石海林+夏峰杨+惠红

摘 要 目的：观察中西医结合康复治疗脑卒中后遗症的临床效果。方法：选取2015年1月—2016年1月脑卒中后遗症患者72例，分为对照组36例，采用常规西医治疗与康复，治疗组36例，在对照基础上联合四站式中医康复治疗，共8周4个疗程，之后比较两组治疗效果。结果：治疗组有效率为99.27%（35/36），对照组有效率77.78%（28/36），两间差异有统计学意义（P<0.05）。治疗前、后治疗组神经功能缺损评分分别为（18.4±5.4）分和（9.4±4.4）分，差异有统计学意义（P<0.01）；对照组分别为（17.9±5.2）分和（11.2±4.1）分，治疗组优于对照组（P<0.05）。结论：社区中西医结合康复治疗脑卒中后遗症是疗效高、成本低，值得推广。

关键词 脑卒中 后遗症 中西医结合 康复

中图分类号：R743.3 文献标志码：A 文章编号：1006-1533（2016）14-0058-03

Effect of combination of traditional Chinese medicine and Western medicine in the rehabilitation of stroke sequel in the community

SHI Hailin， XIA Fengyang， HUI Hong

（Jinshanwei Community Health Service Center of Jinshan District， Shanghai 201512， China）

ABSTRACT Objective： To observe the clinical effect of combination of traditional Chinese and Western medicines in the rehabilitation and treatment of stroke sequela. Methods： A total of 72 cases of stroke sequela were selected from Jan. 2015 to Jan. 2016， and divided into a control group with 36 cases who were treated and rehabilitated with the conventional Western medicine， and a treatment group with 36 cases who were treated with four stops TCM rehabilitation services， a total of 8 weeks for four courses based on the method of the control group. After treatment， the treatment effects were compared between the two groups. Results： The effective rate of the treatment group was 99.27% （35/36）， that of the control group was 77.78%（28/36）， and the differences between the two groups had the statistical significance（P<0.05）. The neural function defect scores of the treatment group were18.4±5.4）and（9.4±4.4）before and after treatment， respectively and the differences had the statistical significance（P<0.01）. Those of the control group were （17.9±5.2） and（11.2±4.1）， respectively. The treatment group was better than the control group（P<0.05）. Conclusion： Community rehabilitation and treatment of stroke sequela with combination of Chinese and Western medicines has high efficacy and low cost and is worthy of promotion.

KEY WORDS stroke； sequel； combination of traditional Chinese and Western medicines； rehabilitation

在我国脑卒中新发病例为150万/年[1]，其后遗症常见的有口眼歪斜、言语不利、半身不遂等，严重影响患者的生活质量。金山卫镇社区卫生服务中心应用中西医结合康复治疗脑卒中后遗症疗效满意，现总结如下。

1 资料与方法

1.1 一般资料

收2015年1月—2016年1月门诊及住院的脑卒中后遗症患者72例，分为治疗组36例，其中男性20例，女性16例，年龄56～78岁，平均66.6岁，神经功能缺损评分（NDS）为（18.4±5.4）分；对照组36例，男性21例，女性15例，年龄48～82岁，平均64.3岁，NDS为（17.9±5.2）分。两组患者一般资料差异无统计学意义（P>0.05）。患者均签署知情同意书。排除生命体征不稳定、有心肝肾等脏器疾病患者；同时患有癌症或者恶性肿瘤者；重度抑郁症及精神疾病；有严重出血倾向的患者。

所有患者均符合《各类脑血管疾病诊断要点》[2]中的诊断标准；神经功能缺损评分参照《脑卒中患者临床神经功能程度评分标准与临床疗效评定标准》[3]；中医诊断参照《脑卒中病诊断与疗效评定标准》[4]中的脑卒中中经络、辨证属气虚血瘀证的诊断标准。

1.2 方法