摘要
目的:横断面调查脑卒中恢复期患者病情,分析不同维度的多个评估量表及标准对其病情的评价结果。方法:以2000-07-26/2001-02-28广州中医药大学第二附属医院收治的194例脑卒中恢复期患者为调查对象。采用第二代中风病诊断及疗效评定标准、自编中医症状量表(28个症状、体征,按无、轻、中、重分别计0,1,2,3分)、改良爱丁堡与斯堪的那维亚组标准(总分45分,0～15分为轻度缺损,16～30分为中度缺损,31～45分为重度缺损)、改良Barthel指数(满分100分,<60分为不能自理)、健康调查简表SF-36的活力和精神健康分量表为测量工具,对194例患者进行评价。采用描述性分析、Spearmen相关分析、因子分析等方法进行量表评估及各量表间的相关性分析。结果:194例患者均完成了测试,进入结果分析。①各量表及标准平均得分:第二代中风病诊断及疗效评定标准:6.51±6.29;中医症状量表:13.73±6.97;改良爱丁堡与斯堪的那维亚组标准:7.56±7.35;改良Barthel指数:63.58±23.68;SF-36的活力和精神健康分量表:52.79±23.32,62.83±22.75。②改良爱丁堡与斯堪的那维亚组标准与其他量表的相关性:与第二代中风病诊断及疗效评定标准高度正相关(R’=0.885),与中医症状量表相关性不高(R’=0.302),与改良Barthel指数高度负相关(R’=-0.824),与SF-36的活力和精神健康分量表相关性不高(R’=-0.294,-0.258)。结论:①改良爱丁堡与斯堪的那维亚组标准与第二代中风病诊断及疗效评定标准基本属于相同维度,两者一定条件下可相互替代。②患者不同维度健康状态并不一致,应建立脑卒中恢复期疗效的多维评价标准,以更全面地评价患者的病情,和更科学地反映中医药治疗的真正效能。
AIM： To analyze the outcome assessments of the cases of stroke convalescence measured with different criteria consisting of various dimensions by a cross-sectional investigation of the condition of stroke convalescent patients. METHODS： Totally 194 stroke convalescent patients treated in the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from July 26, 2000 to February 28, 2001 were taken as subjects of the study. They were assessed by assessment methods including the following assessment instruments： diagnosis-treatment criteria of stroke（the second version）, self-designed scale of traditional Chinese medicine（TCM） symptoms（28 symptoms and physical signs were scored as 0, 1, 2, 3 marks from none to severity）, modified Edinburgh-Scandinavia stroke scale（a total of 45 marks, 0 to 15 marks as mild defect, 16 to 30 as moderate defect, 31 to 45 as severe defect）, modified Barthel activities of daily life（ADL） index （a total of 100 marks, less than 60 marks as unable self-care）, vitality and mental health（subscales derived from Health Survey Questionnaire, SF-36）. The collected data from scales and inter-scale correlation were processed by the statistic methods mainly including descriptive analysis, Spearmen correlatiorr analysis, factor analysis, etc. RESULTS： All of the patients completed the assessment, and analyzed in the result. ①The average scores of the scales and criteria： The average scores of diagnosis-treatment criteria of stroke （the second version）, selfdesigned scale of TCM symptoms, modified Edinburgh-Scandinavia stroke scale, modified Barthel ADL index, vitality and mental health scales were 6.51±6.29, 13.73±6.97, 7.56±7.35, 63.58±23.68, 52.79±23.32 and 62.83 ±22.75 respectively.②The Spearment correlation coefficients （R＇） of modified Edinburgh-Scandinavia stroke scale with diagnosis-treatment criteria of stroke, scale of TCM symptoms, modified Barthel ADL index, vitality scale and mental health scale were 0.885, 0.302, -0.824 -0.294 and -0.258 respectively. CONCLUSION：①The modified Edinburgh-Scandinavia stroke scale and diagnosis-treatment criteria of stroke the second version shared the same assessment dimension, so they can be mutually alternated in some clinical practice. ②Discrepancy in measurements of health status was gained due to the diverse dimensions applied in outcome assessments. It is necessary to build up a multi-dimensional assessment criteria system for assessing the stroke convalescent cases in a more comprehensive scope and reflecting theefficacy of TCM treatment Scientifically.
出处
《中国临床康复》
CSCD
北大核心
2005年第29期4-7,共4页
Chinese Journal of Clinical Rehabilitation
基金
国家"九五"科技攻关课题(96-903-01-11)
国家中医药管理局资助课题(00-01LP16)~~
