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

【摘要】： 目的:系統(tǒng)評(píng)價(jià)中西醫(yī)結(jié)合卒中單元治療急性腦卒中的有效性。 方法:檢索國(guó)內(nèi)外發(fā)表的以中西醫(yī)結(jié)合卒中單元為治療組、以普通內(nèi)科治療或西醫(yī)卒中單元為對(duì)照組治療急性腦卒中的隨機(jī)或半隨機(jī)對(duì)照試驗(yàn)的研究文獻(xiàn),共計(jì)254篇。制定文獻(xiàn)的選擇標(biāo)準(zhǔn),進(jìn)行三次篩選,將合格研究進(jìn)行Jadad評(píng)分評(píng)價(jià)其質(zhì)量,篩選和評(píng)價(jià)過(guò)程由2位研究者獨(dú)立進(jìn)行,意見(jiàn)不同者通過(guò)討論解決,最終16篇文獻(xiàn)納入研究。采用Review Manager 4.2軟件對(duì)納入文獻(xiàn)進(jìn)行分析,分別對(duì)總有效率、病死率、衛(wèi)生經(jīng)濟(jì)學(xué)指標(biāo)、神經(jīng)功能缺損評(píng)分、日常生活能力評(píng)分等相關(guān)效應(yīng)指標(biāo)進(jìn)行同質(zhì)性檢驗(yàn)、Meta分析、漏斗圖分析、敏感性分析。 結(jié)果: 1、最終納入的16個(gè)臨床研究是以中西醫(yī)結(jié)合卒中單元為治療組,與西醫(yī)卒中單元/普通內(nèi)科治療為對(duì)照組治療急性腦卒中的隨機(jī)對(duì)照試驗(yàn),對(duì)照組為西醫(yī)卒中單元的研究為6項(xiàng),對(duì)照組為普通內(nèi)科治療的研究為10項(xiàng)。累計(jì)樣本量2858例,中西醫(yī)結(jié)合卒中單元組1474例,對(duì)照組1384例,包括西醫(yī)卒中單元組488例,普通內(nèi)科治療組896例。 2、與普通內(nèi)科治療相比,中西醫(yī)結(jié)合卒中單元在臨床總有效率、腦卒中后1個(gè)月病死率、平均住院時(shí)間、出院時(shí)NIHSS評(píng)分、出院時(shí)OHS評(píng)分、治療后3周NDS評(píng)分、出院時(shí)BI評(píng)分、腦卒中后1個(gè)月BI評(píng)分、治療后WHOQOL-100評(píng)分、MBI評(píng)分、FMA評(píng)分、BBS評(píng)分較普通內(nèi)科治療更有優(yōu)勢(shì)(P0.05)。而在腦卒中3個(gè)月后病死率、治療后25天MESSS評(píng)分方面與普通內(nèi)科治療相比沒(méi)有顯著性差異(P0.05)。 3、與西醫(yī)卒中單元相比,中西醫(yī)結(jié)合卒中單元在平均住院時(shí)間、卒中后1周NIHSS評(píng)分、1個(gè)月NIHSS評(píng)分、3個(gè)月NIHSS評(píng)分、出入院NIHSS評(píng)分差值、腦卒中后1個(gè)月OHS評(píng)分、腦卒中后3個(gè)月OHS評(píng)分、治療后2周NDS評(píng)分、3周NDS評(píng)分、4周NDS評(píng)分、腦卒中后1周BI評(píng)分、腦卒中后1個(gè)月BI評(píng)分、3個(gè)月BI評(píng)分、出入院BI評(píng)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(shì)(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(gè)月、3個(gè)月、6個(gè)月、12個(gè)月病死率、治療后1周NDS評(píng)分、平均住院費(fèi)用方面,中西醫(yī)結(jié)合卒中單元與西醫(yī)卒中單元相比沒(méi)有顯著性差異(P0.05)。 結(jié)論: 1、現(xiàn)有有限證據(jù)證實(shí)了中西醫(yī)結(jié)合卒中單元模式治療急性腦卒中的有效性。 2、中西醫(yī)結(jié)合卒中單元治療急性腦卒中療效的證據(jù)仍十分有限,尚需高質(zhì)量的研究以增加證據(jù)的強(qiáng)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(xué)位授予單位】：遼寧中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R743.3

【引證文獻(xiàn)】

相關(guān)期刊論文 前1條

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

相關(guān)博士學(xué)位論文 前2條

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

2 闞保紅;基于腦梗死中醫(yī)全程適時(shí)干預(yù)方案的實(shí)施過(guò)程評(píng)價(jià)研究[D];北京中醫(yī)藥大學(xué);2013年

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本文編號(hào)：1953172