中西医结合综合方案治疗急性脑梗死的预后评价

Prognosis evaluation of integrative medicine on acute period of ischemic stroke

目的:评价中西医结合综合方案治疗急性脑梗死的预后。方法:采用多中心、随机、对照的研究方法,将5家医院295例急性脑梗死(发病时间>6 h)病例随机分为综合治疗组、对照组。对照组予西医规范化的基础治疗与康复锻炼;综合治疗组在西医规范化治疗的基础上,早期介入中药、针刺、推拿等为一体的传统中医综合治疗方法。两组疗程均为21 d。评价治疗后第21、90、180天时改良Rankin(MRS)量表评分,独立生活能力量表BI指数及第7、14、21天时的美国国立卫生院卒中量表(NIHSS)评分的变化。结果:综合治疗组在随访第180天时MRS评分≤2分比例明显高于对照组(P<0.05);综合治疗组在干预后第21天的BI评分≥85的比例与对照组相比,差异无统计学意义(P>0.05),第90天、第180天的BI评分≥85的比例明显高于对照组(P<0.05);在干预后第7天、第14天、第21天综合治疗组的NIHSS评分实测值明显优于对照组(P<0.05)。结论:中西医结合综合治疗方案可以促进缺血性脑卒中患者神经功能的恢复,降低致残率,提高患者日常生活活动能力,改善卒中患者的生活质量。

Objective：To observe combined traditional and western medicine function of treating acute cerebral infarction.Methods：Adopt a multicenter,randomized,controlled study method.A total of 295 cases patients in 5 hospitals with acute cerebral infarction（onset6 h） were randomly divided into treatment group and control group.Some patients in control group accepted standardizing western medicine treatment and rehabilitation,the others in the experiment group accepted herb,acupuncture,massage,etc. besides western medicine treatment.The two groups accepted 21 days cure for a course of treatment.Count and compare function recovery scale called modified Rankin scores（MRs）in 21 d,90 d,and 180 d;count and compare independent living ability scale index（BI）in 21 d,90 d,and 180 d;and observe USA NIH Stroke Scale（NIHSS）score changes in 7 d,14 d,and 21 d.Results：Therapeutic effectiveness of the treatment group who accepted both Chinese and Western medicine was obvious superior to control group in 180 d（P0.05）.In the 90th and the 180th day,BI score≥ 85 ratio in treatment group was higher than that in control group（P0.05）,while the vantage was not obvious in the 21st day.In the 7th,14th and the 21st day,measured NIHSS score of treatment group was better than that of control group（P0.05）.Conclusion：The combination of traditional Chinese and Western medicine integrated treatment programs could help ischemic stroke patients in recovery of neurological function,could reduce the disability rate,could improve the ability of daily life of stroke patients.