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目的:横断面调查脑卒中恢复期患者病情,分析不同维度的多个评估量表及标准对其病情的评价结果。方法:以2000-07-26/2001-02-28广州中医药大学第二附属医院收治的194例脑卒中恢复期患者为调查对象。采用第二代中风病诊断及疗效评定标准、自编中医症状量表(28个症状、体征,按无、轻、中、重分别计0,1,2,3分)、改良爱丁堡与斯堪的那维亚组标准(总分45分,0～15分为轻度缺损,16～30分为中度缺损,31～45分为重度缺损)、改良Barthel指数(满分100分,<60分为不能自理)、健康调查简表SF-36的活力和精神健康分量表为测量工具,对194例患者进行评价。采用描述性分析、Spearmen相关分析、因子分析等方法进行量表评估及各量表间的相关性分析。结果:194例患者均完成了测试,进入结果分析。①各量表及标准平均得分:第二代中风病诊断及疗效评定标准:6.51±6.29;中医症状量表:13.73±6.97;改良爱丁堡与斯堪的那维亚组标准:7.56±7.35;改良Barthel指数:63.58±23.68;SF-36的活力和精神健康分量表:52.79±23.32,62.83±22.75。②改良爱丁堡与斯堪的那维亚组标准与其他量表的相关性:与第二代中风病诊断及疗效评定标准高度正相关(R’=0.885),与中医症状量表相关性不高(R’=0.302),与改良Barthel指数高度负相关(R’=-0.824),与SF-36的活力和精神健康分量表相关性不高(R’=-0.294,-0.258)。结论:①改良爱丁堡与斯堪的那维亚组标准与第二代中风病诊断及疗效评定标准基本属于相同维度,两者一定条件下可相互替代。②患者不同维度健康状态并不一致,应建立脑卒中恢复期疗效的多维评价标准,以更全面地评价患者的病情,和更科学地反映中医药治疗的真正效能。
OBJECTIVE: To investigate the condition of patients in recovery stage of stroke by cross-sectional analysis, and to evaluate the evaluation results of multiple assessment scales and criteria of different dimensions in their condition. Methods: A total of 194 patients with convalescent stroke admitted to the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from July 2000 to July 26, 2001 were enrolled. Using the second generation of stroke diagnosis and evaluation criteria, self-compiled TCM Symptom Inventory (28 symptoms, signs, according to no, light, medium and heavy respectively 0,1,2,3 points), improved Edinburgh and Scandinavia Of the nadavia group (a total of 45 points, 0 to 15 with mild defects, 16 to 30 with moderate defects and 31 to 45 with severe defects), a modified Barthel index (out of 100, <60 As can not take care of themselves), Health survey summary SF-36 vitality and mental health subscale measurement tools, 194 patients were evaluated. Descriptive analysis, Spearmen correlation analysis, factor analysis and other methods for scale assessment and correlation between the scales. Results: All 194 patients completed the test and entered the result analysis. (1) Scale and standard average score of each scale: the second generation of stroke diagnosis and efficacy evaluation standard: 6.51 ± 6.29; TCM symptom scale: 13.73 ± 6.97; Modified Edinburgh and Scandinavia group standard: 7.56 ± 7.35; improved Barthel index: 63.58 ± 23.68; Vitality and mental health subscale of SF-36: 52.79 ± 23.32,62.83 ± 22.75. ② The correlation between the modified Edinburgh and Scandinavian standards and other scales was highly correlated with the second-generation stroke diagnosis and evaluation criteria (R ’= 0.885), but not correlated with TCM Symptom Scale (R ’= 0.302), which was highly negatively correlated with the modified Barthel index (R’ = -0.824). The correlation was not significant between the vitality and mental health subscale of SF-36 (R ’= - 0.294, -0.258). Conclusion: ①The standards of diagnosis and evaluation of second-generation stroke in the modified Edinburgh and Scandinavian groups basically belong to the same dimension, and they can be replaced under certain conditions. ② Patients with different dimensions of health are not consistent, multi-dimensional evaluation criteria should be established for the recovery of stroke in order to more fully evaluate the patient’s condition, and more scientifically reflect the true efficacy of traditional Chinese medicine treatment.