Post-stroke Antihypertensive Treatment Study (PATS) was a randomized, double-blind and placebo-controlled trial, which aimed at determining whether antihypertensive treatment could reduce the risk of fatal and nonfata...Post-stroke Antihypertensive Treatment Study (PATS) was a randomized, double-blind and placebo-controlled trial, which aimed at determining whether antihypertensive treatment could reduce the risk of fatal and nonfatal stroke incidence in patients with a history of stroke or transient ischemic attack (TLA). 5 665 patients were randomized by a sealed envelope system. Systolic blood pressure (SBP) ranged from 80 to 280 mm Hg and diastolic (DBP) from 50 to 150 mmHg. The average SBP was 154 mmHg and average DBP 93 mmHg. The mean age was 60 years. Among the patients, women accounted for 28%. In 71% the latest stroke was ischemic. Average follow-up approximated to 2 years. The three-year average SBP was 149 mmHg for the placebo group and 144 mmHg for the indapamide treatment group, and the three-year DBP was 89 mmHg and 87 mmHg respectively. The three-year first incidence of fatal and nonfatal stroke was 12.3 per 100 patients placebo treatment and 9.4 per 100 with indapamide. The relative risk by proportional hazards regression analysis was 0.71 (P=0.0009). For deaths from all causes, the relative risk was 0.91. (P>0.05). The findings of this trial indicate that in patients with a history of stroke or TLA, blood pressure reduction of 5 / 2 mmHg with 2.5 mg indapamide reduced the first incidence of fatal and nonfatal stroke by 29%, with three-year absolute benefit of 29 events per 1000 participants.展开更多
目的系统评价运动想象疗法对脑卒中后患者功能康复的效果。方法计算机检索Cochrane Database of Systematic Reviews、MEDLINE、EMbase、PEDro、OpenSIGLE、National Technical Information Service(NTIS)、CNKI、VlP、万方数据库和CBM...目的系统评价运动想象疗法对脑卒中后患者功能康复的效果。方法计算机检索Cochrane Database of Systematic Reviews、MEDLINE、EMbase、PEDro、OpenSIGLE、National Technical Information Service(NTIS)、CNKI、VlP、万方数据库和CBM中关于运动想象疗法改善脑卒中后患者肢体功能障碍的随机对照试验,同时追索纳入文献的参考文献。检索时限均为从建库至2010年10月。由3名研究者根据GRADE系统推荐分级方法,对纳入研究的质量进行严格评价和资料提取,对符合质量标准的RCT进行Meta分析。统计学分析采用RevMan 5.0.25软件和GRAEDpro ler 3.2.2软件。结果共纳入16个RCT。Meta分析四个主要结局的结果显示:Furl-Meyer运动评分量表(FMA)持续8周、6周和4周的运动想象疗法训练对患者上肢运动功能障碍的康复效果与脑卒中后常规康复治疗比较,其差异均有统计学意义[WMD(95%CI)分别为13.89(4.53,23.25)、9.45(3.67,15.23)和7.81(1.96,13.65)],上肢动作研究量表(ARAT)持续6周的运动想象疗法训练对患者上肢运动功能障碍的康复效果与其他脑卒中后康复治疗方法(物理治疗或作业治疗)比较,其差异也有统计学意义[WMD=5.70,95%CI(3.17,8.22),P=0.30]。每个结局的GRADE系统推荐分级均为低等级。结论现有研究显示,运动想象疗法可明显改善患者上肢运动功能,且副作用甚小,操作简便,与脑卒中后其他康复治疗方法相比成本较低,临床医生可将实施运动想象疗法作为强推荐。但鉴于纳入研究较少,样本量小,且质量不高,各研究评价方法变异性较大,并且存在评价时间的不同,故仍需开展大样本、多中心、方法科学和规范的高质量RCT,以求进一步验证运动想象疗法的实施方式与方法对脑卒中后患者肢体功能障碍的康复效果。展开更多
目的观察中医传统功法联合康复治疗对脑卒中恢复期患者轻度抑郁、焦虑及日常生活活动能力(Activity of Daily Living Scale,ADL)功能恢复的影响,为脑卒中后出现轻度抑郁、焦虑的群体提供新的治疗方法,改善其功能,提高其日常生活能力。...目的观察中医传统功法联合康复治疗对脑卒中恢复期患者轻度抑郁、焦虑及日常生活活动能力(Activity of Daily Living Scale,ADL)功能恢复的影响,为脑卒中后出现轻度抑郁、焦虑的群体提供新的治疗方法,改善其功能,提高其日常生活能力。方法选取60例有抑郁、焦虑的脑卒中恢复期患者,将其随机分为观察组30例及对照组30例,所有患者均进行脑卒中后常规康复治疗、康复护理以及健康教育,而观察组在对照组基础上再进行每天1次、每次20 min的传统功法(放松功)训练,连续训练8周。在治疗前、治疗后应用汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD),汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA),巴塞尔指数(Barthel),Fugl-Meyer上、下肢运动功能评估量表(Fugl-Meyer Assessment,FMA)。结果治疗8周后,两组的HAMD、HAMA评分均比治疗前降低(均P<0.05),观察组低于对照组(P<0.05);Barthel指数评分、FMA评分均比治疗前提高(均P<0.05),观察组高于对照组(P<0.05);观察组的HAMD、HAMA量表减分率比对照组明显(P<0.05);观察组HAMD量表中的"抑郁情绪、早醒、工作兴趣减退感、现实解体、全身性症状、能力减退感、绝望感"项目的改善比对照组明显(P<0.05);观察组HAMA量表中的"焦虑体验、紧张感、失眠"项目的改善比对照组明显(P<0.05)。结论传统功法(放松功法)结合康复治疗对脑卒中恢复期患者的抑郁、焦虑不良情绪以及日常生活活动能力的改善有效且效果比单纯的康复治疗明显。展开更多
目的探讨高压氧(HBO)辅助草酸艾司西酞普兰对脑卒中后抑郁(PSD)患者的疗效及血清结合珠蛋白(Hp)、视黄醇结合蛋白4(retinol-binding protein 4,RBP4)表达的影响.方法选取2017年1月至2018年12月青岛市精神卫生中心接受治疗的60例PSD患者...目的探讨高压氧(HBO)辅助草酸艾司西酞普兰对脑卒中后抑郁(PSD)患者的疗效及血清结合珠蛋白(Hp)、视黄醇结合蛋白4(retinol-binding protein 4,RBP4)表达的影响.方法选取2017年1月至2018年12月青岛市精神卫生中心接受治疗的60例PSD患者为研究对象,按照随机双盲抽签法将患者分为对照组和观察组,每组30例.对照组患者给予草酸艾司西酞普兰治疗,观察组在对照组的基础上联合HBO治疗.观察治疗前后2组患者的单胺类神经递质及炎症因子的表达水平,并进行抑郁及神经功能评分;酶联免疫吸附法检测血清Hp及RBP4的表达水平.结果治疗3个月后,观察组单胺类神经递质水平明显升高,炎性因子水平明显下降,且变化幅度均高于对照组,差异均有统计学意义(P<0.05或P<0.01);观察组患者的蒙哥马利抑郁评定量表(MADRS)评分[(9.84±1.08)vs.(31.48±4.06)分]及中国卒中量表(CSS)评分[(10.86±2.06)vs.(23.76±3.87)分]显著降低,且改善情况优于对照组,差异均有统计学意义(P<0.05或P<0.01);观察组患者血清Hp及RBP4水平较治疗前有明显降低,且明显低于对照组,差异均有统计学意义(P<0.05或P<0.01).结论HBO辅助草酸艾司西酞普兰治疗PSD患者,主要通过提高患者血清单胺类神经递质水平,降低炎症因子及血清Hp、血清RBP4水平来改善患者抑郁状态,提高临床疗效.展开更多
OBJECTIVE:To systematically evaluate the curative effect of acupuncture on post-stroke depression(PSD).METHODS:The internet was used to retrieve the Wanfang Medical Data System,Chinese Periodical Net,the Weipu Informa...OBJECTIVE:To systematically evaluate the curative effect of acupuncture on post-stroke depression(PSD).METHODS:The internet was used to retrieve the Wanfang Medical Data System,Chinese Periodical Net,the Weipu Information Resources System,PubMed and the Cochrane Library Database.Relevant articles,up to September 2010,were manually retrieved.These papers included studies that had performed random and semi-random control trials for the use of acupuncture to treat PSD.Fifteen random control tests involving 1096 patients were included in this study and individual cases,interventional measures and curative effects were extracted from this research.Grade methodological quality evaluation and meta-analysis were performed on these studies.RESULTS:Comparison between the acupuncture group and the Western medicine group for the curative rate on PSD revealed an OR of 1.48,95% CI = [1.11 1.97] and P=0.008.Comparison of obviously effective rate shows that OR=1.39,95% CI=[1.08 1.80] and P=0.01.Comparison of effective rate showsthatOR=0.83,95%CI=[0.631.09]andP=0.18.CONCLUSION:Comparison between the acupuncture group and Western medicine group in treating PSD revealed that there is a statistical difference in curative rate and remarkably effective rate,but no difference in effective rate.展开更多
文摘Post-stroke Antihypertensive Treatment Study (PATS) was a randomized, double-blind and placebo-controlled trial, which aimed at determining whether antihypertensive treatment could reduce the risk of fatal and nonfatal stroke incidence in patients with a history of stroke or transient ischemic attack (TLA). 5 665 patients were randomized by a sealed envelope system. Systolic blood pressure (SBP) ranged from 80 to 280 mm Hg and diastolic (DBP) from 50 to 150 mmHg. The average SBP was 154 mmHg and average DBP 93 mmHg. The mean age was 60 years. Among the patients, women accounted for 28%. In 71% the latest stroke was ischemic. Average follow-up approximated to 2 years. The three-year average SBP was 149 mmHg for the placebo group and 144 mmHg for the indapamide treatment group, and the three-year DBP was 89 mmHg and 87 mmHg respectively. The three-year first incidence of fatal and nonfatal stroke was 12.3 per 100 patients placebo treatment and 9.4 per 100 with indapamide. The relative risk by proportional hazards regression analysis was 0.71 (P=0.0009). For deaths from all causes, the relative risk was 0.91. (P>0.05). The findings of this trial indicate that in patients with a history of stroke or TLA, blood pressure reduction of 5 / 2 mmHg with 2.5 mg indapamide reduced the first incidence of fatal and nonfatal stroke by 29%, with three-year absolute benefit of 29 events per 1000 participants.
文摘【目的】评价醒脑开窍针刺法治疗脑卒中后吞咽困难的疗效。【方法】计算机检索中文数据库如中国生物医学文献数据库(CBM)、中国学术文献网络出版总库(CNKI)、中文科技期刊数据库(维普VIP)和万方数据库(Wanfang Data),及外文数据库如Pub Med、Web of Science、EMbase、The Cochrane Library等(从数据库建库到2014年12月)有关醒脑开窍针刺法治疗脑卒中后吞咽困难的随机对照试验(RCT)的文献。由2位评价员按纳入和排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量后,采用Rev Man 5.3.0进行Meta分析。【结果】共纳入8个RCT,涉及766例患者。Meta分析显示:(1)对于恢复期患者,疗程4周的醒脑开窍针刺法联合常规治疗(内科常规治疗或内科常规治疗+吞咽功能训练)总有效率高于不联合治疗组(P<0.01);(2)对于急性期患者,疗程4周的醒脑开窍针刺法联合内科常规治疗与不联合治疗的总有效率无差别(P=0.05);(3)联合醒脑开窍针刺法对肺部并发症作用尚不确定。【结论】醒脑开窍针刺法联合常规治疗(吞咽功能训练、内科治疗)有利于脑卒中恢复期患者的吞咽功能恢复。对于脑卒中后吞咽困难的治疗时机、疗程、并发症等的疗效评估等仍然需要设计合理、报告规范的大规模、高质量的随机对照试验的验证。
文摘目的探讨高压氧(HBO)辅助草酸艾司西酞普兰对脑卒中后抑郁(PSD)患者的疗效及血清结合珠蛋白(Hp)、视黄醇结合蛋白4(retinol-binding protein 4,RBP4)表达的影响.方法选取2017年1月至2018年12月青岛市精神卫生中心接受治疗的60例PSD患者为研究对象,按照随机双盲抽签法将患者分为对照组和观察组,每组30例.对照组患者给予草酸艾司西酞普兰治疗,观察组在对照组的基础上联合HBO治疗.观察治疗前后2组患者的单胺类神经递质及炎症因子的表达水平,并进行抑郁及神经功能评分;酶联免疫吸附法检测血清Hp及RBP4的表达水平.结果治疗3个月后,观察组单胺类神经递质水平明显升高,炎性因子水平明显下降,且变化幅度均高于对照组,差异均有统计学意义(P<0.05或P<0.01);观察组患者的蒙哥马利抑郁评定量表(MADRS)评分[(9.84±1.08)vs.(31.48±4.06)分]及中国卒中量表(CSS)评分[(10.86±2.06)vs.(23.76±3.87)分]显著降低,且改善情况优于对照组,差异均有统计学意义(P<0.05或P<0.01);观察组患者血清Hp及RBP4水平较治疗前有明显降低,且明显低于对照组,差异均有统计学意义(P<0.05或P<0.01).结论HBO辅助草酸艾司西酞普兰治疗PSD患者,主要通过提高患者血清单胺类神经递质水平,降低炎症因子及血清Hp、血清RBP4水平来改善患者抑郁状态,提高临床疗效.
基金Supported by Specific scientific research fund for doctoral points of higher learning institutions of Education Ministry,20094425110005State natural science fund,30772828+1 种基金Guangdong provincial natural science fund,07004846Project in sci-tech plan of sci-tech department of Guangdong province,2008B030301206
文摘OBJECTIVE:To systematically evaluate the curative effect of acupuncture on post-stroke depression(PSD).METHODS:The internet was used to retrieve the Wanfang Medical Data System,Chinese Periodical Net,the Weipu Information Resources System,PubMed and the Cochrane Library Database.Relevant articles,up to September 2010,were manually retrieved.These papers included studies that had performed random and semi-random control trials for the use of acupuncture to treat PSD.Fifteen random control tests involving 1096 patients were included in this study and individual cases,interventional measures and curative effects were extracted from this research.Grade methodological quality evaluation and meta-analysis were performed on these studies.RESULTS:Comparison between the acupuncture group and the Western medicine group for the curative rate on PSD revealed an OR of 1.48,95% CI = [1.11 1.97] and P=0.008.Comparison of obviously effective rate shows that OR=1.39,95% CI=[1.08 1.80] and P=0.01.Comparison of effective rate showsthatOR=0.83,95%CI=[0.631.09]andP=0.18.CONCLUSION:Comparison between the acupuncture group and Western medicine group in treating PSD revealed that there is a statistical difference in curative rate and remarkably effective rate,but no difference in effective rate.
