CAJ | 학술논문

目的通过横断面调查,了解缺血性卒中患者应用中药现况.方法自2008年6月至2010年10月,将全国48家中心采用简单整群抽样及随机数字表法,随机分配至接受标准化治疗组和常规治疗组.标准化治疗组采用标准化的缺血性卒中二级预防工具对卒中患者进行治疗随诊.常规治疗组对于治疗干预措施无特殊建议和规定.两组均无对中药治疗的特别规定和限制.各参加中心连续入组住院治疗的急性缺血性脑血管病患者,记录入组患者的各项临床资料及卒中治疗相关中药汤剂或者中成药名称.描述样本人群特点以及入院前3个月及出院时中药服用的频数及百分率.计数资料采用卡方检验比较两组间的差异.结果纳入分析的3 664例患者中,标准化治疗组1 709例,常规治疗组1 955例,男性与女性比例约2∶1.两组间年龄、性别和教育程度分布差异无统计学意义.187例(5.10％)患者在入院前3个月内曾服用中药治疗,其中81.28％患者服用1种中药.两组间中药服用比例差异无统计学意义.出院时患者服用中药的比例明显升高,30.65％的患者出院时服用中药.常规治疗组服用中药比例(38.16％)高于标准化治疗组(22.06％),且应用2种以上中药的比例也高于标准化治疗组,差异有统计学意义(x2=141.43,P＜0.01).出院时共有112种不同名称药物被开处方.结论 1/3的缺血性卒中患者出院时采用中成药单药治疗,且药物品种繁多.
목적 통과횡단면조사,료해결혈성졸중환자응용중약현황.방법 자2008년6월지2010년10월,장전국48가중심채용간단정군추양급수궤수자표법,수궤분배지접수표준화치료조화상규치료조.표준화치료조채용표준화적결혈성졸중이급예방공구대졸중환자진행치료수진.상규치료조대우치료간예조시무특수건의화규정.량조균무대중약치료적특별규정화한제.각삼가중심련속입조주원치료적급성결혈성뇌혈관병환자,기록입조환자적각항림상자료급졸중치료상관중약탕제혹자중성약명칭.묘술양본인군특점이급입원전3개월급출원시중약복용적빈수급백분솔.계수자료채용잡방검험비교량조간적차이.결과 납입분석적3 664례환자중,표준화치료조1 709례,상규치료조1 955례,남성여녀성비례약2∶1.량조간년령、성별화교육정도분포차이무통계학의의.187례(5.10％)환자재입원전3개월내증복용중약치료,기중81.28％환자복용1충중약.량조간중약복용비례차이무통계학의의.출원시환자복용중약적비례명현승고,30.65％적환자출원시복용중약.상규치료조복용중약비례(38.16％)고우표준화치료조(22.06％),차응용2충이상중약적비례야고우표준화치료조,차이유통계학의의(x2=141.43,P＜0.01).출원시공유112충불동명칭약물피개처방.결론 1/3적결혈성졸중환자출원시채용중성약단약치료,차약물품충번다.
Objective To investigate current situation of prescription of traditional Chinese medicine (TCM) for acute stroke patients.Methods From June 2008 to October 2010,with simple cluster sampling,48 centers were randomly assigned to the intervention group receiving a standardized treatment strategy,and the usual care group without specific recommendations for treatment.No specific recommendations or restrictions of TCM were proposed for both groups.Consecutive hospitalized patients with acute ischemic stroke were recruited in this study.Clinical data and treatment strategy (including TCM) were recorded by trained investigators.The prescription of TCM three months prior to admission and at discharge was recorded and analyzed.The chi-square test was used for analysis of qualitative data.Results Totally 3 664 patients were included in the analysis (1 709 patients in standard care group and 1 955 patients in the usual care group) with male to female ratio 2∶ 1.The difference of distribution of age,sex and education level between the two groups was not statistically significant.One hundred and eighty-seven patients (5.10％) had taken TCM three months prior to admission,81.28％ of them only taking one type of TCM,without significant difference between the two groups.The percentage of patients taking TCM at discharge was significantly increased to 30.65％ for all the patients with higher percentage (38.16％) in the usual care group than that in the standard care group (22.06％).The percentage of using more than one type of TCM was also higher in the usual care group (x2 =141.43,P ＜ 0.01).Totally,112 types of TCM were prescribed at discharge.Conclusions Nearly one third of hospitalized patients with acute stroke were prescribed TCM at discharge,with mostly monotherapy and a great variety.