中风病后期内风证候与简化mRS问卷的功能结局相关性分析(1)
摘 要：目的 探究急性期中风病患者后期(第7天)中医证候要素分布情况与smRSq的功能结局的相关性。方法 连续入组2016年12月1日～2017年4月31日在广州中医药大学第一附属医院脑病中心脑病科首次中风病急性期住院患者140例，对入组患者逐一于起病90 d根据smRSq进行电话随访，最终符合标准且完成电话随访纳入研究共127例，收集患者的一般资料、起病第7天中医证候要素量表评分及起病90 d smRSq评分，各证候组间比较采用Spearman相关分析中医证候要素与smRSq功能结局的相关性。结果 急性期中风病后期合并内风证候的患者smRSq功能结局评分3(2，4)分，高于不合并内风证候的患者2(1，3)分，Spearman相关分析显示内风证候r=0.579，P=0.000，其余证候结果差异无统计学意义(P>0.05)。结论 后期合并内风证候的中风病急性期患者与smRSq的功能结局显著相关。
关键词：中风病；中医证候要素；简化mRS问卷
中图分类号：R255.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.12.033
, 百拇医药
文章编号：1006-1959(2018)12-0107-03
Abstract：Objective To investigate the correlation between the distribution of TCM syndrome elements in the late stage(day 7)of acute stroke patients and the functional outcome of smRSq.Methods From the 1st of December 2016 to the April 31st of 2017 in the first phase of acute stroke disease in the encephalopathy department of the First Affiliated Hospital of Guangzhou University of traditional Chinese medicine，140 patients were admitted to the group.Patients were enrolled in the follow-up telephone visits according to smRSq 90 d after the onset of the disease，and they met the criteria and completed the telephone follow-up.A total of 127 patients were included in the study.The general data of the patients， the score of the TCM syndrome element scale on the 7th day of onset and the 90 d smRSq score on the onset of the disease were used.The correlation between the TSH syndrome parameters and the smRSq functional outcome was analyzed by Spearman correlation.Results The smRSq functional outcome scores of patients with acute stroke at the end of stroke were 3(2，4)points，2(1，3)points higher than those without internal wind syndrome，Spearman correlation analysis showed that r=0.579，P=0.000，and there was no significant difference in other syndromes(P>0.05).Conclusion The acute phase of stroke patients with late-influenza syndrome is significantly associated with the functional outcome of smRSq.
, 百拇医药
Key words：Stroke；TCM syndrome elements；Simplified mRS questionnaire
現代中医证候学的发展基于临床实践中“病证结合”的新理念，根据现有病证的客观诊断标准对疾病的状态作出病位与病性的证候要素辨别，通过“量化”的客观症状或征象以减少辨证过程中产生过多的主观性，在一定程度上有益于推动中医药标准化的进程。而中风病的证候学研究更是从1994年《中风病辨证诊断标准》的拟定开始，大量相关的临床研究显示中医证候的规律和动态演变与中风病的功能预后有着紧密的联系[1，2]。结合我国目前的医疗体制和现状，普遍出院后的中风病患者随访工作难以实施到位，一方面在于患者的依从性难以把握，另一方面也在于随访形式的开展附带随访者很多主观的影响，国内大多数临床随访大都基于电话的方式进行，少数依靠门诊跟踪随访也同样不可避免地面临较高的脱落率。对于中风病患者，在住院期间采用国际公认且应用广泛的改良Rankin量表(mRS)评估患者的功能预后有其独特的优势，然而患者一旦出院，随访者需要在有限时间内的电话随访对患者的功能结局作出快速的判断，往往需要面临时间控制不足和沟通理解存在误差等情况发生，因而在实际运用中对于出院随访患者具有其较大的局限性。本研究拟采用更适合电话随访且简易省时的smRSq结构式问卷调查工具以随访评价患者功能结局预后，以尽可能保证随访患者功能结局预后评估的准确性，探究中医证候与急性期中风病患者smRSq的功能结局的相关性。, http://www.100md.com(庾国桢 杨小梅 沈强 吴智兵)
关键词：中风病；中医证候要素；简化mRS问卷
中图分类号：R255.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.12.033
, 百拇医药
文章编号：1006-1959(2018)12-0107-03
Abstract：Objective To investigate the correlation between the distribution of TCM syndrome elements in the late stage(day 7)of acute stroke patients and the functional outcome of smRSq.Methods From the 1st of December 2016 to the April 31st of 2017 in the first phase of acute stroke disease in the encephalopathy department of the First Affiliated Hospital of Guangzhou University of traditional Chinese medicine，140 patients were admitted to the group.Patients were enrolled in the follow-up telephone visits according to smRSq 90 d after the onset of the disease，and they met the criteria and completed the telephone follow-up.A total of 127 patients were included in the study.The general data of the patients， the score of the TCM syndrome element scale on the 7th day of onset and the 90 d smRSq score on the onset of the disease were used.The correlation between the TSH syndrome parameters and the smRSq functional outcome was analyzed by Spearman correlation.Results The smRSq functional outcome scores of patients with acute stroke at the end of stroke were 3(2，4)points，2(1，3)points higher than those without internal wind syndrome，Spearman correlation analysis showed that r=0.579，P=0.000，and there was no significant difference in other syndromes(P>0.05).Conclusion The acute phase of stroke patients with late-influenza syndrome is significantly associated with the functional outcome of smRSq.
, 百拇医药
Key words：Stroke；TCM syndrome elements；Simplified mRS questionnaire
現代中医证候学的发展基于临床实践中“病证结合”的新理念，根据现有病证的客观诊断标准对疾病的状态作出病位与病性的证候要素辨别，通过“量化”的客观症状或征象以减少辨证过程中产生过多的主观性，在一定程度上有益于推动中医药标准化的进程。而中风病的证候学研究更是从1994年《中风病辨证诊断标准》的拟定开始，大量相关的临床研究显示中医证候的规律和动态演变与中风病的功能预后有着紧密的联系[1，2]。结合我国目前的医疗体制和现状，普遍出院后的中风病患者随访工作难以实施到位，一方面在于患者的依从性难以把握，另一方面也在于随访形式的开展附带随访者很多主观的影响，国内大多数临床随访大都基于电话的方式进行，少数依靠门诊跟踪随访也同样不可避免地面临较高的脱落率。对于中风病患者，在住院期间采用国际公认且应用广泛的改良Rankin量表(mRS)评估患者的功能预后有其独特的优势，然而患者一旦出院，随访者需要在有限时间内的电话随访对患者的功能结局作出快速的判断，往往需要面临时间控制不足和沟通理解存在误差等情况发生，因而在实际运用中对于出院随访患者具有其较大的局限性。本研究拟采用更适合电话随访且简易省时的smRSq结构式问卷调查工具以随访评价患者功能结局预后，以尽可能保证随访患者功能结局预后评估的准确性，探究中医证候与急性期中风病患者smRSq的功能结局的相关性。, http://www.100md.com(庾国桢 杨小梅 沈强 吴智兵)