- 期刊
中醫針灸治療對於出血型腦中風住院患者之療效評估：回溯性分析
The Study on the Assessment of Therapeutic Effect in Hemorrhagic Stroke Hospitalize Patients with Acupuncture Treatment: A Retrospective Observational Study
摘要
目的：中醫全聯會配合健保署開辦「全民健康保險西醫住院病患中醫特定疾病輔助醫療試辦計畫」，期能幫助腦中風住院患者的恢復，多家教學醫院執行多年以來成效如何有待探討。本研究藉由回溯資料分析，評估出血型腦中風住院患者接受中醫針灸治療的前後各項評估指標的恢復狀況。方法：本研究採回溯性資料庫分析，透過台灣南部某醫學中心腦中風登錄系統，收集自2014年1月至2017年12月期間於該醫學中心神經內科住院的出血型腦中風病人。針對其住院期間治療前與治療後的GCS昏迷指數（Glasgow Coma Scale）、巴氏量表（Barthel Index）、徒手肌力測試（MMT）及美國國家衛生研究院腦中風評估量表（NIHSS）評估結果，以成對樣本T檢定進行分析。結果：排除死亡者10位、資料不全者27位，最後共271位出血型腦中風病人資料納入研究，在以中醫針灸治療前後進行比較結果，GCS昏迷指數（睜眼、說話及運動）顯示意識改善程度達顯著差異（P＜0.0001），四肢徒手肌力測試顯示上下肢肌力變化均達到顯著差異（P＜0.0001），巴氏量表總分顯示生活功能的變化有顯著差異（P＜0.0001）；NIHSS量表總分顯示神經學功能的變化達顯著差異（P＜0.0001）。結論：經回溯性資料庫分析，本研究收集271位出血型腦中風住院病人的資料分析，經會診中醫針灸治療，比較其前後變化，發現病人經治療後的意識狀態、四肢肢體力量和日常生活能力等各項指標均達到統計學上的顯著差異。顯示中醫針灸治療有助於協助出血型腦中風病人的恢復。
並列摘要
Background and Purpose: The auxiliary medical care pilot project has been implemented for several years to improve prognosis of stroke patients during hospitalization. However, the effectiveness of this pilot project did not be well established. Hence, we conducted a retrospective study to assess improvement of patients' functional outcomes after receiving acupuncture treatment. Methods: This retrospective study collected subjects from stroke registration database of a medical center in south Taiwan since 1st January 2014 to 31st December 2017. We only enrolled patients with hemorrhagic stroke and then all of them had at least once acupuncture treatment. We used Glasgow coma scale (GCS), Barthel Index, manual muscle testing (MMT), and National Institute of Health Stroke Scale (NIHSS) as our outcomes. For statistics, all results were analyzed by using a paired-sample t test. Results: We enrolled 271 patients with hemorrhagic stroke in this study. All outcomes including Glasgow coma scale (GCS), Barthel Index, manual muscle testing (MMT), and National Institute of Health Stroke Scale (NIHSS) were represented significant improvement (P ＜ 0.0001) after acupuncture treatment. Conclusion: Based on this retrospective study, acupuncture as an adjuvant treatment could improve the functional outcomes of hemorrhagic stroke patients.