中风醒脑液治疗出血性脑卒中的回顾性分析

Zhongfeng Xingnao Liquid for Hemorrhagic Stroke:A Retrospective Analysis

目的观察中风醒脑液对出血性脑卒中患者预后的影响。方法回顾性分析成都中医药大学附属医院2008年10月至2017年10月的247例(最终纳入192例)出血性脑卒中患者,以服用中风醒脑液>14 d为暴露因素,分为中药组和对照组。收集患者的一般资料、既往史、病程、入院时血压、出血部位、血肿体积、美国国立卫生研究院卒中量表(NIHSS)评分、GCS评分、合并症等影响患者死亡率的相关因素,记录其生存时间,采用Kaplan-Meier法构建生存曲线,比较两组累积病死率的差异;利用COX回归控制混杂偏倚,分析中风醒脑液对出血性脑卒中患者预后的影响。结果1)生存曲线显示,中药组第15个月、第77个月累积病死率分别为8.5%(12/141)、31.9%(45/141),对照组第15个月、第77个月累积病死率为31.4%(16/51)、70.6%(36/51),Log-rank检验结果发现,两组累积病死率差异有统计学意义(χ^(2)=26.047,P<0.001)。2)调整了年龄、入院时血压、出血部位、血肿体积、合并症、NIHSS评分、格拉斯哥昏迷量表(GCS)评分后,中风醒脑液对两组生存时间影响的差异具有统计学意义(HR=0.392,P<0.001),中药组死亡风险是对照组的0.392倍(95%CI 0.243-0.630)。结论中风醒脑液能有效降低患者累积病死率,延长生存时间。

Objective:To observe the effect of Zhongfeng Xingnao Liquid on the prognosis of hemorrhagic stroke patients.Methods:A total of 247 patients with hemorrhagic stroke in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from October 2008 to October 2017(192 patients were finally includ-ed)were retrospectively analyzed.The patients were divided into the TCM group and the control group after tak-ing Zhongfeng Xingnao Liquid for more than 14 days as exposure factors.The general information,past medical history,course of disease,blood pressure on admission,bleeding site,hematoma volume,NIHSS score,GCS score,and comorbidities of the patients were collected,and the survival time was recorded.Kaplan-Meier method was used to build the survival curve,and the difference of cumulative mortality between the two groups was compared.COX regression was used to control confounding bias and analyze the effect of Zhongfeng Xingnao Liquid on the prognosis of patients with hemorrhagic stroke.Results:1)The survival curves showed that the cumulative case fa-tality rates were 8.5%(12/141),31.9%(45/141)at month 15 and month 77 in the TCM group,and 31.4%(16/51),70.6%(36/51)at month 15 and month 77 in the control group,respectively,and the log rank test showed that there was a significant difference between the two groups(χ^(2)=26.047,P<0.001).2)After adjusting for age,blood pressure on admission,site of hemorrhage,hematoma volume,comorbidities,NIHSS score,and GCS score,the ef-fect of Zhongfeng Xingnao Liquid on survival time in both groups was statistically significant(HR=0.392,P<0.001),and the risk of death in the TCM group was 0.392-fold(95%CI 0.243-0.630)of that in the control group.Conclusion:Zhongfeng Xingnao Liquid can effectively reduce the cumulative mortality and prolong the survival time of patients.