摘要
目的 探讨中医药综合治疗急性缺血性脑梗死的临床疗效及卫生经济学评价.方法将56例急性缺血性脑梗死患者随机分为试验组(28例)和对照组(28例).对照组采用内科基础治疗和肢体康复;试验组在对照组基础上,加辨证口服中药、辨证静脉应用中药注射剂、针刺等中医药综合治疗方案.于治疗前及治疗1、2、4周末用神经缺损情况评分[美国国立卫生院卒中量表(NIHSS)]、中风患者运动功能评分[简化FMA(SFMA)评分]及日常生活活动能力(ADL)评分进行疗效评价.结果试验组治疗后NIHSS评分[(5.27±1.43)分]、SFMA评分[(90.13±12.63)分]、ADL评分[(73.82±19.00)分]均较对照组[分别为(6.34±1.81)、(78.01±16.92)、(63.55±18.37)分]显著改善(P均<0.05).试验组成本-效果比优于对照组,试验组NIHSS评分每减少1分所花费用较对照组减少189.67元,SFMA评分每提高1分所花费用减少57.43元,ADL评分每提高1分所花费用减少60.98元.结论用中医药综合治疗方案治疗急性缺血性脑梗死可明显改善患者的神经功能缺损、运动功能、日常生活活动能力,提高成本-效果比,具有疗效好、经济、实用的优势.
Objective To observe the clinical therapeutic effect of comprehensive treatment of traditional Chinese medicine(TCM) in patients with acute ischemic stroke(AIS) and its economic evaluation．Methods The study was randomly divided into two groups：treatment (28 cases) and control (28 cases) groups ．The control group was treated with medical basic treatment and limb rehabilitation；on the base of treatment in the control group，the treatment group was additional treated with comprehensive TCM therapies ,including specific patent Chinese medicine，composite Chinese medicine injection and acupuncture therapy，etc．and dialectic TCM method was applied during the diagnosis and treatment．Before and after treatment for 1，2 and 4 weeks 。the international index of nerve defect of US National Institutes of Health Stroke Scale( NIHSS),stroke patients with motor function score (simplify the FMA(SFMA) score) and activities of daily living score (ADL)were evaluated．Results There were significant differences between treatment group and control group in NIHSS score( 5.27±1．43)，SFMA score( 90．13±12．63) ，ADL score( 73．82±19．00，all P< 0．05) after treatment ，showing that the improvement was better in the treatment group than that in the control group;the control group data was 6．34±1．81，78．01±16．92，63.55±18.37，respectively．The cost—effectiveness ratio of the treatment group was better than that of the control group (when NIHSS score was reduced 1 compared with the control group，189.67 yuan was saved，when SFMA score was increased 1 compared with the control group，57．43 yuan was saved，when ADL score was increased 1 compared with the control group，60．98 yuan was saved)．Conclusion The therapeutic effect of application of TCM comprehensive therapy in addition to the medical basic treatment for cases with AIS is superior to that of the medical basic treatment alone．The therapy can significantly improve the nerve defect ，motor function，capability of dailyliving activities and elevation of cost —effectiveness ratio．Thus，the therapy has good therapeutic effect and it is economic and practical．
出处
《中国中西医结合急救杂志》
CAS
北大核心
2009年第6期356-358,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
脑梗死
急
丹参注射液
清开灵注射液
针灸
辨证论治
acute ischemic stroke
composite salvia injection
Qingkailing injection
acupuncture therapy
determination of treatment based on differentiation of symptoms and signs
