基于社区的非急性期缺血性脑卒中患者健康状态和中医特征调查  

Investigation on Health Status and Characteristics of Traditional Chinese Medicine in Patients with Non-acute Ischemic Stroke Based on Community

作　　者：龚柳 王宇[1] 姚迎叶[1] 俞建锋 汤伟 吉宏彬[5] 孙青 诸杰 张晓钢 刘宪锋 马洁 忻伟[1] 张云云 GONG Liu;WANG Yu;YAO Ying-ye;YU Jian-feng;TANG Wei;JI Hong-bin;SUN Qing;ZHU Jie;ZHANG Xiao-gang;LIU Xian-feng;MA Jie;XIN Wei;ZHANG Yun-yun(Department of Neurology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai(200437;Department of Neurology,Baoshan Branch,Shuguang Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai(201999;Community Health Service Center,Waigang Town,Jiading District,Shanghai(201806;Community Health Service Center,Jiading Town,Jiading District,Shanghai(201899;Yingyuan Hospitaly Jiading District,Shanghai(201800;Community Health Service Center,Malu Town,Jiading District,Shanghai(201801;Community Health Service Center,Juyuan New District,Jiading District,Shanghai(201899;Community Health Service Center,Nanxiang Town,Jiading District,Shanghai(201802;Community Health Service Center,Jiading Industrial Zoney Jiading District,Shanghai(201815))

机构地区：[1]上海中医药大学附属岳阳中西医结合医院神经内科,上海200437 [2]上海中医药大学附属曙光医院宝山分院神经内科,上海201999 [3]上海市嘉定区外冈镇社区卫生服务中心,上海201806 [4]上海市嘉定区嘉定镇街道社区卫生服务中心,上海201899 [5]上海市嘉定区迎园医院,上海201800 [6]上海市嘉定区马陆镇社区卫生服务中心,上海201801 [7]上海市嘉定区菊园新区社区卫生服务中心,上海201899 [8]上海市嘉定区南翔镇社区卫生服务中心,上海201802 [9]上海市嘉定区嘉定工业区社区卫生服务中心,上海201815

出　　处：《中国中西医结合杂志》2019年第12期1434-1439,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：上海市进一步加快中医药事业发展三年行动计划(No.ZY3-FWMS-1-1001-YY)

摘　　要：目的观察非急性期缺血性脑卒中患者的健康状态和中医特征。方法采用流行病学方法,调查上海市嘉定区和闵行区的11个社区中发病2周~2年的缺血性脑卒中患者,共305例,以血管危险因素、中医证型、中医体质、躯体残障[日常活动的依赖程度评分(MRS)和残障表现]、认知[简易智能状态检查表(MMSE)]和情志[抑郁自评量表(SDS),焦虑自评量表(SAS)]为观察指标,比较恢复期(57例)和后遗症期(248例)患者健康状态和中医特征。结果305例非急性期缺血性脑卒中患者中,男性189例,女性116例,平均年龄(67.0±7.9)岁,最常见危险因素是高血压病[78.0%(238/305)],中医证型以气虚血瘀证[42.0%(128/305)]为主,中医体质以气虚质[32.8%(100/305)]为主。66.6%(203/305)的患者有不同程度后遗症(MRS 1~5),以感觉障碍[18.0%(55/305)]最多见,38.7%(118/305)的患者有不同程度认知障碍,20.3%(62/305)的患者有不同程度抑郁,12.5%(38/305)的患者有不同程度焦虑。恢复期患者高胆固醇血症的伴发率[26.3%(15/57)]高于后遗症期患者[15.3%(38/248),P=0.048],其余指标比较,差异无统计学意义(P>0.05)。结论非急性期缺血性脑卒中患者以气虚血瘀证和气虚质最多见,部分患者存在躯体残障、认知障碍和情志障碍。Objective To observe the health status and traditional Chinese medicine(TCM) characteristics of patients with non-acute ischemic stroke.Methods Totally 305 patients with ischemic stroke within 2 weeks to 2 years in 11 communities in Jiading district and Minhang district,Shanghai were investigated and their vascular risk factors,TCM syndromes and constitution,physical disability [Modified Rankin Scale(MRS) and disability manifestations],cognition [Mini-mental State Examination(MMSE)],and emotional [Self-rating Depression Scale(SDS),Self-rating Anxiety Scale(SAS)] were observed and compared between patients with recovery period(57 patients) and sequelae-retaining period(248 patients).Results Among 305 patients with non-acute ischemic stroke,189 were male and 116 were female,with an average age of(67.0±7.9) years.The most common risk factors were hypertension [78.0%(238/305)],and TCM syndromes were Qi deficiency and Blood stasis syndrome [42.0%(128/305)].TCM constitution was most common with Qi deficiency [32.8%(100/305)].66.6%(203/305) of patients had different degrees of sequelae(MRS 1-5),in which sensory disturbances [18.0%(55/305)] were most common.38.7%(118/305) of patients had different degrees of cognitive impairment,20.3%(62/305) of patients had different degrees of depression,and 12.5%(38/305) of patients had different degrees of anxiety.Compared with patients with recovery period and sequelae-retaining period,the concomitant rate of hypercholesterolemia in patients with recovery period [26.3%(15/57)] was significantly higher than that in patients with sequelae-retaining period [15.3%(38/248),P=0.048],and the remaining indicators were not statistically different(P>0.05).Conclusions Non-acute ischemic stroke patients with Qi deficiency and Blood stasis syndrome were most common.Some patients had physical disability,cognitive impairment and emotional disorders.

关 键 词：缺血性脑卒中 流行病学调查 健康状态 中医特征 

分 类 号：R74[医药卫生—神经病学与精神病学]