初步無對照評估中醫住院治療對中風及腦傷患者的療效

No Control, Preliminary Study Evaluating the Effects of Acupuncture and Chinese Medicine in Traditional Chinese Medical Ward for Patients with Stroke or Patients with Traumatic Brain Injury

為了瞭解入住長庚醫院中醫針傷科病房病患之特性及住院治療的療效，因此針對常見疾病進行療效評估研究，亦作為中醫住院未來納入保險給付項目之參考。回溯收集2013年3月至2015年6月期間於桃園長庚中醫針傷科住院之腦中風及顱腦損傷患病患病歷，登錄其基本資料及入出院時的巴氏量表評分，比較於中醫病房接受針灸合併中藥及復健治療前後對病人日常生活功能的改善程度。結果共97位病患納入研究。中醫病房的病人族群，有很大一部份是嚴重依賴 (Barthel指數低於40分，共75人)。入住中醫針傷科病房進行中西合併治療可以改善其日常生活功能，尤其是針對缺血性腦中風及外傷所致之顱腦損傷者(分別為P=0.032，P=0.043)。而分析初始巴氏量表評分的不同進行分組分析時，發現於初始分數介於5至20分及25至40分之間的患者其進步幅度較明顯。推論入住中醫針傷科病房進行針灸合併中藥及復健治療，對腦中風和顱腦損傷患者的日常生活功能改善均有幫助。

Self paid hospitalization to Traditional Chinese Medicine Ward (TCM) of Chung Gung Memorial Hospital Taoyuan branch has been carried out for many years. A lot of patients were admitted to Acupuncture and Moxibustion division for receiving acupuncture and Chinese herbal medicaion treatment. This study aimed to outline a demographic data of the admitted patients, and evaluate the effectiveness of acupuncture and Chinese herbal treatment in our ward. Our report may provide suggestions for health authorities to consider covering hospitalization in TCM ward by health insurance payment. We reviewed the medical records of the hospitalized patients with diagnosis of stroke or traumatic brain injury in Traditional Chinese medicine ward of Chung Gung Memorial Hospital, Taoyuan Branch, from March 2013 to June 2015. The clinical profiles included general characteristics and Barthel index. Barthel indices before and after hospitalization were compared with subgroup analysis. Ninety-seven patients were enrolled. Generally, hospitalization in Chinese Medical ward for combined acupuncture, Chinese herbal therapy, and conventional rehabiliation treatment improved activity of daily life (ADL), especially for ischemic stroke and traumatic brain injury patients. Besides, patients with initial Barthel index around 5 to 40 got more improvement. Hospitalization to Traditional Chinese Medicine Ward for combined acupuncture, Chinese herbal therapy, and conventional rehabiliation treatment benefits stroke and traumatic brain injury patients.