中西医结合康复卒中单元对脑卒中恢复期偏瘫患者的影响  

Impact of Integrated Chinese and Western Medicine Rehabilitation Stroke Unit on Stroke Patients with Hemiplegia at Convalescent Period

作　　者：李曼玲 潘锐焕[2] 詹珠莲 艾怡然 詹乐昌[2] 陈凤 陈莹 罗梦 陈红霞 周国平[1,3] LI Man-Ling;PAN Rui-Huan;ZHAN Zhu-Lian;AI Yi-Ran;ZHAN Yue-Chang;CHEN Feng;CHEN Ying;LUO Meng;CHEN Hong-Xia;ZHOU Guo-Ping(School of Traditional Chinese Medicine,Southern Medical University,Guangzhou 510515 Guangdong,China;Universitytown Hospital of Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510006 Guangdong,China;Integrated Hospital of Chinese and Western Medicine,Southern Medical University,Guangzhou 510315 Guangdong,China)

机构地区：[1]南方医科大学中医药学院,广东广州510515 [2]广东省中医院大学城医院,广东广州510006 [3]南方医科大学中西医结合医院,广东广州510315

出　　处：《广州中医药大学学报》2023年第1期43-49,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81674048);广东省科技计划项目(编号:2013A032500014)。

摘　　要：【目的】比较卒中单元与非卒中单元模式治疗脑卒中恢复期偏瘫患者的临床效果。【方法】将200例脑卒中恢复期偏瘫患者随机均分为治疗组和对照组,每组各100例。治疗组患者予以中西医结合康复卒中单元治疗,对照组患者予以常规中西医康复治疗,疗程为14 d。观察2组患者治疗前后中医证候积分、神经功能缺损评分(NDS)、Barthel指数(BI)评分、FuglMeyer评分和Berg评分的变化情况,并评价2组患者的西医疗效和中医证候疗效。【结果】(1)剔除脱落情况:研究过程中,剔除12例,脱落4例,最终共纳入184例,其中,治疗组91例,对照组93例。(2)中医证候疗效情况:治疗14 d后,治疗组的总有效率为61.54%(56/91),对照组为47.31%(44/93);组间比较,治疗组的中医证候疗效明显优于对照组(P<0.05)。(3)西医疗效情况:治疗后,治疗组的总有效率为41.76%(38/91),对照组为25.81%(24/93);组间比较,治疗组的西医疗效明显优于对照组(P<0.05)。(4)量表评分情况:治疗后,2组患者的中医证候积分、NDS评分均较治疗前明显降低(P<0.01),BI评分、Fugl-Meyer评分和Berg评分均较治疗前明显提高(P<0.01),且治疗组对中医证候积分、NDS评分的降低程度及对Fugl-Meyer评分的提高程度均明显优于对照组,组间差值比较,差异均有统计学意义(P<0.05或P<0.01),而对BI评分和Berg评分的提高程度有优于对照组趋势,但组间差值比较,差异均无统计学意义(P>0.05)。【结论】中西医结合康复卒中单元对脑卒中恢复期偏瘫患者神经功能的恢复、肢体活动能力的提升以及预后的改善作用均比非卒中单元模式的治疗效果更显著。Objective To compare the clinical efficacy of the stroke unit management mode and non-stroke unit management mode for the treatment of stroke patients with hemiplegia at convalescent period.Methods Two hundred stroke patients with hemiplegia at convalescent period were randomly divided into treatment group and control group,with 100 patients in each group.The patients in the treatment group were treated with integrated Chinese and western medicine rehabilitation stroke unit management,while the patients in the control group were treated with conventional Chinese and western medicine rehabilitation therapy.The treatment for both groups lasted14 days.The changes in the traditional Chinese medicine(TCM)syndrome scores,neurological deficit scores(NDS),Barthel index(BI)scores,Fugl-Meyer scores and Berg scores in the two groups were observed before and after treatment.Furthermore,western medicine efficacy and the TCM syndrome efficacy in the two groups were evaluated.Results(1)During the trial,12 cases were excluded and 4 cases fell off,and a total of 184 cases were eventually included,of which 91 cases were in the treatment group and 93 cases were in the control group.(2)After 14 days of treatment,the overall effective rate for TCM syndrome efficacy in the treatment group was61.54%(56/91)and that in the control group was 47.31%(44/93).The intergroup comparison showed that the TCM syndrome efficacy of the treatment group was significantly superior to that of the control group(P<0.05).(3)After treatment,the overall effective rate for western medicine efficacy in the treatment group was 41.76%(38/91)and that of the control group was 25.81%(24/93).The intergroup comparison showed that the western medicine efficacy of the treatment group was significantly superior to that of the control group(P<0.05).(4)After treatment,the TCM syndrome scores and NDS of the patients in the two groups were significantly decreased(P<0.01),and the BI scores,Fugl-Meyer scores and Berg scores were significantly increased compared with those bef

关 键 词：脑卒中恢复期 偏瘫 卒中单元 中西医结合康复卒中单元 神经功能 肢体活动能力 

分 类 号：R277.743[医药卫生—中医学]