中医康复临床实践指南·缺血性脑卒中(脑梗死)

Clinical Practice Guidelines of Chinese Medicine Rehabilitation for Ischemic Stroke(Cerebral Infarction)

缺血性脑卒中(脑梗死)是临床常见的局限性脑组织缺血性坏死或软化性疾病,在中医学里属“中风病”。近年来其发病率逐步增高,发病年龄趋于年轻化,严重影响患者的生活质量。中医康复是改善其临床症状和预防复发的有效方法之一。基于循证医学理念与方法制定的脑梗死中医康复临床实践指南具有重要意义,有助于规范脑梗死中医康复操作技术,取得更好的疗效。本指南从范围、术语、中西医诊断、康复评定、中医康复治疗和护理等方面对脑梗死的诊断与康复治疗流程进行规范,旨在为临床医师/康复医师提供诊疗指导和参考。①诊断:分为中医诊断和西医诊断2部分,其中中医诊断包括辨病诊断和辨证诊断(中经络、中脏腑);西医诊断包括诊断依据、临床分期、临床病情程度量化分型。②康复评定:主要包括神经功能缺损程度评定、运动功能评定、平衡功能评定、言语功能评定、吞咽功能评定、认知功能评定、心理评定、生活质量评定等8个方面。③中医康复治疗:主要规定了脑梗死超早期、急性期、恢复期及后遗症期的中药治疗、针灸疗法、推拿疗法、传统功法、康复治疗及护理等方面的诊疗技术。该指南可为各级各类康复机构、其他中医医院或综合医院康复科的康复从业人员进行脑梗死的中医康复治疗提供指导,具有较好的临床适用性和有效性。

Ischemic stroke(cerebral infarction)is a common clinical disease of ischemic necrosis or softening of localized brain tissue,which belongs to"stroke disease"in traditional Chinese medicine(TCM).In recent years,its incidence rate has gradual‐ly increased,the age of onset tends to be younger,and seriously affects the quality of life of patients with cerebral infarction.TCM rehabilitation is one of the effective methods to improve clinical symptoms and prevent recurrence.The clinical practice guideline of TCM rehabilitation of cerebral infarction based on the concept and method of evidence-based medicine is of great significance,which is helpful to standardize the operation technique of TCM rehabilitation of cerebral infarction and obtain better curative effect.This guideline standardizes the diagnosis and rehabilitation treatment of cerebral infarction in terms of scope,terminology,diagnosis of TCM and western medicine,rehabilitation assessment,TCM rehabilitation treatment and nursing,in order to provide guidance and reference for clinicians or rehabilitation doctors in diagnosis and treatment.①Diagnosis:it is divided into TCM diagnosis and western medicine diagnosis,TCM diagnosis includes disease differentiation and syndrome differentiation(meridian involved style and viscera involved style),and western medicine diagnosis includes diagnosis basis,clinical stage and quantitative classification of clinical condition.②Rehabilitation assessment:it mainly includes the assessment of neurological impairment,motor function,bal‐ance function,speech function,swallowing function,cognitive function,psychological assessment and quality of life.③Rehabilita‐tion treatment of traditional Chinese medicine(TCM):it mainly stipulates the diagnosis and treatment technologies of traditional Chinese medicine treatment,acupuncture therapy,massage therapy,traditional functional methods,rehabilitation treatment and nurs‐ing in the ultra early stage,acute stage,recovery stage and sequelae stage of cerebral infarction.The guideline could provide guid‐ance for the rehabilitation treatment of cerebral infarction in different levels and kinds of rehabilitation institutions,traditional Chi‐nese medicine hospitals or general hospitals.It has good clinical applicability and effectiveness.