综合治疗脑卒中后痉挛性瘫痪的PRO疗效评价及相关性分析  

PRO effectiveness assessment of comprehensive therapy for post-stroke spastic paralysis and relativity analysis

作　　者：马会靖 张春红[2] 张丹[1] 戴琛[1] 

机构地区：[1]天津中医药大学,天津300193 [2]天津中医药大学第一附属医院,天津300193

出　　处：《长春中医药大学学报》2016年第1期88-90,共3页Journal of Changchun University of Chinese Medicine

基　　金：公益性行业专项"中医防治中风病技术转化与社区推广研究"(201007002)

摘　　要：目的采用基于患者报告结局(PRO)的原则对综合治疗脑卒中后痉挛性瘫痪的疗效进行评价,并分析本结局与其他疗效评价指标之间的相关性。方法对365例患者采用综合治疗方案,脑卒中痉挛性瘫痪PRO量表为主要疗效指标,Ashworth量表、Barthel指数量表、Fugl-Meyer量表、Rankin量表为相关性指标,分别在治疗前、治疗1、6个月后随访3个时点进行观察。结果治疗后及随访期PRO得分均低于治疗前。Ashworth量表评分与PRO评分相关性最高(0.425、0.581、0.658),PRO量表与Barthel指数量表有一定相关性(-0.319、-0.301、-0.421),PRO量表与Fugl-Meyer量表(-0.290、-0.265、-0.414)、Rankin量表(0.262、0.269、0.417)相关系数较小,无明显相关。结论综合疗法治疗脑卒中后痉挛性瘫痪在患者自身感受的改善方面有较好的疗效。对疗效评价要以患者为中心并旨在测量患者所认为最重要的结局。Objective Patient-reported outcome（ PRO） method was used to evaluate clinical effects of comprehensive therapy for post-stroke spastic paralysis and analyze the relativity between the outcome and the other effect evaluation index. Methods Using comprehensive therapy in 365 cases. PRO was used as main outcome index,while Ashworth scale,Barthel index scale,Fugl-Meyer scale and Rankin scale as secondary index. Patients were evaluated before and after treatment,follow-up 5 months after the end of the treatment course. Results After treatment and follow-up PRO scores were lower than before treatment. The relativity between Ashworth score and PRO was the closest（ 0. 425 and 0. 581,0. 658）. PRO and Barthel index score had some relationship（- 0. 319,- 0. 301,- 0. 421）.Fugl-Meyer scale（ 0. 290,- 0. 265,- 0. 414） and Rankin Scale（ 0. 262,0. 269,0. 417） had smaller correlation coefficient with PRO. There was little significant relationship. Conclusion Comprehensive treatment for patients of poststroke spastic paralysis had a better effect in the their own feelings improvement. The efficacy evaluation should take the patient as the center and aim to measure the most important outcome for the patients.

关 键 词：脑卒中 综合疗法 痉挛性瘫痪 PRO 相关性分析 

分 类 号：R255.2[医药卫生—中医内科学]