缺血性脑卒中二级预防中医特色护理干预效果研究

Study on the effect of traditional Chinese medicine nursing intervention on secondary prevention of Ischemic stroke

目的观察中医特色护理干预在缺血性脑卒中二级预防中的应用效果。方法将广州中医药大学第一附属医院脑病科2016年1月-2017年12月收治的缺血性脑卒中患者120例随机分为对照组和观察组,各60例。对照组予常规护理,观察组予中医特色护理(辨证施膳、五音调情、循经拍打与点穴按摩)。从入院入组开始至出院后持续干预1年,出院患者随访。于干预前后分别用中风症状积分量表、世界卫生组织生活质量评定表(WHOQOL-BREF),运动功能Furl-Meyer运动评分量表(FMA)、改良Barthel生活能力指数评分对两组患者进行测评,观察并比较两组患者在临床症状、生活质量、运动功能、生活能力方面的变化情况及1年内复发情况。结果 (1)干预后,2组中医症状分级量化积分和QOL-BREF总分均显著改善(P<0.05或P<0.001),且观察组2项分值的改善均优于对照组(P<0.001)。(2)干预后,2组运动功能FMA评分和生活能力Barthel指数评分均显著改善(P<0.05或P<0.001),且观察组2项分值的改善均优于对照组(P<0.001)。(3)干预后,2组患者1年内复发率比较,观察组显著低于对照组(P<0.05)。结论中医特色护理干预措施简便,效果好,明显降低缺血性脑卒中患者复发率,值得推广应用。

Objective To observe the application effect of traditional Chinese medicine(TCM) nursing intervention on secondary prevention of ischemic stroke. Method 120 patients with ischemic stroke in encephalopathcy department of the first affiliated hospital of Guangzhou university of traditional Chinese medicine from January 2016 to December 2017 were randomly divided into control group and observation group, 60 cases in each group. Patients in control group was given routine care, and the observation group was given TCM treatment(i.e. dialectical feeding, Chinese classical music remedy, tapping along main and collateral channels and acupressure). From admission to hospital/group to discharge, continuous intervention lasted for 1 year. After discharge, patients were followed up to ensure the continuity of nursing intervention. These 2 groups of patients were evaluated before and after the intervention with the stroke symptom score scale, the world health organization quality of life scale(WHOQOL-BREF), the Furl-Meyer assessment of motor recovery(FMA) and the modified Barthel index of activities of daily living(MBI-ADL). The changes in clinical symptoms, quality of life, motor function, living ability and the recurrence of ischemic stroke in the 2 groups within 1 year was compared. Results(1) After the intervention, the TCM symptom grading, quantifying scores and WHOQOL-BREF total scores of the 2 groups were significantly improved(P<0.05 or P<0.001), and the improvement of the scores of the observation group was better than that of the control group(P<0.001).(2) After the intervention, the FMA scores and the MBI-ADL of the 2 groups were significantly improved(P<0.05 or P<0.001), and the improvement of the scores in the observation group was better than that of the control group(P<0.001).(3) After the intervention, the recurrence rate of the observation group within 1 year was significantly lower than that of the control group(P<0.05).Conclusion The TCM nursing intervention is simple and effective. It can significantly reduce the recurrence rate of ischemic stroke. It is worthy of popularization and application.