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[中西医结合方案对急性缺血性脑卒中患者神经功能缺损及残疾结局改善的影响]

[Effects of integrative medicine protocols on the improvement of neural function deficit and disability outcomes in patients with acute ischemic cerebral stroke].

作者信息

Xie Ren-ming, Chen Hong-xia, Xie Yan-ming

机构信息

Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2011 Sep;31(9):1175-80.

Abstract

OBJECTIVE

To study the effects of integrative medicine protocols on the neural function deficit and short-term disability outcomes in patients with acute ischemic cerebral stroke.

METHODS

99 patients were randomly assigned to three groups, i.e., the Dengzhan Xixin (fleabane) group (Group A), the Kudiezi (sowthistle-leaf ixeris seedling) group (Group B), and the Western medicine control group (Group C). Dengzhan Xixin Injection was intravenously dripped to patients in Group A for 14 days. Chinese decoction was administered to them by pattern typing as well. Meanwhile, they took Dengzhan Shengmai Capsule for two months. Kudiezi Injection was intravenously dripped to patients in Group B for 14 days. Chinese decoction was administered to them by pattern typing as well. Meanwhile, they took Naoshuantong Capsule for two months. In addition to internal therapies, patients in Group A and B received acupuncture, massage, and external washing with Chinese medicine for 21 days. Patients in Group C also received modem rehabilitation therapy for 21 days, including rehabilitation training and electronic stimulus in addition to the internal medicine. The National Institute of Health Stroke Scale (NIHSS) and disability outcome (modified Rank Scale, mRS) were taken as main effect indices.

RESULTS

The NIHSS scores at each time point obviously decreased more than before treatment in all the three groups (P<0.01), but with no difference at each time point (P>0.05). The disability outcomes of all the three groups postponed as time went by. Significant difference existed among the three groups by log-lineal model (CATMOD) (P<0.05). The best effect was shown in Group B, with the markedly effective rate of 19. 35% and the total effective rate 54.84%.

CONCLUSIONS

The integrative medicine protocols could improve the nerve functions of ischemic stroke patients. Therefore, it could improve the disability outcomes. The comprehensive protocol (Kudiezi Injection + Naoshuantong Capsule + Chinese decoction according to pattern typing + acupuncture + massage + external washing with Chinese medicine) was better.

摘要

目的

探讨中西医结合方案对急性缺血性脑卒中患者神经功能缺损及短期残疾结局的影响。

方法

将99例患者随机分为3组,即灯盏细辛组(A组)、苦碟子组(B组)和西药对照组(C组)。A组患者静脉滴注灯盏细辛注射液14天,同时辨证给予中药汤剂,服用灯盏生脉胶囊2个月。B组患者静脉滴注苦碟子注射液14天,同时辨证给予中药汤剂,服用脑栓通胶囊2个月。A、B两组除内治法外,还接受针灸、推拿及中药外洗治疗21天。C组除内科治疗外,还接受现代康复治疗21天,包括康复训练及电刺激。以美国国立卫生院卒中量表(NIHSS)及残疾结局(改良Rankin量表,mRS)作为主要疗效指标。

结果

三组各时间点NIHSS评分均较治疗前明显降低(P<0.01),但各时间点组间比较差异无统计学意义(P>0.05)。三组残疾结局均随时间推迟。经对数线性模型(CATMOD)分析,三组间差异有统计学意义(P<0.05)。B组疗效最佳,显效率为19.35%,总有效率为54.84%。

结论

中西医结合方案可改善缺血性脑卒中患者的神经功能,进而改善残疾结局。综合方案(苦碟子注射液+脑栓通胶囊+辨证中药汤剂+针灸+推拿+中药外洗)效果更佳。

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