中西結合治療腦中風療效的回溯性分析

Chinese Medicine Treatment in Patients with Severe Cerebrovascular Disease in Acute Phase-Retrospective Research

背景：腦中風高居已開發國家之前三大死因並且造成國家重大負擔，以中醫針灸或中藥照護可明顯提升照護品質與恢復速度，然而醫界對中醫治療於急性期介入仍持保留態度，故本研究分析中醫於急性期介入進行中西醫合併治療重度腦中風患者之前後療效。材料與方法：選擇本院2016 年1 月到2016 年12 月符合ICD-9(430-438) 診斷，加入「全民健康保險西醫住院病患中醫特定疾病輔助醫療計畫」之病患，進行回朔分析。結果：依照本研究之納入及排除條件篩後，選出急性期合併中醫介入重度腦中風個案，共23 人納入分析，（男性13 人，女性10 人，平均年齡65.10±11.05 歲）。本研究針對重度腦中風患者急性期介入進行治療前後分析，發現經中西醫結合治療後NIHSS 總分與巴氏量表於治療前後總分有大幅度改善達顯著差異(P<0.01)，多個分項亦有顯著差異。結論：腦中風發病7 日內中醫介入治療可能有利於中風患者之恢復。

Background: Cerebrovascular disease is often one of top three major causes of death in developed country and cause great financial burden to society. Chinese medicine or acupuncture treatment can significantly improve the quality of care and recovery, so this study aim to figure out the effect of TCM treatment in acute phase of severe cerebrovascular disease. Methods and methods: Patients with ICD-9 (430-438) diagnosis from January 2016 to December 2016 who joined the 'National Health Insurance of Western medicine hospitalized patients with Chinese medicine specific disease auxiliary medical program ' and meet all inclusion and exclusion criteria were selected, and SPSS(V18)were used to analyze NIHSS and Barthel index. Results: 23 patients (13 males and 10 females, mean age 65.10±11.05) were analyzed. Patients with severe cerebrovascular disease (NIHSS ≧15) showed significant improvement in NIHSS and Barthel index when receiving combine care of TCM in acute phase. (P<0.01**) Conclusions: NIHSS scores of 96.65% (22/23) patients with severe cerebrovascular disease (NIHSS ≧15) were significantly improved and showed significant difference in pretest and posttest(p<0.01**). And there was no significant difference in NIHSS change in two weeks between receiving TCM treatment in 0-3day-group or 4-7-day-group , which indicated the correctness and safety of TCM treatment in the acute phase of cerebrovascular disease.