针刺和中药结合卒中单元治疗缺血性脑卒中恢复期患者的临床研究

Clinical Observation on Acupuncture and Chinese Medicine Combined with Stroke Unit for Treatment of Ischemic Stroke at Convalescence Stage

目的观察针刺和中药结合卒中单元治疗缺血性脑卒中恢复期患者的临床疗效。方法将符合纳入标准的240例缺血性脑卒中恢复期患者随机分为A组(针刺和中药结合卒中单元组)、B组(针刺结合卒中单元组)、C组(中药结合卒中单元组)、D组(卒中单元组)组,每组60例。每组病例均治疗8周,分别于治疗前后观察脑卒中残损评定法(SIAS)评分、日常生活活动能力评分量表(BI)评分、简明精神状态量表(MMSE)评分、牛津残障量表(OHS)评分,同时观察治疗前后整体临床疗效,并于出院后第6个月随访OHS评分。结果 4组患者并发症发生率比较无统计学意义;A、B、C、D组治疗前后SIAS评分差值分别为21.91±3.25,17.11±4.12,17.25±4.26,10.64±5.42,A组差值与B、C、D组差值比较有统计学意义(P<0.05);A、B、C、D组治疗前后BI评分差值分别为43.58±1.69,38.69±2.35,39.16±2.54,33.57±1.28,A组差值与B、C、D组差值比较有统计学意义(P<0.05);A、B、C、D组治疗前后MMSE评分差值分别为12.33±2.25,9.20±3.02,8.04±3.16,5.93±3.38,A组差值与B、C、D组差值比较有统计学意义(P<0.05);四组患者治疗后和出院后第6周OHS评分比较,A组与B、C、D组比较经秩和检验有统计学意义(P<0.05);A组的总有效率93.33%,B组总有效率86.67%,C组总有效率85%,D组总有效率86.67%,A组与其他三组比较有统计学意义(P<0.05)。结论针刺和中药结合卒中单元治疗缺血性脑卒中恢复期患者能有效改善运动功能、日常生活活动能力、认知能力、社会参与能力,可提高整体临床疗效,较针刺结合卒中单元组、中药结合卒中单元组、卒中单元组有一定的优势。

Objective To observe the effect of acupuncture and Chinese medicine combined with stroke unit for treatment of ische mic stroke at convalescence stage. Methods Two hundreds and forty patients with ischemic stroke at convalescence stage were ran domly divided into 4 groups：Group A（n =60） treated with acupuncture and Chinese medicine combined with stroke unit,group B（n= 60） treated with acupuncture and stroke unit,group C（n=60） treated with Chinese medicine and stroke unit,group D（n= 60） treated with stroke unit for 8 weeks. The Barthel index（BI）, stroke impairment assessment set（SIAS）, Oxford handicap cale（ OHS）, mini - mental state examination（MMSE） were evaluated before and after treatment. The total clinical efficacy was observed. After six months of discharge,OHS score was observed. Results There was statistical significance in the scores of SIAS,BI,MMSE,OHS between group A and group B,group C,group D（P〈0.05）. The total clinical efficacy were 93. 33%,86.67; ,85% ,86.67% in group A,group B,group C and group D. The total clinical efficacy in group A was better than that in group B,group C and group D（P〈0.05）. Conclusion Acupuncture,Chinese medicine and stroke unit has an obvious effect on isehemic stroke at convalescence stage,which can improve their motor function, activities of daily living, cognitive abilities, social participation.