中西医综合治疗阴类证缺血性中风的临床疗效评价  

Clinical evaluation on comprehensive protocol of Chinese & western medicine in treating acute ischemic stroke of yin pattern

作　　者：裴建[1] 宋毅[1] 方邦江[1] 袁灿兴[1] 魏江磊[2] 董强[3] 汪昕[4] 汪涛[5] 黄燕[6] 

机构地区：[1]上海中医药大学附属龙华医院,上海200032 [2]上海中医药大学附属曙光医院,上海200021 [3]复旦大学附属华山医院,上海200040 [4]复旦大学附属中山医院,上海200032 [5]上海中医药大学附属岳阳中西医结合医院,上海200437 [6]广东省中医院,广东广州510120

出　　处：《上海中医药杂志》2010年第4期14-17,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家科技部"十五"攻关项目(2004BA721A02);上海市科委"登山计划"项目(06DZ19734)

摘　　要：目的观察中西医综合治疗急性缺血性中风的疗效,优选体现中医药干预特色的疗效评价指标,探索缺血性中风的疗效评价体系的多维模式。方法采用前瞻性、多中心、中央随机、平行对照的试验设计,将136例患者分别用中西医综合方案(试验组,76例)和西药加中药安慰剂(对照组,60例)治疗,观察美国国立卫生研究院中风量表(NIHSS)和中医症征积分表(SSTCM)积分情况。结果与对照组比较,试验组治疗21天后NIHSS总分差异有显著性意义(P<0.05);治疗后14、21、60和90天,两组SSTCM总分比较差异有统计学意义(P<0.05)。结论中西医综合治疗方案比单纯西药治疗更能有效改善神经功能缺损和中风相关不适症状体征;用NIHSS评价两组临床疗效差异,时间节点出现在治疗后21天,而用SSTCM则提前到治疗后14天,说明SSTCM更能显示中医药的独特疗效优势。Objective To observe the clinical effects of comprehensive protocol of Chinese ＆ western medicine in treating acute ischemic stroke, optimize the evaluation indexs showing the advantages and characteristics of Chinese medicine, and explore the muti-dimensions evaluation system in treating ischemic stroke. Methods A prospective, muhicenter, central randomized and parallel control clinical trial was adopted in 156 cases of acute ischemic stroke from 7 hospitals. They were di- vided into observation group（ 76 cases） treated with integrated Chinese and western medicine protocol, and control group（ 60 cases） treated with western medicine plus placebo. NIHss and SSTCM were assessed after treatment. Results Compared with the control group, the 21st day assessment showed that the total score of NIHSS in the observation group was lower（ P 〈0.05 ） ; and on the 14th, 21 st, 60th and 90th days assessment also showed that the total score of SSTCM was lower （P 〈0.05 ）. Conclusion The integrative Chinese and western medicine protocol can better improve neural function, symptom and signs of stroke patients, and difference in the total score of NIHSS between two groups is from the 21 st day, while that in the total score of SSTCM is from 14th day, indicating that SSTCM may show much more advantage and characteristics of Chinese medicine.

关 键 词：急性缺血性中风 中西医结合疗法 随机对照试验 多中心 

分 类 号：R743[医药卫生—神经病学与精神病学]