基于GEE模型评价中医综合方案对缺血性中风患者神经功能损伤的临床观察

Clinical evaluation on treating nerve function deficit of patients with ischemic stroke with traditional Chinese medicine integrated program based on GEE model

目的:采用GEE模型评价在缺血性中风早期中医综合方案对缺血性中风患者神经功能缺损、运动功能损伤的临床疗效。方法:采用实用性随机对照试验,多中心合作,中医综合方案与卒中单元模式下的西医方案作对照。共纳入缺血性中风患者共260例。疗效指标借鉴公认的现代康复医学的疗效评价标准。住院期间疗效评价指标采用美国国立卫生研究院卒中量表(NIHSS)评价神经功能缺损程度、Fugl-Meyer运动功能评价量表(FMI)评价运动功能、修改后的Ash Worth痉挛评定量表评价痉挛程度。结果:简式Fugl-Meyer的GEE模型:中医组和西医组随着治疗时间的延长,其治疗效果均得到改善,且中医组对Fugl-Meyer评分的改善要优于西医组,差异有统计学意义。NIHSS评分的GEE模型:中医组和西医组随着治疗时间的延长,其治疗效果均得到改善,且中医组对NIHSS评分的改善要优于西医组,但差异无统计学意义。结论:通过对253例临床试验分析表明,GEE模型评价重复测量数据的临床疗效具有一定的科学性和可行性。

Objective： To evaluate the clinical effect of treating nerve function and motor function damage of patients with ischemic stroke with traditional Chinese medicine integrated program based on GEE model. Methods： The pragmatic randomized controlled trial, multi-center cooperation were adopted, and made traditional Chinese medicine integrated program and western medicine scheme under the management mode of stroke unit as a comparison. Two hundred sixty patients with ischemic stroke were included. Therapeutic effect index used accepted curative effect evaluation standard of modern rehabilitation medicine for reference. NIHSS was used to evaluate the nerve function damage degree, and Fugl-Meyer was used to evaluate the movement function, and spasticity was evaluated by using improved AshWorth method. Results： Fugl-Meyer scores of Chinese medicine group and western medicine group were improved as the extension of treatment time, and the improvement of Fugl- Meyer score of Chinese medicine treatment group was better than that of western medicine treatment group, and the comparison had remarkable statistics significance. NIHSS scores of Chinese medicine group and western medicine group were improved as the extension of treatment time, and the improvement of NIHSS score of Chinese medicine treatment group was better than that of western medicine treatment group, but the comparison had no statistics significance. Conclusion： Based on the analysis of more than two hundred cases show that clinical trials, the clinical curative effect of repeated measurement data of GEE model evaluation has a scientific and feasible.