绱犳爴鍓傦紝浣滀负娌荤枟鎶楄嵂鎬ф伓鎬х枱鍜屾姠鏁戣剳鍨嬬枱鐥呬汉鐨勭壒鏁堣嵂鐮斿埗鎴愬姛锛屽紑濮嬫姇鍏ュ競鍦?/span>[51][52]銆?/span>1992骞达紝鎴戝浗鍙堟壒鍑嗕簡鍙屾阿闈掕捒绱犵墖鍓傚拰钂跨敳閱氾紞鏈姶閱囧鏂规姇浜с€?/span>1998~2004骞达紝鍥藉鑽搧鐩戠潱绠＄悊灞€鍙堝厛鍚庢壒鍑嗛鍙戜簡闈掕捒绱狅紞钀橀厷鍠瑰鏂广€佸弻姘㈤潚钂跨礌锛嶅搶鍠圭郴鍒楀鏂圭瓑澶氫釜鏂拌嵂璇佷功鍜岀敓浜ф壒浠?/span>銆?/span>
浠?/span>1985骞存垜鍥藉紑濮嬪疄琛屾柊鑽瘎瀹¤瀹氬埌1995骞达紝鍏ㄥ浗鎬诲叡鎵瑰噯涓€绫绘柊鑽?/span>14涓紝鍏朵腑闈掕捒绱犵被鎶楃枱鏂拌嵂灏卞崰浜?/span>7涓€傝繖鍏呭垎璇存槑涓庡浗闄呮帴杞ㄥ鏂拌嵂鐮旂┒鎵€璧嬩簣鐨勬椿鍔涳紝鍚屾椂涔熻〃鏄庨潚钂跨礌绫昏嵂鍦ㄦ垜鍥芥柊鑽爺绌跺巻鍙蹭腑鎵€鍗犵殑鍦颁綅銆?/span>
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鏃╁湪1978骞寸敱鍥藉鍗敓閮ㄣ€佸尰鑽鐞嗘€诲眬銆佽В鏀惧啗鎬诲悗鍕ら儴鑱斿悎鍙戞枃涓嬭揪绱ф€ョ敓浜ч潚钂跨礌浠诲姟鐨勮繃绋嬩腑锛岃櫧鐒讹紝鏈夊叧鍗曚綅杈冨ソ鍦板畬鎴愪簡鎴樺鐢ㄨ嵂鐨勭敓浜т换鍔★紝浣嗕篃鍙戠幇瀛樺湪涓€浜涗簾寰呰В鍐崇殑闂銆備竴鏄闈掕捒璧勬簮鎺屾彙鍜屽偍澶囧緱杩樹笉澶熷叏闈紱浜屾槸鍘熸湁鐨勫嚑绉嶆彁鍙栧伐鑹轰笌宸ヤ笟鍖栬妯＄敓浜х殑鏉′欢浠嶆湁杈冨ぇ宸窛銆傚洜姝わ紝灏藉揩寤虹珛闈掕捒绱犲伐涓氬寲鐢熶骇鐨勮鏂斤紝琚彁鍒版湁鍏抽儴闂ㄥ叿浣撶殑璁簨鏃ョ▼銆?/span>
20涓栫邯70骞翠唬缁勭粐鐨勫叏鍥介潚钂胯祫婧愯皟鏌ワ紝宸辩粡鍙戠幇鍥涘窛鐪侀厜闃冲湴鍖虹殑閲庣敓闈掕捒鐨勮暣钘忛噺澶с€佸搧璐ㄤ紭鑹€侀潚钂跨礌鍚噺杈冮珮锛屼笖鍛堢兢钀藉垎甯冪殑鐗圭偣銆傚綋鏃堕潚钂跨礌鐨勭鐮斻€佷复搴婇渶瑕佺殑闈掕捒绱犲師鏂欙紝澶ч儴鍒嗘槸浠庢潵鑷厜闃冲湴鍖虹殑闈掕捒鑽夋彁鍙栫殑銆傞潚钂跨礌鎸囧濮斿憳浼氳€冭檻鍒板紑鍙戝拰淇濇姢閰夐槼鍦板尯鐨勪紭璐ㄩ潚钂胯祫婧愶紝瀵瑰疄鐜版垜鍥介潚钂跨礌鍙婂叾琛嶇敓鐗╀骇鍝佸晢涓氬寲鐨勯噸瑕佹剰涔夛紝浜?/span>1983~1984骞存嫧涓撴锛岀粍缁囩鎶€浜哄憳寮€灞曢厜闃冲湴鍖轰紭璐ㄩ潚钂胯祫婧愮殑璋冩煡锛屽苟灏卞湪閰夐槼寤虹珛闈掕捒绉嶆鍩哄湴鍜岄潚钂跨礌宸ヤ笟鍖栫敓浜у巶鍙鎬х殑鐮旂┒銆?/span>
鍦ㄩ潚钂跨礌鎸囧濮斿憳浼氱殑寤鸿鍜屾帹鍔ㄤ笅锛?/span>1986骞?/span>7鏈堬紝鍥涘窛鐪侀厜闃冲幙寮€濮嬬寤洪潚钂跨礌鎻愮偧鍘傘€備负浜嗕繚璇佹垜鍥借嚜琛岀爺绌惰璁＄殑绗竴涓惃绾ч潚钂跨礌宸ヤ笟鍖栧伐鍘傜敓浜у伐鑹虹殑鎬ц兘锛屽悓鏃惰€冭檻鍒伴厜闃冲湴鍖哄浜庤传鍥板北鍖虹己涔忔妧鏈拰缁忚垂锛屾牴鎹紭鍔夸簰琛ョ殑绮剧锛岄潚钂跨礌鎸囧濮斿憳浼氭嫧涓撴鏀寔灞变笢鐪佷腑鍖昏嵂鐮旂┒鎵€鐮旂┒闈掕捒绱犵殑鐢熶骇宸ヨ壓鍜岃В鍐虫闄靛北鍒惰嵂鍘傜殑鐢熶骇璁惧锛屽悓骞?/span>11鏈堢敱鍥涘窛鐪佸尰鑽鐞嗗眬鍜岀渷鍗敓鍘呮壒鍑嗘垚绔嬩簡姝﹂櫟灞卞埗鑽巶銆?/span>1987骞?/span>7鏈堬紝姝﹂櫟灞卞埗鑽巶涓庡北涓滅渷涓尰鑽爺绌舵墍绛捐浜嗐€婇潚钂跨礌鍘熸枡鑽敓浜х殑宸ヨ壓鎶€鏈浆璁╁悎鍚屻€嬶紝缁忚繃闈掕捒绱犲伐涓氬寲鐢熶骇鐨勫皬璇曞拰涓瘯锛屾垚鍔熺敓浜у嚭鍚堟牸鐨勯潚钂跨礌浜у搧銆傚浗瀹跺崼鐢熼儴銆佸浗瀹跺尰鑽鐞嗗眬浜?/span>1987骞?/span>9鏈堝湪鏂伴椈鍙戝竷浼氬甯冿紝鎴戝浗鍚ㄧ骇鐨勯潚钂跨礌鍘傚缓鎴愭姇浜с€傚畠鏄垜鍥戒篃鏄笘鐣岀涓€涓伐涓氬寲鐢熶骇闈掕捒绱犲伐鍘傘€?/span>
涓轰簡鎵╁ぇ闈掕捒绱犱骇鑳斤紝瑙ｅ喅钂跨敳閱氱瓑缁堢浜у搧鐨勫師鏂欐潵婧愶紝鍦ㄩ潚钂跨礌鎸囧濮斿憳浼氱殑鏀寔鍗忚皟涓嬶紝鏄嗘槑鍒惰嵂鍘備笌鍥涘窛姝﹂櫟灞卞埗鑽巶缁忚繃鍗忓晢锛屽弻鏂瑰悓鎰忓缓绔嬬敓浜ч潚钂跨礌鐨勫悎浣滃叧绯伙紝骞剁璁簡鑱斿悎鐢熶骇闈掕捒绱犵殑鍗忚銆傚崗璁槑纭敱鏄嗘槑鍒惰嵂鍘傝礋璐ｆ妸濂介潚钂跨礌鐨勭敓浜ц川閲忓叧锛屽苟鍚戞闄靛北鍒惰嵂鍘傛姇璧?/span>20涓囧厓銆傛湁鍔涘湴鎺ㄨ繘浜嗘垜鍥介潚钂跨礌鐨勪骇涓氬寲銆?/span>1987骞?/span>12鏈堬紝鍥涘窛鐪佹丢闄靛湴鍖烘壒鍑嗘闄靛北鍒惰嵂鍘傛柊寤洪潚钂跨礌杞﹂棿銆?/span>1988骞村厓鏃︼紝杞﹂棿鐮村湡鍔ㄥ伐銆?/span>1990骞村湪涓婄骇棰嗗閮ㄩ棬鐨勫叧鎬€鍜屽ぇ鍔涙敮鎸佷笅锛屼竴涓璁″勾浜ч噺鏇村ぇ鐨勯潚钂跨礌宸ヤ笟鍖栨彁鐐艰溅闂村缓鎴愭姇浜с€?/span>
姝﹂櫟灞卞埗鑽巶闈掕捒绱犵殑鎶曚骇锛屽鎺ㄥ姩鎴戝浗闈掕捒绱犲強鍏惰鐢熺墿璧板悜涓栫晫鍒涢€犱簡鏉′欢锛屽叿鏈夊巻鍙叉€х殑鎰忎箟銆?/span>
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闈掕捒绱犺鐢熺墿鐨勭爺绌朵笌寮€鍙戞槸涓€椤归珮绉戞妧銆佸鍚戞€с€佺宸ヨ锤涓夌粨鍚堢殑绯荤粺宸ョ▼锛岄暱鏈熶互鏉ヤ竴鐩村湪鍏ㄥ浗523鍔炲叕瀹ゃ€侀潚钂跨礌鎸囧濮斿憳浼氬強鍥藉鏈夊叧閮ㄩ棬鐨勭粺涓€棰嗗涓庡崗璋冧笅杩涜銆?/span>
闈掕捒绱犵被鏂拌嵂鍥介檯甯傚満鐨勫紑鍙戯紝鐢变簬鍙楁姇璧勫ぇ銆佹爣鍑嗛珮銆佹妧鏈€ц兘寮虹瓑鍥犵礌鍒剁害锛屼笉璁烘槸瀵规垜鍥藉埗鑽敓浜т紒涓氳繕鏄鐮斿崟浣嶏紝鍦ㄥ綋鏃堕兘鏄棦闄岀敓鍙堜妇姝ョ淮鑹扮殑浜嬨€傛洿閲嶈骞朵负澶у鎵€鎷呭績鐨勶紝鍥藉鐮旂┒寮€鍙戦潚钂跨礌鐑疆鐨勫叴璧凤紝浣挎垜鍥界殑闈掕捒绱犱骇涓氶潰涓寸潃涓ュ郴鐨勬寫鎴橈紱鍥藉唴浜夊ず闈掕捒璧勬簮銆侀潚钂跨礌鐢熶骇鍜屽嚭鍙ｇ殑鏃犲簭绔炰簤鐨勭姸鎬佷篃鍦ㄥ嚭鐜般€傚姞涓婃鏃?/span>鐢卞浗瀹跺崼鐢熼儴鍜屽浗瀹跺尰鑽鐞嗗眬鎴愮珛鐨?ldquo;闈掕捒绱犳寚瀵煎鍛樹細”锛屽湪瀹屾垚钂跨敳閱氥€侀潚钂跨惀閰拰闈掕捒绱犳爴鍓傚浗鍐呰嵂鐗╂敞鍐屽皻鏈浆鍏ュ競鍦哄紑鍙戦樁娈典箣闄咃紝浜?/span>1988骞?/span>6鏈?/span>13鏃ュ鍛婄粨鏉燂紝鏈夊叧闈掕捒绱犵被鎶楃枱鑽殑鐮旂┒寮€鍙戝伐浣滐紝缁х画绾冲叆鍚勬湁鍏抽儴闂ㄣ€佸崟浣嶈嚜琛岀鐞嗐€傚叏鍥藉師鏈夌殑绉戙€佸伐銆佽锤涓夌粨鍚堢殑閾炬潯鍏崇郴涔熺敱姝よ€屼腑鏂€?o:p>
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1987骞?/span>11鏈堬紝鍥藉绉戝閮功瑷€鍓富浠诲拰鍥藉鍖昏嵂绠＄悊灞€
閮功瑷€鍥炲浗鍚庯紝渚跨潃鎵嬫姄绱ц繖椤瑰伐浣滐紝骞舵寚瀹氱ぞ浼氬彂灞曠鎶€鍙革紝骞剁敱璇ュ徃鐨勪笡浼楀闀垮拰闄堜紶瀹忓叿浣撹礋璐ｇ粍缁囧拰鍗忚皟锛屽師鍏ㄥ浗523鍔炲叕瀹ゅ拰闈掕捒绱犳寚瀵煎鍛樹細绉樹功澶勮礋璐ｄ汉鍛ㄥ厠榧庢媴浠婚【闂€?/span>1988骞?/span>1鏈堬紝鍥藉绉戝鍚戝浗鍔￠櫌鍔炲叕鍘呮姤閫佷簡銆婂叧浜庢姄绱ф垜鍥介潚钂跨礌绫绘姉鐤熻嵂鐢熶骇鍜屽浗闄呭競鍦洪攢鍞伐浣滅殑鎶ュ憡銆嬶紝鎻愬嚭浜嗚嫢骞叉帾鏂藉拰寤鸿鍙婃湁鍏抽儴濮旂殑鍒嗗伐銆?/span>1988骞?/span>5鏈?/span>24鏃ワ紝閮功瑷€鍓富浠诲氨闈掕捒绱犵瓑鎶楃枱鑽殑鐢熶骇銆侀攢鍞拰寮€鎷撳浗闄呭競鍦虹瓑闂鍙紑浜嗗骇璋堜細銆傚浗瀹跺崼鐢熼儴銆佸浗瀹跺尰鑽鐞嗗眬銆佸浗瀹跺澶栫粡娴庤锤鏄撻儴銆佸浗瀹跺啘涓氶儴锛屼互鍙婃槅鏄庡埗鑽巶銆佹鏋楃涓€銆佺浜屽埗鑽巶銆佸箍宸炵櫧浜戝北鍒惰嵂鍘傜瓑鍗曚綅鏈夊叧璐熻矗浜哄嚭甯簡搴ц皥浼氥€?/span>
閮功瑷€鍓富浠绘寚鍑猴細“涓烘帹鍔ㄨ繖椤瑰伐浣滐紝鍥藉绉戝鍜屾湁鍏抽儴闂ㄥ厛鍚庡彫寮€杩?/span>3娆′細璁苟鑱斿悎涓嬪彂浜嗘枃浠躲€傝繖瀵圭悊椤哄叧绯伙紝鎼炲ソ鍒嗗伐涓庡崗璋冭捣鍒颁簡淇冭繘浣滅敤銆傚鏋滃崗璋冧笉濂斤紝涔熷彲鑳戒細鏈夐闄┿€傚洜涓虹洰鍓嶅浗澶栨鍦ㄥ姞绱у紑鍙戣繖绫讳骇鍝併€傛垜浠彧鏈夋綔鍦ㄧ殑缁忔祹鏁堢泭锛岃繕娌℃湁鐪熸鐨勬晥鐩娿€傚嚑涓巶瀹堕兘寰堢潃鎬ワ紝鏅亶鍙嶆槧鐢变簬浜у搧鏈兘鍑哄彛鍒涙眹锛屽綋鍓嶈祫閲戝崄鍒嗙煭缂猴紝鍧愮瓑鏁堢泭绛変簬澶辨帀鑹満锛屽崄鍒嗕负闅俱€傝繖娆¤澶у鏉ュ氨鏄负浜嗗浣曟悶濂藉浗鍐呭崗璋冿紝鍥㈢粨涓€鑷村澶栵紝鎶婃綔鍦ㄦ晥鐩婂彉鎴愮湡姝ｆ晥鐩娿€?rdquo;[53]
搴ц皥浼氬悗锛屽浗瀹剁濮斿埗瀹氫簡銆婂姞蹇潚钂跨礌绫绘姉鐤熻嵂绉戠爺鎴愭灉鎺ㄥ箍鍜屽嚭鍙ｅ垱姹囧疄鏂借鍒掓柟妗堛€嬨€傛柟妗堟彁鍑猴紝鍦ㄥ浗瀹剁濮旂粺涓€缁勭粐鍗忚皟涓嬶紝閲囧彇绉戙€佸伐銆佽锤涓€浣撳寲鏂瑰紡锛屾湁閽堝鎬у湴寮€灞曞浗闄呮妧鏈悎浣溿€佽嵂鐗╂敞鍐屽拰璐告槗璋堝垽锛涢€氳繃鎷涙爣鐨勬柟寮忛€夋嫨鍑哄彛浠ｇ悊鍟嗭紝骞舵彁渚涗竴瀹氱殑鎶曡祫锛屼綔涓哄皢鏉ュ垱姹囧垎鎴愮殑渚濇嵁銆?/span>
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閭撹搲浠?/span>鏁欐巿棰嗗鐨勬姉鐤熻嵂鍖栧鍚堟垚瀹わ紝浠?/span>523椤圭洰绉戠爺宸ヤ綔寮€濮嬶紝渚垮悎鎴愪簡澶ч噺鐨勬柊鍖栧悎鐗╋紝浠庝腑绛涢€夊嚭浜嗘柊鐨勬姉鐤熷寲鍚堢墿鏈姶閱囥€傝瀹ょ殑鏉庣鏋楃爺绌跺憳绛変汉鍚堟垚浜嗙７閰歌悩閰氬柟銆傝繖涓や釜鏂板寲鍚堢墿鐢辨粫缈曞拰銆佸懆涔夋竻銆佺劍宀嵖銆佺帇浜戠幉绛夌爺绌朵汉鍛樺畬鎴愪簡鑽銆佽嵂鐞嗐€佷复搴婄殑鐮旂┒鍚庯紝閮借鎵瑰噯涓轰竴绫绘柊鑽紱鏈姶閱囪幏寰楀浗瀹跺彂鏄庝竴绛夊锛岀７閰歌悩閰氬柟鑾峰緱鍥藉鍙戞槑浜岀瓑濂栥€傞潚钂跨礌浠ュ強杩欎袱涓柊鑽紝閮芥槸杩勪粖鎴戝浗鏂拌嵂鏈€楂樼殑鍙戞槑濂栭」銆傝繖浜涙柊鑽拰闈掕捒绱狅紝涓哄悗鏉ユ垜鍥介潚钂跨礌澶嶆柟棰嗗厛涓栫晫鎻愪緵浜嗗潥瀹炵殑鐗╄川鍩虹銆?/span>
1990骞达紝鍐涗簨鍖诲绉戝闄㈠井鐢熺墿娴佽鐥呯爺绌舵墍锛岀巼鍏堟垚鍔熷紑鍙戜簡钂跨敳閱?mdash;鏈姶閱囧鏂癸紝鑾峰浗瀹舵柊鑽敞鍐屻€?/span>20涓栫邯90骞翠唬锛屼粬浠敤闈掕捒绱犲拰纾烽吀钀橀厷鍠圭粍鎴愪簡鍙︿竴涓柊澶嶆柟锛屼篃鑾峰緱鍥藉鏂拌嵂娉ㄥ唽銆傝捒鐢查啔—鏈姶閱囧鏂逛笌鐟炲＋璇哄崕鍏徃锛堝師涓烘苯宸?mdash;鍢夊熀鍏徃锛夊悎浣滐紝璇哄崕鍏徃鎶曞叆澶ч噺璧勯噾锛屾寜鍥介檯鏂拌嵂鐮斿彂鏍囧噯閲嶆柊杩涜浜嗙爺绌惰瘎浠凤紝浣胯澶嶆柟鏂拌嵂浜?/span>2002骞磋杞藉叆WHO鍩烘湰鑽墿鐩綍銆傚畠鏍囧織鐫€缁ч潚钂跨礌鍙婂叾琛嶇敓鐗╀箣鍚庯紝鎴戝浗闈掕捒绱犲鏂圭爺绌舵妧鏈張鎴愪负鍥介檯鍏堣繘姘村钩鐨勪唬琛ㄣ€?/span>
1981骞村湪鍖椾含涓捐鐨?/span>WHO SWG锛?/span>CHEMAL闈掕捒绱犲強鍏惰鐢熺墿瀛︽湳璁ㄨ浼氫笂锛屼笌浼氫汉鍛樺洿缁曟媴蹇冮潚钂跨礌涓€鏃﹁骞挎硾搴旂敤鍙兘浜х敓鎶楄嵂鎬х殑闂灞曞紑浜嗚璁恒€傚啗浜嬪尰瀛︾瀛﹂櫌寰敓鐗╂祦琛岀梾鐮旂┒鎵€鐨勭鎶€浜哄憳锛屼互鏁忛攼鐨勭溂鍏夊拰鎬濊矾锛屾妸闃叉鍜屽欢缂撻潚钂跨礌绯诲垪鍙婂叾浠栨柊鎶楃枱鑽骇鐢熸姉鑽€э紝鎴栨彁楂樺凡鍑虹幇鎶楄嵂鎬х殑鑽墿鐤楁晥锛屼綔涓轰竴涓繁鍏ョ殑鐮旂┒鏂瑰悜锛屽紑绔嬩簡鐮旂┒璇鹃銆?/span>
浠ュ懆涔夋竻銆佹粫缈曞拰涓鸿棰樿礋璐ｄ汉鐨勭爺绌跺皬缁勶紝鍦ㄦ棭鏈熸彺澶栧簲鎬ラ闃插鏂圭殑鍩虹涓婏紝浜?/span>20涓栫邯80骞翠唬鍒濆嵆寮€灞曚簡闈掕捒绱犲強鍏惰鐢熺墿涓庡叾浠栨姉鐤熻嵂缁勬垚澶嶆柟鐨勬帰绱㈢爺绌躲€備粬浠湪涓?/span>WHO鐨勫悎浣滀腑琚嫆缁濄€佸苟琚柇瑷€“浣犱滑娌℃湁鐮旂┒澶嶆柟鑽墿鐨勬潯浠跺拰鑳藉姏”鐨勬儏鍐典笅锛?/span>1982骞村湪鑾峰緱闈掕捒绱犳寚瀵煎鍛樹細缁欎簣璧勯噾璧勫姪鍚庯紝寤虹珛浜嗘柊鐨勫疄楠屾ā鍨嬶紝寮€灞曢潚钂跨礌鍙婂叾琛嶇敓鐗╀笌SP銆佹湰鑺撮唶绛夎嵂鐗╅厤浼嶅鏁堢殑瀹為獙锛屼粠涓€夊嚭钂跨敳閱氫笌鏈姶閱囩殑閰嶄紞浣滀负涓昏鐨勭爺绌惰棰?/span>[54]銆?/span>
姝ｅ鍓嶉潰鎵€鎻愬埌鐨勶紝钂跨敳閱氭槸鐢变腑鍥界瀛﹂櫌涓婃捣鑽墿鐮旂┒鎵€涓庢槅鏄庡埗鑽巶鍚堜綔鐮斿彂鐨勬姉鐤熻嵂锛?/span>1981骞村垵閫氳繃閴村畾锛屾槸鐢辨垜鍥借嚜涓荤爺鍙戠殑涓€绫绘柊鑽€傛湰鑺撮唶涔熸槸鎴戝浗鑷富鐮斿彂鐨勶紝鍏锋湁鏂扮殑鍖栧缁撴瀯鐨勬姉鐤熸柊鑽紝涓庢隘鍠规棤浜ゅ弶鎶楄嵂鎬э紝浜?/span>1989骞磋幏鍥藉涓€绫绘柊鑽瘉涔︼紝鍏堢敱鏄嗘槑鍒惰嵂鍘傜敓浜э紝鍚庢敼鐢辨禉姹熸柊鏄屽埗鑽巶鐢熶骇銆傛湰鑺撮唶浣滀负娌荤枟鑽樉鏁堣緝鎱紝涓庤捒鐢查啔绛夐€熸晥鑽墿閰嶄紞锛屼紭鍔夸簰琛ワ紝骞舵樉绀轰簡鏄庢樉鐨勫鏁堜綔鐢ㄣ€?/span>
鏈姶閱囦笌钂跨敳閱氱粍鎴愮殑澶嶆柟锛屽啗浜嬪尰瀛︾瀛﹂櫌寰敓鐗╂祦琛岀梾鐮旂┒鎵€鎸夊浗瀹舵柊鑽爺鍙戠殑鏍囧噯瀹屾垚浜嗗悇椤圭爺绌跺伐浣滃悗锛屼簬1992骞?/span>4鏈堣鎵瑰噯涓轰笁绫绘柊鑽紝棰佸彂浜嗘柊鑽瘉涔﹀強鐢熶骇鎵逛欢銆傝嚦姝わ紝棣栦釜闈掕捒绱犵被澶嶆柟鏂拌嵂鍦ㄦ垜鍥借癁鐢熴€?/span>
5銆佹柊鑽爺鍙戝浗闄呭悎浣滃垱鍏堜緥
钂跨敳閱氾紞鏈姶閱囧鏂规姉鐤熸柊鑽紝闈㈠鐨勬槸鍥藉唴鎶楃枱鑽殑寰皬甯傚満鍜屽浗澶栬传鍥板湴鍖虹殑鐤剧梾锛屼笉鍙兘寰楀埌涓板帤鍒╂鼎銆傚浗鍐呭埗鑽紒涓氬姝や篃鍏磋叮涓嶅ぇ銆傚浣曞彂鎸ヨ繖涓€澶嶆柟鐨勪綔鐢紝閫犵鍏ㄧ悆鐤熺柧娴佽鍖虹殑姘戜紬锛屼綋鐜板叾鐪熸浠峰€硷紝灏卞繀椤昏鍏惰繘鍏ュ浗闄呭競鍦恒€?/span>1990骞翠箣鍓嶏紝涓轰簡鎴戝浗闈掕捒绱犵被鎶楃枱鑽殑鍑哄彛锛屼负鍥藉鍒涢€犳晥鐩婏紝鍥藉绉戞妧閮ㄣ€佸浗瀹跺尰鑽鐞嗘€诲眬绛夐瀵奸儴闂紝铏界劧閮芥浘涓烘杩涜浜嗗皾璇曪紝浣嗙粓鏈兘鍙栧緱婊℃剰鐨勮繘灞曘€傝捒鐢查啔锛嶆湰鑺撮唶澶嶆柟濡備綍璧板嚭鍥介棬锛岃蛋鍚戝叏鐞冿紝鍒涢€犳晥鐩婏紝纭疄鏄竴涓緢鐜板疄鐨勯棶棰樸€?/span>
1990骞翠互鏉ワ紝涓浗涓俊鎶€鏈叕鍙镐笌鍐涗簨鍖诲绉戝闄㈠井鐢熺墿娴佽鐥呯爺绌舵墍銆佹槅鏄庡埗鑽泦鍥㈣偂浠芥湁闄愬叕鍙稿拰娴欐睙鍖昏嵂鑲′唤鏈夐檺鍏徃鏂版槍鍒惰嵂鍘傚悎浣滐紝浣滀负澶嶆柟钂跨敳閱氱墖鍓傦紙钂跨敳閱氾紞鏈姶閱囧鏂癸級椤圭洰鐨勫晢鍔′唬琛紝鍦ㄥ浗瀹剁濮旓紙鐜板浗瀹剁鎶€閮級绛夊浗瀹?/span>5閮ㄥ鐨勬敮鎸佷笅锛屼笌鐟炲＋姹藉反锛嶅槈鍩哄叕鍙革紙鐜颁负璇哄崕鍏徃锛夎繘琛屽悎浣滃紑鍙戠殑璋堝垽銆傜粡杩囦簡闀胯揪15骞寸殑鍥介檯绉戞妧鍚堜綔锛岃鍗庡叕鍙告姇鍏ュぇ閲忚祫閲戯紝鎸夊浗闄呮柊鑽爺鍙戞爣鍑嗛噸鏂板璇ュ鏂硅繘琛岀爺鍙戣瘎浠凤紝鐜板凡鍦ㄥ叏鐞?/span>79涓浗瀹躲€佸湴鍖烘敞鍐岋紝28涓浗瀹跺湴鍖轰笂甯傞攢鍞€傚畠鏄縿浠婁负姝紝涓浗鑽搧閫氳繃涓庡浗闄呬笂鐭ュ悕搴﹂珮鐨勫埗鑽紒涓氬悎浣滐紝浣夸箣浠ュ浗闄呮按骞崇殑鐮旂┒鎴愭灉璧板悜涓栫晫鐨勪竴涓厛渚嬨€傚畠涔熸爣蹇楃潃缁ч潚钂跨礌鍙婂叾琛嶇敓鐗╀箣鍚庯紝鎴戝浗闈掕捒绱犲鏂圭爺鍙戣兘鍔涘張鎴愪负鍥介檯鍏堣繘姘村钩鐨勪唬琛ㄣ€傚悓鏃讹紝瀹冧篃鏄湪鐢熶骇鎶€鏈鐞嗚鑼冨寲锛屽師鏂欏強缁堢浜у搧鍦ㄥ浗鍐呯敓浜э紝鎴愭灉鍜屼骇鍝佸€熻埞鍑烘捣锛屼负鎴戝浗瀹炵幇缁忔祹鏁堢泭鐨勬垚鍔熸ā寮忋€傝捒鐢查啔锛嶆湰鑺撮唶澶嶆柟浜у搧鍦ㄥ啝涓婄憺澹鍗?/span>Coartem鐨勫晢鍝佸悕鍚庯紝鍦ㄥ浗闄呬笂浜湁寰堥珮鐨勫０瑾夛紝2002骞磋杞藉叆WHO鍩烘湰鑽墿鐩綍銆?/span>
钂跨敳閱氾紞鏈姶閱囧鏂圭殑鍥介檯鍚堜綔鐨勮繃绋嬶紝鏄緢鍊煎緱鍥為【鍜屾€荤粨鐨勩€傚畠鐨勬垚鍔熷鍚庝汉鏈夐噸瑕佺殑鍚ず銆傚畠浠庝竴涓柟闈㈠悜鍥藉唴鏂拌嵂鐮斿埗銆佺敓浜т紒涓氬拰缁忚锤浼佷笟鎻愪緵浜嗘€庢牱寮€灞曞浗闄呭悎浣滐紝璁╀腑鍥借嵂鍝佽蛋鍚戜笘鐣岀殑鏂拌矾銆傛瘡涓叿浣撶殑浜у搧涓嶅畬鍏ㄤ竴鏍凤紝涔熶笉鍙兘閮藉鐢ㄤ竴绉嶆ā寮忥紝浣嗗叡鎬х殑涓€鐐规槸鍥介檯鏍囧噯鍖栵紝涓庡浗闄呮帴杞ㄦ槸涓嶈兘鍥為伩鐨勩€?/span>
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1990骞达紝浠栦滑鍙楀嵃搴﹀鑰呭叧浜庨潚钂跨礌瀵归棿鏃ョ枱閰嶅瓙浣撲綔鐢ㄧ爺绌剁殑鍚彂锛屽緱鍒扮憺澹綏姘忓熀閲戜細鐨勮祫鍔╋紝寮€灞曚簡闈掕捒绱犲鎭舵€х枱閰嶅瓙浣撴劅鏌撴€у奖鍝嶇殑鐮旂┒銆?/span>1991~1995骞撮棿锛屼粬浠鐗归個鍒拌秺鍗楀府鍔╄剳鍨嬬枱鐨勬晳娌伙紝浠庣梾浜虹殑楠ㄩ珦娑傜墖瑙傚療鍒伴潚钂跨礌瀵规棭鏈熼厤瀛愪綋鍙戣偛鐨勫奖鍝嶏紝骞跺湪3骞撮噷寤虹珛浜嗘寜铓婃劅鏌撹瘯楠屾柟娉曘€傞€氳繃瑙ｅ墫鍑犲崈鍙疄楠岀殑鎸夎殜锛屽垵姝ヨ瘉鏄庨潚钂跨礌涓嶄粎瀵规伓鎬х枱鎴愮啛閰嶅瓙浣撴湁杈冨ソ鐨勬姂鏉€浣滅敤锛岃€屼笖瀵归楂撲腑鐨?/span>鈪?/span>~鈪?/span>鏈熸棭鏈熼厤瀛愪綋鍧囨湁杈冨揩閫熺殑鏉€鐏綔鐢紱瀵瑰垰杩涘叆澶栧懆琛€娑茶€屾湭鍏锋劅鏌撴€х殑閰嶅瓙浣擄紝涔熻兘闃绘鍏舵垚鐔熻€岄槻姝㈠叾浼犳煋鎬э紱瀵瑰鍛ㄨ娑蹭腑鐨勬垚鐔熼厤瀛愪綋鐨勬姂鏉€浣滅敤锛屼篃浜庣敤鑽不鐤楀悗7澶╁拰14澶╋紝浣垮叾浼犳煋鎬у垎鍒檷浣?/span>70%鍜?/span>{bfb}锛屽け鍘讳簡浼犳煋鎬с€傝繖涓噸瑕佺殑鍙戠幇绾犳浜?/span>1978骞存湁浜轰粎鍑复搴婃不鐤楀悗琛€涓垚鐔熼厤瀛愪綋杩熻繜涓嶈浆闃达紝灏辨彁鍑洪潚钂跨礌瀵归厤瀛愪綋鏃犳晥鐨勯敊璇粨璁恒€傞€氳繃杩涗竴姝ヤ粠闈掕捒绱犲閰嶅瓙浣撲紶鎾€ц兘鐨勬湰璐ㄧ爺绌讹紝瀵归潚钂跨礌鐨勬姉鐤熶綔鐢ㄦ彁鍑轰簡鏂扮殑璁よ瘑銆傞潚钂跨礌鎶戞潃鐤熷師铏厤瀛愪綋杩欎竴鐙壒鐨勪綔鐢紝鏄繃鍘绘墍鏈夌枱鐤炬不鐤楄嵂閮戒笉鍏峰鐨勩€傝繖涓€鍙戠幇锛屾湁鍙兘涓烘帶鍒剁枱鐤炬祦琛屾彁渚涗竴绉嶆柊鐨勬€濊矾鎴栭€斿緞锛屽嵆鍒╃敤闈掕捒绱犳姂鏉€閰嶅瓙浣撹繖涓€鐗规€э紝鍙戞尌鍏堕樆鏂厤瀛愪綋浼犳挱鐤熺柧鐨勪綔鐢紝杩涜€屾湁鍔╀簬鎺у埗鐤熺柧鐨勬祦琛屻€?/span>
鐢变簬鍥藉唴鐤熺柧鐥呬汉杈冨皯锛?/span> | 