本文選題：急性腦卒中 + 中西醫(yī)結合卒中單元　； 參考：《遼寧中醫(yī)藥大學》2010年碩士論文

【摘要】： 目的:系統(tǒng)評價中西醫(yī)結合卒中單元治療急性腦卒中的有效性。 方法:檢索國內外發(fā)表的以中西醫(yī)結合卒中單元為治療組、以普通內科治療或西醫(yī)卒中單元為對照組治療急性腦卒中的隨機或半隨機對照試驗的研究文獻,共計254篇。制定文獻的選擇標準,進行三次篩選,將合格研究進行Jadad評分評價其質量,篩選和評價過程由2位研究者獨立進行,意見不同者通過討論解決,最終16篇文獻納入研究。采用Review Manager 4.2軟件對納入文獻進行分析,分別對總有效率、病死率、衛(wèi)生經濟學指標、神經功能缺損評分、日常生活能力評分等相關效應指標進行同質性檢驗、Meta分析、漏斗圖分析、敏感性分析。 結果: 1、最終納入的16個臨床研究是以中西醫(yī)結合卒中單元為治療組,與西醫(yī)卒中單元/普通內科治療為對照組治療急性腦卒中的隨機對照試驗,對照組為西醫(yī)卒中單元的研究為6項,對照組為普通內科治療的研究為10項。累計樣本量2858例,中西醫(yī)結合卒中單元組1474例,對照組1384例,包括西醫(yī)卒中單元組488例,普通內科治療組896例。 2、與普通內科治療相比,中西醫(yī)結合卒中單元在臨床總有效率、腦卒中后1個月病死率、平均住院時間、出院時NIHSS評分、出院時OHS評分、治療后3周NDS評分、出院時BI評分、腦卒中后1個月BI評分、治療后WHOQOL-100評分、MBI評分、FMA評分、BBS評分較普通內科治療更有優(yōu)勢(P0.05)。而在腦卒中3個月后病死率、治療后25天MESSS評分方面與普通內科治療相比沒有顯著性差異(P0.05)。 3、與西醫(yī)卒中單元相比,中西醫(yī)結合卒中單元在平均住院時間、卒中后1周NIHSS評分、1個月NIHSS評分、3個月NIHSS評分、出入院NIHSS評分差值、腦卒中后1個月OHS評分、腦卒中后3個月OHS評分、治療后2周NDS評分、3周NDS評分、4周NDS評分、腦卒中后1周BI評分、腦卒中后1個月BI評分、3個月BI評分、出入院BI評分差值、治療后28天中醫(yī)證候積分較西醫(yī)卒中單元更有優(yōu)勢(P0.05)。而在臨床總有效率、中醫(yī)證候總有效率、腦卒中后1個月、3個月、6個月、12個月病死率、治療后1周NDS評分、平均住院費用方面,中西醫(yī)結合卒中單元與西醫(yī)卒中單元相比沒有顯著性差異(P0.05)。 結論: 1、現有有限證據證實了中西醫(yī)結合卒中單元模式治療急性腦卒中的有效性。 2、中西醫(yī)結合卒中單元治療急性腦卒中療效的證據仍十分有限,尚需高質量的研究以增加證據的強度。
[Abstract]:Objective : To evaluate the efficacy of integrated traditional Chinese and western medicine combined with stroke unit in the treatment of acute stroke .



Methods : A total of 254 literatures were used to study the random or semi - randomized controlled trial of acute stroke with traditional Chinese and western medicine combined with stroke unit .



Results :



1 . The 16 clinical studies that were eventually included were randomized controlled trials with integrated traditional Chinese and western medicine combined with stroke unit as control group and control group as control group for acute stroke . The control group was the study of 6 patients with stroke unit of western medicine . The control group was 10 items . The total sample size was 2858 cases . There were 1474 cases of integrated traditional Chinese medicine and western medicine combined stroke unit and 1384 control group , including 488 cases of Western medicine stroke unit group and 896 cases of common internal medicine treatment group .



2 . Compared with the general medical treatment , the total effective rate , the mortality rate of 1 month after stroke , the mean hospitalization time , the NIHSS score after the stroke , the score after the treatment , the scores of NDS , the score of MBI , the score of 1 month after the stroke , the post - treatment WHO QOL - 100 score , the MBI score , and the score of the BBS were more superior than those of the general medical treatment ( P0.05 ) .



3 . Compared with the western medicine stroke unit , the scores of NIHSS score , NIHSS score , NIHSS score , NIHSS score , NIHSS score of 1 month , NIHSS score of 1 month , NIHSS score at 3 months , NIHSS score after stroke , 1 month after stroke , 3 months of NDS , 1 week after stroke , 1 month after stroke , 3 months , 12 months mortality rate , NDS score of 1 week after stroke , and average hospitalization expense were not significantly different between traditional Chinese and western medicine combined stroke unit ( P0.05 ) .



Conclusion :



1 . The existing limited evidence confirms the effectiveness of traditional Chinese and western medicine combined with stroke unit model for acute stroke .



2 . The evidence of treatment of acute cerebral apoplexy by integrated traditional Chinese medicine and western medicine is still very limited , and high - quality research is needed to increase the strength of evidence .
【學位授予單位】：遼寧中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R743.3

【引證文獻】

相關期刊論文 前1條

1 尤茂海;;構建急性腦卒中中西醫(yī)結合綠色通道的研究[J];河南中醫(yī);2013年10期

相關博士學位論文 前2條

1 周莉;基于循證的中醫(yī)臨床實踐指南研制方法研究[D];北京中醫(yī)藥大學;2011年

2 闞保紅;基于腦梗死中醫(yī)全程適時干預方案的實施過程評價研究[D];北京中醫(yī)藥大學;2013年

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本文編號：1953172