172例恢复期脑梗死患者康复中医综合管理效果研究
摘要
目的探讨恢复期脑梗死患者在二级预防基础上给予康复中医综合管理的效果。方法选择2016年10月至2017年12月北京市垂杨柳医院172例恢复期脑梗死患者,随机分为观察组(n=90)和对照组(n=82)。对照组给予抗血小板-他汀类药物-降压药(S-A-S)治疗,观察组在对照组基础上给予二级预防管理和康复、辨证治疗,随访6个月,观察记录各项指标。结果经过6个月二级预防康复干预管理,观察组LDL-C、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、BP的达标率均高于对照组(72.2%、31.1%、61.1%vs. 47.6%、20.7%、40.2%),差异有统计学意义(P<0.01);观察组美国国立卫生研究院卒中量表(NIH stroke scale, NIHSS)评分的中位数减少到1分、中度以上残疾率降至2.3%,均低于对照组(NIHSS中位数3分、残疾率26.8%),差异均有统计学意义(P<0.01)。结论在恢复期脑梗死患者药物治疗基础上给予康复中医综合管理,对改善患者基础疾病,降低能力缺陷、残疾率,促进脑梗死恢复较单独用药疗效更好。
引文
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[2]中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48:246-257.
[3]国家中医药管理局脑病急症科研协作组.中风病诊断与疗效评定标准(试行)[J].北京中医药大学学报,1996,19:55-56.
[4]张廷杰,吴时达.1999年世界卫生组织及国际高血压协会(WHO/ISH)高血压处理指南(第四次修订版)[J].心血管病学进展,1999,20:177-181.
[5]方圻,王钟林,宁田海,等.血脂异常防治建议[J].中华心血管病杂志,1997,25:169-173.
[6]林荣武,王鸿利.临床检验诊断学[M].上海:上海科学技术出版社,2001:160-161.
[7]Goldstein LB,Samsa GP.Reliability of the National Institutes of Health Stroke Scale.Extension to non-neurologists in the context of a clinical trial[J].Stroke,1997,28:307-310.
[8]Cheng EM,Cunningham WE,Towfighi A,et al.Efficacy of a chronic care-based intervention on secondary stroke prevention among vulnerable stroke survivors:a randomized,controlled trial[J].Circ Cardiovasc Qual Outcomes,2018,11:e003228.
[9]贾秀贤,雷少军,刘卫霞,等.综合康复治疗对脑卒中患者肢体功能恢复的作用分析[J].北京医学,2016,38:1119-1121.
[10]Dean SG,Poltawski L,Forster A,et al.Community-based rehabilitation training after stroke:results of a pilot randomised controlled trial(ReTrain)investigating acceptability and feasibility[J].BMJ Open,2018,8:e018409.
[11]Brokaw EB,Nichols D,Holtey RJ,et al.Robotic therapy provides a stimulus for upper limb motor recovery after stroke that is complementary to and distinct from conventional therapy[J].Neurorehabil Neural Repair,2014,28:367-376.