中西医结合卒中单元对出血性中风患者神经功能的影响

目的 观察中西医结合卒中单元对出血性中风患者神经功能的影响.方法 急性脑出血患者80例,随机分为中西医结合卒中单元组(40例)和常规卒中单元组(40例),21 d相关治疗后,观察神经功能缺损指标变化情况.结果 中西医结合组及常规组治疗21 d后与治疗前神经功能缺损程度比较,差异均有统计学意义(P均＜0.01);中西医结合组患者在治疗21 d后神经功能缺损改善优于常规组(10.58±4.36 vs 13.71±4.81,P＜0.05).按统一标准进行神经功能缺损评分疗效判定,中西医结合组显效率高于常规组(25.6% vs 12.8%,P＜0.05).结论 中西医结合卒中单元治疗能够促进急性期出血性中风患者脑神经功能恢复,降低致残率,且疗效优于常规卒中单元治疗.     

中西医结合治疗急性脑卒中患者疗效观察

目的：观察中西医结合治疗急性脑卒中患者的临床疗效。方法：将200例急性脑卒中患者按随机数字表法分为治疗组和对照组,每组各100例。对照组按照卒中单元模式规范治疗及管理,治疗组在卒中单元模式规范治疗基础上增加中医辨证施治。结果：对照组有效率为82．5％,治疗组有效率为93．75％,两组有效率比较,差异具有统计学意义（P〈0．05）;两组患者除言语外的各项神经功能缺损（意识、感觉、面瘫、上肢、下肢、步行能力）疗效比较,治疗组均优于对照组（P〈0．05）;两组神经功能缺损评分比较,治疗组与对照组有极显著性差异（P〈0．01）。结论：中西医结合卒中单元模式能明显改善急性脑卒中患者的神经功能缺损程度,并可提高临床疗效。     

探讨中西医结合卒中单元治疗缺血性脑卒中患者的临床护理方法

目的探讨中西医结合卒中单元治疗缺血性脑卒中患者的临床护理效果.方法 选取我院从2010年1月~2012年3月所收治的130例缺血性脑卒中患者作为研究对象,将患者随机分为实验组和对照组两组,对照组采用常规护理方法,实验组在对照组的基础上,采用加入中医护理方案的护理方法.在患者住院1d、15d、30d、45d和60d的时候,采用Barthel指数(BI)对患者生活自理能力进行评定.结果 两组患者在30d之前的Barthel指数得分差异无统计学意义(P>0.05).而实验组在45d和60d的得分高于对照组,差异有统计学意义(P<0.05).结论 中西医结合卒中单元可以提高患者生活质量,降低了患者及其家属的负担,可在临床推广.     

中西医结合治疗78例急性期脑梗死

目的观察中西医结合治疗急性期脑梗死的临床疗效。方法将152例急性期脑梗死患者随机分为两组,观察组78例,对照组74例。对照组给予西医常规治疗,观察组在对照组治疗基础上结合中医辨证论治,加服中药汤剂。两组均治疗21 d。结果临床症状、体征总有效率,观察组为91.5%,对照组为81.1%。两组比较差异有显著性(P<0.05)。中国脑卒中临床神经功能缺损程度评分量表功能评分比较:两组治疗前后差异均有显著性(P<0.01)。结论中西医结合辨证治疗急性期脑梗死优于单纯西医治疗疗效。     

卒中单元治疗脑卒中的远期生活质量分析

目的:探讨卒中单元治疗对急性脑卒中患者远期生活质量的影响。方法:156例急性脑卒中患者随机分为卒中单元组和非卒中单元组,进行相应的治疗。比较两组治疗后的神经功能缺损评分(NIHSS),生活指数(BI),脑卒中复发率,焦虑、抑郁评分。结果:卒中单元组治疗后6月、1年、2年,BI明显高于对照组(P<0.05)。两组6月、1年、2年NIHSS观察组低于对照组(P<0.05)。观察组3年内的复发率低于对照组(P<0.05)。HAMA评分14d、2年、3年,观察组明显低于对照组(P<0.05)。HAMD评分6月、3年观察组明显低于对照组(P<0.05)。结论:卒中单元治疗能明显改善急性脑卒中患者的远期生活质量。     

早期规范康复治疗对脑卒中患者生活质量的影响

目的:研究脑卒中患者早期规范康复治疗对日常生活能力的影响.方法:应用神经功能缺损程度和改良Barthel指数(MBI)为量表评定早期康复的治疗效果,研究30例脑卒中患者的临床资料并进行统计学处理.结果:神经功能缺损程度评分和MBI在1个疗程后,两组有显著性差异(P＜0.05和P＜0.01).结论:脑卒中患者进行早期康复治疗可以提高患者的日常生活能力.     

脑卒中后抑郁对神经功能康复的影响

目的 探讨脑卒中后抑郁状态及黛力新治疗对神经功能康复的影响.方法 随机选择20例脑卒中无抑郁状态的患者作为对照,对40例脑卒中的抑郁患者,随机分为抑郁组和治疗组.治疗前后行汉密顿抑郁量表(HAMD),神经功能缺损评分(SSS),进行评定其疗效.结果 抑郁组在治疗后SSS评分比对照组显著降低,与对照组比较有显著差异(P<0.01).治疗组在治疗后SSS评分比抑郁组显著升高,与抑郁组比较有显著差异(P<0.01).治疗组HAMD评分治疗后较治疗前显著下降(P<0.01);对照组和抑郁组治疗后与治疗前比较无显著差异.结论 脑卒中后抑郁状态可明显延缓神经功能的恢复,黛力新治疗可促进脑卒中后神经功能的康复.     

卒中单元管理模式治疗急性脑梗死73例疗效观察

目的探讨卒中单元治疗急性脑脑梗死的临床疗效。方法 151例脑梗死患者,随机分为治疗组和对照组,对照组只给予常规的治疗,治疗组除了常规治疗外,再给予卒中单元治疗,比较2组治疗前后神经功能缺损评分和日常生活活动能力评定,以及疗效。结果治疗后治疗组神经功能缺损程度评分与对照组相比,差异有统计学意义（P〈0.01）;治疗后治疗组日常生活活动能力评定与对照组相比,差异有统计学意义（P〈0.01）;2组总有效率比较,差异有统计学意义（P〈0.01）。结论卒中单元明显改善急性脑梗死患者神经功能,显著提高患者日常生活活动能力,值得推广应用。     

舍曲林对脑卒中后抑郁的临床研究

目的:探讨早期抗抑郁治疗对脑卒中后抑郁患者日常生活能力和神经功能康复的影响.方法:124例脑卒中后抑郁症患者随机分为治疗组和对照组,舍曲林1治疗组64例,对照组60例,对照组采取常规药物治疗 肢体康复训练,舍曲林治疗组在此基础上同时合用舍曲林50 mg/d抗抑郁治疗,各组患者观察治疗,并随防至12周末.在入选时(治疗前)、病程4、8、12周时分别进行Barthel指数、HAMD、NIHSS评定.结果:与对照组比较,舍曲林治疗组患者Barthel指数得分在病程8周和12周时明显提高(P<0.05),HAMD得分在病程4～12周时显著降低(P<0.01),NIHSS神经缺损功能评分在4周到12周时明显低于对照组(P<0.01).结论:早期使用舍曲林50 mg/d治疗脑卒中后抑郁症不仅能显著改善患者的抑郁症状,而且能够改善患者的日常生活能力和神经功能缺损症状.     

中医特色卒中单元对缺血性脑卒中患者生活质量的影响

目的：观察中医特色卒中单元对缺血性脑卒中患者生活质量的影响。方法将70例患者随机分为治疗组和对照组。2组均采用卒中单元常规治疗,即降颅压、抗血小板聚集、脑保护、神经细胞营养剂和西医对症治疗,以及西医心理治疗、语言康复、肢体功能康复。治疗组予中医特色卒中单元———在组织管理上,参照正规卒中单元医疗模式的实施形式,结合自身实际情况整合最有效的中医资源,强调团队合作,明确工作任务;在治疗措施上,除了对患者实施脑卒中的上述西医常规治疗外,给予中医学的经典方药、中医心理疗法、养生保健指导、传统康复技术。2组按此方案治疗28 d。结果治疗28 d 后,治疗组在神经功能缺损程度（NIHSS）评分、Barthel 指数（BI）评定、抑郁自评量表（SDS）上均优于对照组,2组比较,P ＜0.05。结论中医特色卒中单元对缺血性脑卒中患者生活质量的提高具有良好的效果。     

中西医结合治疗缺血性脑卒中的成本效益分析

Objective:To evaluate the cost-effectiveness of combining Chinese medicine(CM)with Western medicine(WM)for ischemic stroke patients.Methods:Hospitalization summary reports between 2006 and 2010from eight hospitals in Beijing were used to analyze the length of stay(LOS),cost per stay(CPS),and outcomes at discharge.Results:Among 12,009 patients(female,36.44%;mean age,69.98±13.06 years old),a substantial number of patients were treated by the WM_Chinese patent medicine(CPM)_Chinese herbal medicine(CHM)(38.90%);followed by the WM_CPM(32.55%),the WM(24.26%),and the WM_CHM(4.15%).With adjustment for confounding variables,LOS of the WM_CPM_CHM group was about 10 days longer than that of the WM group,and about 6 days longer than that of the WM_CPM group or the WM_CHM group(P0.01);CPS of the WM_CPM_CHM group was United States dollar(USD)1,288 more than that of the WM group,and about USD600 more than that of the WM_CPM group or the WM_CHM group(P0.01).Compared with the WM group,odd ratio(OR)of recovered and improved outcome of the WM_CPM_CHM group was the highest[OR:12.76,95%confidence intervals(CI):9.23,17.64,P0.01],OR of death outcome of the WM_CPM_CHM group was the lowest(OR:0.08,95%CI:0.05,0.12,P0.01).There was no significant difference between LOS,CPS and OR of the WM_CPM group and those of the WM_CHM group(P0.05).Cost/effectiveness and incremental costeffectiveness ratio of the WM_CPM_CHM group were robustly higher than those of the WM group.Conclusion:Compared with WM alone,supplementing CPM and CHM to WM provides significant health benefits of improving the chance of recovered and improved outcome,and reducing the death rate,at an expense of longer LOS and higher CPS.     

中西医结合治疗对急性缺血性脑卒中的临床综合干预效果评价

目的：研究中西医结合疗法治疗急性缺血性脑卒中患者的治疗价值。方法随机选取2014年3月—2015年9月期间该院收治的140例急性缺血性脑卒中患者的临床资料,患者发病时间均大于6 h,根据不同治疗方式将其分成观察组(n=72)与对照组(n=68),对照组行常规西医疗法联合康复锻炼,观察组在对照组基础上行中医疗法,主要包括针灸﹑中药等。结果观察组NIHSS评分(5.56±2.45)分﹑(4.50±2.62)分明显低于对照组的(7.35±3.70)分与(5.65±3.78)分(P<0.05);观察组Barthel指数(41.43±15.48)分﹑(53.54±16.52)分明显高于对照组(53.54±16.52)分与(44.05±17.20)分(P<0.05);观察组血hs-CRP浓度(11.22±1.50)mg/L﹑(7.46±1.84)mg/L指标明显低于对照组(18.15±11.18)mg/L与(11.10±1.49)mg/L(P<0.05)。结论中西医结合治疗急性缺血性脑卒中患者,可显著加快神经功能恢复,大大降低致残率,提高患者生活自理能力,改善生活质量。     

联合卒中单元治疗急性脑卒中患者近期疗效观察

目的：探讨联合卒中单元治疗急性脑卒中患者的近期内疗效。方法：将300例急性脑卒中患者随机分为2组,即联合卒中单元（Shock Unit）治疗组及神经内科常规病房（General Ward）对照组,比较两组治疗前及治疗2月后患者的神经功能评分（NIHSS）,日常生活能力评价（Barthel指数）,汉密尔顿抑郁量表（HAMD）及院内感染发生率（肺部及泌尿道）以作疗效评价。结果：两组治疗前各评价指标无明显差异性（P〉0.05）,经治疗后治疗组NIHSS、Bl指数、HAMD、院感发生率均优于对照组差异有显著性（P〈0.05）。结论：联合卒中单元对于急性脑卒中疗效优于单一常规病房治疗。     

通络熄风汤治疗急性期缺血性脑卒中临床研究术

目的:观察通络熄风汤对急性期缺血性脑卒中的临床疗效.方法:将92例急性期缺血性脑卒中患者随机分为对照组46例和观察组46例.对照组采用常规西医基础治疗,观察组在对照组基础上予以通络熄风汤治疗.治疗后采用Fugl-Meyer运动量表(fugl meyer motor scale,FMMS)评价患者肢体运动功能,改良爱丁堡-斯堪的那维亚卒中量表(modi-fied edinberg-scandinavian stroke scale,MESSS)评价患者神经功能缺损程度,同时检测血清中缺血修饰白蛋白和脂肪酸结合蛋白水平,评价临床疗效.结果:治疗后,观察组患者FMMS评分显著高于对照组,MESSS评分显著少于对照组,两组比较,差异有统计学意义(P＜0.01);观察组有效率为86.96％,对照组有效率为67.39％,两组比较,差异有统计学意义(P＜0.05);治疗后,观察组血清中缺血修饰白蛋白和脂肪酸结合蛋白水平明显低于对照组(P＜0.01).结论:通络熄风汤联合西医基础治疗可显著抑制急性期缺血性脑卒中患者血清中缺血修饰白蛋白和脂肪酸结合蛋白水平,提高患者生活质量,临床疗效显著.     

Chinese Medicine Improves Postoperative Quality of Life in Endometriosis Patients: A Randomized Controlled Trial

Objective:To investigate the effect of Chinese medicine(CM) and Western medicine(WM) on quality of life(QOL) after conservative surgery for endometriosis.Methods:A total of 320 patients with endometriosis were randomized into two groups by using random block design,CM group(160 cases,activating blood circulation and removing blood stasis treatment based on syndrome differentiation) and WM group(160 cases,gonadotropin-releasing hormone agonist or gestrinone treatment) after conservative surgery.Treatment was given for 3-6 months(according to the revised American Fertility Society scoring system stage),and the World Health Organization QOL-BREF(WHOQOL-BREF) was applied to patients before and after treatment to assess QOL.Results:There were 136 cases in the CM group and 141 cases in the WM group completing therapy.In the CM group,the use of the WHOQOL-BREF showed that the physical,psychological and environmental scores post- treatment were significantly higher than those at pre-treatment(P<0.05),and for 12 items(pain and discomfort, energy and fatigue,sleep and rest,mobility,activities of daily living,work capacity,negative feelings,health and social care:accessibility and quality,participation in and opportunities for recreation/leisure activities,appetite, QOL score,overall health status and QOL),the difference in scores was significant(P<0.05).In the WM group,4 items(pain and discomfort,opportunities for acquiring new information and skills,QOL score,overall health status and QOL) had significantly different scores post-treatment compared with those at pre-treatment(P<0.05).Before treatment,the QOL in the two groups of patients showed no significant difference(P>0.05).After treatment,the scores for physical health in the CM group were significantly higher than those of the WM group(P<0.05) and the scores of 4 items(mobility,activities of daily living,sexual activity,QOL score) in the CM group were significantly higher than those in the WM group(P<0.05).Conclusions:CM and WM treatment could improve the QOL of patients with endometriosis after conservative surgery.CM treatment is more effective than WM.     

依达拉奉注射液治疗急性脑梗死的疗效观察

目的与常规治疗药物对比,观察加用自由基清除剂依达拉奉注射液治疗急性脑梗死的临床效果。方法选择病程在48h内的急性脑梗死80例,随机分为治疗组和对照组各40例,在常规应用活血化淤、保护脑细胞、营养神经和对症等治疗的基础上,治疗组加用依达拉奉30mg,静脉滴注,每天2次,共用14d。第14天后两组治疗方案相同。在治疗2周后进行疗效评定。结果14d后治疗组和对照组有显著性差异(P<0.01)。结论依达拉奉治疗急性脑梗死安全有效。     

论建立具有中医优势的卒中单元

文章从脑中风的治疗现状及中医在脑中风治疗中的优势,探讨了如何在卒中单元中发挥中医整体观念和辨证论治、康复、针灸、推拿、情志疗法、健康教育、饮食疗法、中医特色护理的优势,从而提出创建具有中医优势的卒中单元,必将是我国脑血管病临床实践的必然趋势。     

Effectiveness and Safety Evaluation of Chinese Medicine in Treatment of Metastatic Colorectal Cancer after Chemotherapy Failure: Protocol of a Prospective Multicenter Cohort Study

Background: Colorectal cancer (CRC) is the second most common cause of cancer-related deaths and has the third highest incidence in the world. Almost half of the patients with CRC have metastases at the time of diagnosis. However, the treatment for patients with metastatic CRC that progresses after approved conventional chemotherapy is still controversial. Chinese medicine (CM) has unique characteristics and advantages in treating metastatic CRC. Objective: To assess the effectiveness and safety of CM in patients with metastatic CRC after failure of conventional chemotherapy. Methods: The study is a multicenter prospective cohort study. A total of 384 patients with documented metastatic CRC after failure of conventional chemotherapy will be included from 9 hospitals at Beijing, Shanghai, Nanjing, and Guizhou, and assigned to three groups according to paitents'' wishes: (1) integrated Chinese and Western medicine (ICM) group receiving CM herbal treatment combined with Western medicine (WM) anti-tumor therapy, (2) Chinese medicine (CM) group receiving only CM herbal treatment, and (3) WM group receiving only WM anti-tumor therapy. The primary endpoint is the overall survival (OS). Secondary endpoints include the progression free survival (PFS), quality of life (QOL) assessed by the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire, tumor control, and CM symptom score. Discussion: This prospective study will assess the effectiveness and safety of CM in treating metastatic CRC after conventional chemotherapy failure. Patients in the ICM group will be compared with those in the WM group and CM group. If certified to be effective, national provision of CM treatment in metastatic CRC will probably be advised. (Registration No. NCT02923622)     

早期康复训练对脑卒中偏瘫患者的影响

目的观察早期康复训练对急性脑卒中偏瘫患者神经功能缺损、日常生活活动能力的影响。方法将60例急性脑卒中患者随机分为康复组和对照组,康复组在采用常规药物治疗的同时,给予早期康复训练。对照组仅采用常规药物治疗。35d后分别评价两组患者的NIHSS、ADL。结果治疗后两组的NIHSS和ADL评分与治疗前相比。差异有统计学意义（P〈0．05）,康复组各指标的改善明显优于对照组（P〈0．05）。结论早期康复训练能有效降低脑卒中偏瘫患者的神经功能缺损,提高日常生活能力。