CAJ | 학술논문

目的：观察卒中单元中西医结合治疗对脑梗死患者生活质量及照料者心理状态的影响。方法：将197例患者随机分成对照组58例和治疗组139例，其照料者随之分为照料对照组和照料治疗组。对照组采用常规药物治疗、肢体康复、心理治疗、健康教育等，对照组照料者不作任何干预；治疗组在上述治疗的基础上，加用中草药方剂治疗，同时照料治疗组给予系统的脑卒中健康教育、康复知识、技能培训及适当的抗抑郁抗焦虑药物治疗。2组患者均于治疗前和治疗后第4周、8周、24周进行Barthel指数（BI）、Spitzer生活质量指数（QLI）评定；2组照料者均于治疗前和治疗后第4周、8周、24周进行汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）评定。结果：治疗4周后，2组BI、QLI评分与治疗前比较均有明显差异；与对照组比较，治疗组的BI及QLI评分有明显差异（＜0.05）。2组照料者抑郁41例（21.6%），焦虑55例（28.9%）。治疗后，照料治疗组抑郁、焦虑疗效明显优于照料对照组，差异有统计学意义（＜0.05）。结论：卒中单元中西医结合治疗和对照料者的综合干预能明显提高脑梗死患者的生活质量，且明显改善患者及照料者的心理状态。
목적：관찰졸중단원중서의결합치료대뇌경사환자생활질량급조료자심리상태적영향。방법：장197례환자수궤분성대조조58례화치료조139례，기조료자수지분위조료대조조화조료치료조。대조조채용상규약물치료、지체강복、심리치료、건강교육등，대조조조료자불작임하간예；치료조재상술치료적기출상，가용중초약방제치료，동시조료치료조급여계통적뇌졸중건강교육、강복지식、기능배훈급괄당적항억욱항초필약물치료。2조환자균우치료전화치료후제4주、8주、24주진행Barthel지수（BI）、Spitzer생활질량지수（QLI）평정；2조조료자균우치료전화치료후제4주、8주、24주진행한밀이돈억욱량표（HAMD）、한밀이돈초필량표（HAMA）평정。결과：치료4주후，2조BI、QLI평분여치료전비교균유명현차이；여대조조비교，치료조적BI급QLI평분유명현차이（＜0.05）。2조조료자억욱41례（21.6%），초필55례（28.9%）。치료후，조료치료조억욱、초필료효명현우우조료대조조，차이유통계학의의（＜0.05）。결론：졸중단원중서의결합치료화대조료자적종합간예능명현제고뇌경사환자적생활질량，차명현개선환자급조료자적심리상태。
ObjectiveTo study the therapy effect of combined therapy of Chinese and Western medicines on the life quality of stroke patients and psychological status of caregivers in stroke unit. Methods:In stroke unit, 197 stroke patients were randomly divided into control group (n=58) and treatment group (n=139). At the same time the caregivers were divided into control group (n=58) and treatment group (n=139). The two patient groups were treated with ordinary regimen including routine anti-stroke medication, rehabilitation, psychological counseling and health-education. The caregivers in the control group didn't receive any intervention. The patients in the treat-ment group had received additional Chinese medicine. Meanwhile the family caregivers in the treatment group re-ceived health-education of stroke, comprehensive rehabilitation program, skills training and suitable antidepres-sant and antianxiety drugs. The rating scales of the life quality such as BI and QLI of Spitzer were used to evalu-ate all patients at pre-therapy, 4 weeks, 8 weeks and 24 weeks after therapy. The rating scales of the psychological status such as HAMD and HAMD were used to evaluate all caregivers at the same time points. Results: After 4 weeks of treatment, the scores of BI and QLI of the two groups were significantly different from those at pre-therapy. The scores of BI and QLI improved significantly in the treatment group relative to those in the con-trol group after intervention ( <0.05). The HAMD and HAMA scores of the caregiver-treatment group were much lower than those of the caregiver-control group after intervention ( <0.05). Conclusion:In stroke unit, combined therapy and intervention on the caregivers can improve the life quality of stroke patients and effectively improve the psychological status of both the stroke patients and caregivers.