| 张丽萍,詹乐昌,谢雁鸣,谢仁明,欧海宁,郭友华,冯碧君,陈红霞.中西医结合治疗方案对急性缺血性脑卒中患者神经功能缺损和致残结局的影响[J].,2011,31(9):1175-1180 |
| 中西医结合治疗方案对急性缺血性脑卒中患者神经功能缺损和致残结局的影响 |
| Effects of Integrative Medicine Protocols on the Improvement of Neural Function Deficit and Disability Outcomes in Patients with Acute Ischemic Cerebral Stroke |
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| DOI： |
| 中文关键词: 中西医结合 康复 缺血性脑卒中 美国国立卫生研究院卒中量表 致残量表 |
| 英文关键词:integrative medicine rehabilitation ischemic cerebral stroke National Institute of Health Stroke Scale Rank Scale |
| 基金项目:国家高技术研究发展计划(863)资助课题(No.2007AA02Z4B2) |
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| 中文摘要: |
| 目的研究中西医结合治疗方案对急性缺血性脑卒中患者神经功能缺损和近期致残结局的影响。方法 99例患者随机入3组,即:中药灯盏细辛组(A组)、中药苦碟子组(B组)和西医对照组(C组)。A组:灯盏细辛注射液静脉滴注14天,按辨证分型给予中药汤药,并予灯盏生脉胶囊口服2个月;B组:苦碟子注射液静脉滴注14天,按辨证分型给予中药汤药,并予脑栓通胶囊口服2个月;A、B组除接受内科治疗外,还接受针刺、推拿手法、中药外洗治疗21天。C组除接受内科治疗外,还接受现代康复治疗21天,含康复训练及电刺激治疗。采用美国国立卫生研究院卒中量表(NIHSS)和修订致残量表(mRS)作为判断疗效主要指标。结果 3组各时点NIHSS评分均较治疗前明显降低(P<0.01),但在各时间点3组间差异均无统计学意义(P>0.05)。3组的致残结局随时间后移,经对数线性模型(CATMOD)高维列联表的分析,各组间致残结局差异有统计意义(P<0.05)。疗效以B组最优,显效率19.35%,总有效率为54.84%。结论中西医结合治疗方案可改善缺血中风患者的神经功能,而可改善其致残结局,其中以苦碟子静脉滴注加脑栓通胶囊口服加中医辨证施治加针刺、推拿及中药泡洗方案为优。 |
| 英文摘要: |
| Objective To study the effects of integrative medicine protocols on the neural function deficit and short-term disability outcomes in patients with acute ischemic cerebral stroke.Methods 99 patients were randomly assigned to three groups,i.e.,the Dengzhan Xixin(fleabane) group(Group A),the Kudiezi(sowthistle-leaf ixeris seedling) group(Group B),and the Western medicine control group(Group C).Dengzhan Xixin Injection was intravenously dripped to patients in Group A for 14 days.Chinese decoction was administered to them by pattern typing as well.Meanwhile,they took Dengzhan Shengmai Capsule for two months.Kudiezi Injection was intravenously dripped to patients in Group B for 14 days.Chinese decoction was administered to them by pattern typing as well.Meanwhile,they took Naoshuantong Capsule for two months.In addition to internal therapies,patients in Group A and B received acupuncture,massage,and external washing with Chinese medicine for 21 days.Patients in Group C also received modern rehabilitation therapy for 21 days,including rehabilitation training and electronic stimulus in addition to the internal medicine.The National Institute of Health Stroke Scale(NIHSS) and disability outcome(modified Rank Scale,mRS) were taken as main effect indices.Results The NIHSS scores at each time point obviously decreased more than before treatment in all the three groups(P<0.01),but with no difference at each time point(P>0.05).The disability outcomes of all the three groups postponed as time went by.Significant difference existed among the three groups by log-lineal model(CATMOD)(P<0.05).The best effect was shown in Group B,with the markedly effective rate of 19.35% and the total effective rate 54.84%.Conclusions The integrative medicine protocols could improve the nerve functions of ischemic stroke patients.Therefore,it could improve the disability outcomes.The comprehensive protocol(Kudiezi Injection + Naoshuantong Capsule + Chinese decoction according to pattern typing +acupuncture + massage + external washing with Chinese medicine) was better. |
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