中风病特色中医诊疗方案临床再评价研究

Study on Clinical Re-evaluation of TCM Diagnosis and Treatment Program of Stroke

目的:在辽宁省内对中风病(脑梗死)特色中医诊疗方案进行临床疗效再评价,为进一步优化诊疗方案奠定基础。方法:于2015年11月—2016年11月期间,收集来自省内5家中医院的符合纳入标准的中风病(风痰阻络证)患者300例,随机分为两组,治疗组在基础治疗上加用体针、眼针治疗,对照组在基础治疗上加用体针治疗,针刺20 min,每日1次,14 d为1疗程,共治疗1个疗程。并于试验前、针刺7 d末、针刺14 d末分别进行美国国立卫生研究所卒中量表(NIHSS评分)、BARTHEL指数评价,同时进行治疗前后的病残程度和中医证候疗效评价。结果:治疗组和对照组在治疗7 d末、治疗14 d末的NIHSS评分、BARTHEL指数均较治疗前明显下降(P<0.05),但治疗组与对照组中治疗7 d末、治疗14 d末NIHSS评分、BARTHEL指数的组间比较,则未见明显统计学差异(P>0.05)。病残程度评估比较,治疗组的无残疾率、明显残疾率均高于对照组,且下降1个级别、下降2个级别的患者数也较多。两组中医证候疗效评价表明治疗组的总有效率明显高于对照组。结论:中风病(脑梗死)特色中医诊疗方案具有较好的临床适用性,临床疗效肯定,值得临床推广。

Objective： To evaluate the clinical effect of the traditional Chinese medicine diagnosis and treatment program for stroke（ acute cerebral infarction） in Liaoning province. Methods： During the period from November 2015 to November 2016,300 patients were collected from the 5 hospitals and met the inclusion criteria of stroke（ wind and phlegm）and were randomly divided into 2 groups. The treatment group was treated with basic therapy plus body acupuncture,eye acupuncture treatment. The control group besides the basic treatment used acupuncture treatment,20 min,once a day,14 days for 1 course of treatment,a total of 1 course of treatment. And before the trial,at the end of the 7th and 14 th day,the American National Institutes of Health Stroke Scale（ NIHSS score）,BARTHEL index and the degree of disability were evaluated and the curative effect of TCM syndrome was observed. Results： On the end of the 7th,14 th day,the treatment group and the control group＇s NIHSS score and BARTHEL index were significantly decreased compared with those before treatment（ P〈0. 05）,but the treatment group and the control group＇s NIHSS score and BARTHEL index between the two groups had no statistically significant difference at the end of 7th and 14 th day（ P〉0. 05）. The degree of disability assessment and disability rate in treatment group were higher than that of the control group and the number of patients who decreased one or two grades were more in the treatment group. Two groups ＇TCM syndrome evaluation showed that the total effective rate of the treatment group was significantly higher than that of the control group. Conclusion： Traditional Chinese medicine diagnosis and treatment program of stroke（ acute cerebral infarction） has a good clinical applicability and clinical efficacy,worthy of clinical promotion.