中药脑安胶囊在社区脑卒中高危人群干预管理应用再评价  

Efficacy of the traditional Chinese medicine NAOAN capsule for primary prevention of stroke in high-risk population

作　　者：刘红梅[1,2] 江滨[1] 黄久仪[3] 刘运海[4] 洪震[5] 何俐[6] 詹思延[7] 孙冬玲[1] 茹小娟[1] 孙海欣[1] 王文志[1,2] Liu Hongmei; Jiang Bin; Huang Jiuyi; Liu Yunhai; Hong Zhen; He Li; Zhan Siyan; Sun Dongling; Ru Xiaojuan; Sun Haixin; Wang Wenzh(Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China ; National Office for Cerebrovascular Diseases （CVD） Prevention and Control in China, Beijing 100050, China ; Shanghai Institute of Cerebral Vascular Diseases Prevention and Cure, Shanghai 201203, China ; Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, China ; Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China; Department of Neurology, West China Hospital, Sichuan University, Chengdu 610000, China ; School of Public Health, Peking University, Beijing 100871, China)

机构地区：[1]首都医科大学北京市神经外科研究所,北京100050 [2]全国脑血管病防治研究办公室,北京100050 [3]上海科学院上海脑血管病防治研究所,上海201203 [4]中南大学湘雅医院神经内科,长沙410008 [5]复旦大学华山医院神经内科,上海200040 [6]四川大学华西医院神经内科,成都610000 [7]北京大学公共卫生学院,北京100871

出　　处：《中华健康管理学杂志》2018年第5期415-419,共5页Chinese Journal of Health Management

基　　金：“十二五”国家科技支撑计划课题（2011BA108801）

摘　　要：目的评价在社区脑卒中高危人群中应用中药脑安胶囊进行脑卒中一级预防对脑血管功能的改善效果。 方法采用多中心、随机对照研究方法，在北京、上海、长沙、成都的社区人群中筛查出1 088例脑卒中高危人群（经改良的Framingham卒中风险预测量表评估，10年卒中风险≥6%，同时脑血管功能积分值〈75分者），以村或居委会为单位随机分为脑安胶囊组和阿司匹林组，脑安胶囊组559例，阿司匹林组529例，对其进行2个月1次的随访管理，为期2年，分析比较两组干预期间和干预结束时脑血管功能的改善情况。结果最终进入统计分析的脑安胶囊组531例，阿司匹林组465例。干预2年结束时，脑安胶囊组脑血管功能积分值从基线的（45.2±19.7）分提高到（61.7±26.5）分（t=-12.931, P〈0.01），阿司匹林组脑血管功能积分值从基线的（47.2±18.9）分提高到（53.7±25.1）分（t=-5.058，P〈0.01）；干预2年结束时，脑安胶囊组的脑血管功能积分值平均水平明显高于阿司匹林组（t=4.906，P〈0.01）。结论在脑卒中高危个体的健康管理中，长期服用脑安胶囊可有效改善脑卒中高危个体的脑血管功能，并且效果优于阿司匹林。Objective To evaluate the efficacy of the traditional Chinese medicine NAOAN capsule in primary prevention of stroke in high-risk populations. Methods A multieenter, randomized controlled study was performed in community setting, involving 1 088 individuals at high risk of stroke, with cerebrovascular function scores〈75 and 10-year Framingham stroke risk 〉 6%. Subjects were recruited incommunities at Beijing, Shanghai, Changsha, and Chengdu communities, through resident committees or the village unit. A total of 559 subjects were randomized into a group treated with the NAOAN capsule, and 529 subjects in an aspirin treatment group. Follow-up was performed every 2 months for 2 years. At the mid- point and end of the intervention, we compared cerebrovascular funetion differences between the 2 groups. Results During the 2-year community trial, 531 subjects in the NAOAN capsule group and 465 in the aspirin group followed the protocol. Cerebrovascular function scores increased from 45.2±19.7 at baseline to 61.7±26.5 after the 2-year trial （t= - 12.931, P〈0.001） in the NAOAN capsule group, and from 47.2±18.9 at baseline to 53.7 ± 25.1 （t=- 5.058, P〈0.001） in the aspirin group; greater increases in cerebrovascular function scores were found in the NAOAN capsule group than that in the aspirin group （t=4.906, P〈0.001）. Conclusions Cerebrovascular function in individuals at high risk of stroke was improved by taking NAOAN capsule. Cerebrovascular function scores improved more with NAOAN capsules than with aspirin.

关 键 词：卒中 社区医学 高危人群 脑安胶囊 干预管理 

分 类 号：R494[医药卫生—康复医学]