中西医结合卒中单元对脑卒中恢复期患者的影响

目的研究中西医结合卒中单元对脑卒中恢复期患者的影响。方法456例脑卒中恢复期患者随机分为中西医结合组（中西组）和对照组，两组均按卒中单元模式实施治疗．中西组再加用中药辨证施治和针灸治疗。观察项目有：并发症发生率、Barthe指数（BI）、脑卒中残损评定法（SIAS）、牛津残障量表（OHS）、简明精神状态检查表（MMSE）、牛津残障量表（HRSD）等。结果中西组并发症发生率低于对照组（P〈0．05），中西组MMSE、HRSD出入院差值分别为（11．21±4．76）分与（-17．31±3．72）分，对照组分别为（7．57±2．28）分与（-9．12±2．42）分，两组比较有统计学意义（P〈0．05），中西组SIAS、BI出入院差值分别为（24．76±12．32）分与（25．21±11．69）分，对照组分别为（16．17±6．49）分与（13．77±9．03）分，两组比较有统计学意义（P〈0．05）。中西组出院后2月随访OHS评测，轻中度残障者比例高于对照组（P〈0．01），住院及随访期间，两组病死率及卒中复发率比较无统计学意义。结论中西医结合卒中单元相对于西医卒中单元，对脑卒中恢复期患者更有益。

Effects of Integrated Medicine Stroke Unit on Stroke in Convalescence Stage

Objective To study the effect of integrated traditional Chinese and western medicine stroke unit on patients （pts） with stroke in convalescence stage. Methods Four hundreds and fifty - six pts with stroke in convalescence stage were randomly divided into integrated traditional Chinese and western medicine group（ICWM group）treated according to the stroke unit mode, and control group treated according to the stroke unit mode with acupuncture and normal TCM syndrome differentiation therapy. The complica- tions,Barthel index（BI）, stroke impairment assessment set（SIAS）, Oxford handicap scale（OHS）, minimental state examination （MMSE） ,and Hamilton depression rating scale（HRSD） were studied. Results Complications in ICWM group were lower than that in control group（P〈0.05）. The differences of the MMSE and HRSD in ICWM group before and after treatment were （11.21±4.76） and （-17.31±4.35） respectively,while those in control group were （7.57±2.38） and （-9.12±2.42）（P〈0.05）. The differences of the SIAS and BI in ICWM group before and after treatment were （24.76 ± 12.32） and （25.21± 11.69） respectively, while those in control group were （16.17±6.49） and （13.77±9.03）（P〈0.05）. The OHS after 2 months of discharge,the pts in mild or moderate handicap in ICWM group was more than that in control group（P〈0.01）. There was no difference in death rate and recurrence rate of stroke between two groups during hospitalization and follow - up. Conclusion Integrated traditional Chinese and western medicine stroke unit was superior to common stroke unit for pts with stroke in convalescence stage.