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目的观察综合康复疗法对社区脑卒中患者全面康复的影响。方法将276例脑卒中患者随机分为综合康复组、西医康复组和西药组,每组92例。综合康复组采用一站式社区康复;西医康复组采用机能康复疗法;西药组仅予西药治疗。分别于治疗前及干预中(1个月)和干预后(3个月)对三组患者进行神经功能缺损情况评定(NIHSS)及中医临床证候评分(中风病辨证诊断标准),并随访所有患者1年,统计1年后致残率、复发率及死亡率。结果治疗1个月及3个月后,三组的NIHSS评分均逐步改善,综合康复组与西医康复组对比均有显著差异(t=3.07/3.05,P<0.01),而西药组于治疗3个月后与治疗1个月后对比无差异(P>0.05);治疗1个月及3个月后,三组的中医临床证候评分均逐步改善,综合康复组与西医康复组对比均有显著差异(t=4.43/4.62,P<0.01);随访1年,综合康复组致残率与复发率均明显低于西医康复组(x2=4.36/4.05,P<0.05);三组死亡率无明显差异。结论综合康复治疗对改善社区脑卒中患者的神经功能及中医临床证候具有显著优势,同时能明显降低社区脑卒中患者的致残率和复发率。
Objective To observe the effect of comprehensive rehabilitation therapy on the comprehensive rehabilitation of stroke patients in community. Methods 276 stroke patients were randomly divided into comprehensive rehabilitation group, Western rehabilitation group and Western medicine group, 92 cases in each group. One-stop community-based rehabilitation was used in the comprehensive rehabilitation group; functional rehabilitation was used in the Western rehabilitation group; western medicine was given only to western medicine group. The neurological deficit assessment (NIHSS) and TCM clinical syndrome score (the diagnosis standard of stroke syndrome) were performed before treatment and after intervention (1 month) and after intervention (3 months), and all patients were followed up Patient 1 year, statistics 1 year after the disability rate, recurrence rate and mortality. Results After 1 and 3 months of treatment, the NIHSS scores of the three groups were gradually improved. There was significant difference between the comprehensive rehabilitation group and the Western rehabilitation group (t = 3.07 / 3.05, P <0.01) After one month and three months after treatment, there was no significant difference between the two groups (P> 0.05). After treatment for one month and three months, the scores of TCM clinical syndromes in three groups were all gradually improved. There was significant difference between comprehensive rehabilitation group and western medicine rehabilitation group (T = 4.43 / 4.62, P <0.01). After one year of follow-up, the morbidity and relapse rate of the comprehensive rehabilitation group were significantly lower than those of the Western rehabilitation group (x2 = 4.36 / 4.05, P <0.05) No significant difference. Conclusion Comprehensive rehabilitation therapy has significant advantages in improving neurological function and TCM clinical syndrome in community-based stroke patients, and can significantly reduce the morbidity and relapse rate of stroke patients in community.