中西医结合卒中单元治疗急性期脑卒中疗效的系统评价

发布时间：2018-05-30 00:41

本文选题：急性脑卒中 + 中西医结合卒中单元　；参考：《辽宁中医药大学》2010年硕士论文

【摘要】： 目的:系统评价中西医结合卒中单元治疗急性脑卒中的有效性。方法:检索国内外发表的以中西医结合卒中单元为治疗组、以普通内科治疗或西医卒中单元为对照组治疗急性脑卒中的随机或半随机对照试验的研究文献,共计254篇。制定文献的选择标准,进行三次筛选,将合格研究进行Jadad评分评价其质量,筛选和评价过程由2位研究者独立进行,意见不同者通过讨论解决,最终16篇文献纳入研究。采用Review Manager 4.2软件对纳入文献进行分析,分别对总有效率、病死率、卫生经济学指标、神经功能缺损评分、日常生活能力评分等相关效应指标进行同质性检验、Meta分析、漏斗图分析、敏感性分析。结果: 1、最终纳入的16个临床研究是以中西医结合卒中单元为治疗组,与西医卒中单元/普通内科治疗为对照组治疗急性脑卒中的随机对照试验,对照组为西医卒中单元的研究为6项,对照组为普通内科治疗的研究为10项。累计样本量2858例,中西医结合卒中单元组1474例,对照组1384例,包括西医卒中单元组488例,普通内科治疗组896例。 2、与普通内科治疗相比,中西医结合卒中单元在临床总有效率、脑卒中后1个月病死率、平均住院时间、出院时NIHSS评分、出院时OHS评分、治疗后3周NDS评分、出院时BI评分、脑卒中后1个月BI评分、治疗后WHOQOL-100评分、MBI评分、FMA评分、BBS评分较普通内科治疗更有优势(P0.05)。而在脑卒中3个月后病死率、治疗后25天MESSS评分方面与普通内科治疗相比没有显著性差异(P0.05)。 3、与西医卒中单元相比,中西医结合卒中单元在平均住院时间、卒中后1周NIHSS评分、1个月NIHSS评分、3个月NIHSS评分、出入院NIHSS评分差值、脑卒中后1个月OHS评分、脑卒中后3个月OHS评分、治疗后2周NDS评分、3周NDS评分、4周NDS评分、脑卒中后1周BI评分、脑卒中后1个月BI评分、3个月BI评分、出入院BI评分差值、治疗后28天中医证候积分较西医卒中单元更有优势(P0.05)。而在临床总有效率、中医证候总有效率、脑卒中后1个月、3个月、6个月、12个月病死率、治疗后1周NDS评分、平均住院费用方面,中西医结合卒中单元与西医卒中单元相比没有显著性差异(P0.05)。结论: 1、现有有限证据证实了中西医结合卒中单元模式治疗急性脑卒中的有效性。 2、中西医结合卒中单元治疗急性脑卒中疗效的证据仍十分有限,尚需高质量的研究以增加证据的强度。
[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 .
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R743.3

【引证文献】