中医医院应用综合性医疗模式治疗脑卒中的优越性

目的观察中西医结合综合性医疗模式治疗脑卒中的临床疗效。方法将236例脑卒中住院患者随机分为综合性治疗组(试验组,121例)和常规治疗组(对照组,115例),试验组采用规范化综合性治疗管理模式,并在康复治疗中结合中药或针刺治疗;对照组按照传统的单纯基础药物治疗方法,也可非系统化地开展针对患者和家属的健康教育。比较两组患者住院期间病死率、并发症发生率、短期临床疗效,以及美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力Barthel指数(Barthelindex,BI)和牛津残障评分(OHS)。结果治疗前两组NIHSS评分、BI及OHS评分比较,差异均无统计学意义(P>0.05);治疗第21、90天时,两组患者NIHSS评分、BI及OHS评分比较,差异均有统计学意义(P<0.01),试验组优于对照组。治疗第21、90天时,试验组临床总有效率均高于对照组(分别为80.99%vs61.74%和88.43%vs72.17%),差异均有统计学意义(P<0.05,P<0.01)。试验组常见并发症发生率明显低于对照组(30.58%vs69.56%,P<0.01)。两组病死率比较,差异无统计学意义(P>0.05)。结论中医医院应用中西医结合综合性医疗模式治疗脑卒中患者,效果优于单纯基础药物的常规治疗方法,中医学治疗脑卒中具有优势。

The Superiorities of Applying Comprehensive Medical Model in Treating Stroke in Chinese Medicine Hospitals

Objective To study the clinical effectiveness of applying comprehensive medical model in treating stroke in Chinese medicine(CM)hospitals.Methods Totally 236 stroke inpatients were randomly assigned to the comprehensive treatment group(as the experimental group,121 cases)and the conventional treatment group(as the control group,115 cases).A standard comprehensive treatment mode was applied in the experimental group.The Chinese materia medica(CMM)or acupuncture was combined during the rehabilitation treatment.Traditional basic drug treatment method was applied in the conventional treatment group.The health education for patients and their families was launched non-systematically.The mortality,the occurrence rate of complications,short-term clinical effectiveness,as well as NIHSS,Barthel index(BI),and Oxford Handicap Scale(OHS)were compared between the two groups.Results Before treatment there was no statistical difference in NIHSS score,BI,or OHS score between the two groups(P>0.05).On day 21 and 90 of the treatment,there was statistical difference in NIHSS score,BI,and OHS score(P<0.01).Better results were obtained in the experimental group.On day 21 and 90 of the treatment,the total effectiveness rate was 80.99% and 88.43% in the experimental group,higher than that of the control group(61.74% and 72.17% respectively),showing statistical difference(P<0.05,P<0.01).The occurrence rate of common complications in the experimental group was obviously lower than that in the control group(30.58% vs 69.56%,P<0.01).There was no statistical difference in the mortality between the two groups(P>0.05).Conclusions The application of the comprehensive medical model in treating stroke in CM showed better effects than using traditional basic drug treatment method.Treatment of stroke by CM showed superiorities.