Abstract: Objective To investigate the clinical effect of the organized stroke care model assisted with Chinese traditional medicine and acupuncture treatment for recovery in primary hospital. Methods Two hundred and thirty-six stroke patients were randomly divided into organized care group (organized group, n = 121) and the traditional care group (control group, n = 115). The short-term clinical curative effect, case-fatality rates, and complication incidence of the 2 groups were compared by National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI) and Oxford Handicap Score (OHS). Results Before treatment, NIHSS score was (20.15 ± 3.45) in organized group and (19.85 ± 4.86) in control group, the difference was not statistically significant (P > 0.05). During treatment, NIHSS score, BI and OHS score was (11.28 ± 4.25), (78.00 ± 22.50) and (1.85 ± 1.40) respectively in organized group, and was (16.40 ± 3.80), (62.00 ± 23.60) and (2.60 ± 1.25) respectively in control group, at 21 d. The differences were all statistically significant (P = 0.000, for all). At 90 d, NIHSS score, BI and OHS score was (4.76 ± 3.16), (84.00 ± 20.12) and (1.30 ± 0.98) respectively in organized group, and was (12.23 ± 4.35), (70.00 ± 22.30) and (2.10 ± 1.40) respectively in control group, all differences were also statistically significant (P = 0.000, for all). The total curative effect at 21 d (80.99%, 98/121) and 90 d (88.43%, 107/121) in organized group were all higher than that in control group (61.74%, 71/115) and (72.17%, 83/115; 21 d: Z = 6.207, P = 0.013; 90 d: Z = 8.302, P = 0.004). The complication incidence in organized group (30.58%, 37/121) was significantly lower than that in control group (69.57%, 80/115; χ2 = 35.851, P = 0.000). Conclusion In primary hospital, the curative effect of organized stroke care assisted with Chinese traditional medicine and acupuncture is better than traditional treatment for stroke.

Key words: Stroke, Integrated TCM WM, Patient care team, Critical pathways, Hospitals, district

摘要： 目的 对比观察基层医院应用组织化卒中医疗模式，辅助中医药和针灸等康复方法治疗脑卒中的临床效果。方法 符合纳入标准的236 例脑卒中患者随机分为组织化卒中组和传统治疗组（对照组），分别比较两组患者住院期间美国国立卫生研究院卒中量表（NIHSS）评分、Barthel 指数（BI）评分、牛津残障评分（OHS）、短期临床疗效、病死率及并发症发生率。结果 组织化卒中组患者治疗第21和90 天时，NIHSS 评分为11.28 ± 4.25 和4.76 ± 3.16，BI 评分为78.00 ± 22.50 和84.00 ± 20.10，OHS 评分为1.85 ± 1.40 和1.30 ± 0.98，神经功能缺损程度显著改善、日常生活活动能力增强、社会功能提高，与对照组相比差异具有统计学意义（均P = 0.000）。组织化卒中组患者治疗第21 和90 天总有效率分别为80.99％（98/121）和88.43％（107/121），高于对照组的61.74％（71/115）和72.17％（83/115；第21 天：Z = 6.207，P =0.013；第90 天：Z = 8.302，P = 0.004）；但常见并发症发生率（37 例，30.58％）低于对照组（80 例，69.57％），差异有统计学意义（χ2 = 35.851，P = 0.000）。结论 基层医院以组织化卒中医疗模式管理和治疗脑卒中，并在康复治疗中辅助中医药和针灸治疗，效果优于传统治疗方法。

关键词: 卒中, 中西医结合, 病人医疗小组, 临床路径, 医院, 区