Construction and Significance of Traditional Chinese Medicine Intervention Model in Patients with Ischemic Stroke in Communities

doi:10.12114/j.issn.1007-9572.2019.00.184

Abstract

Abstract: Background　At present，the community has achieved progress in exploring traditional Chinese medicine （TCM） intervention for stroke patients，but the process of TCM intervention is lack of scientific，standardized and authoritative evidence-based support.And the community lacks a reference process on how to establish TCM intervention model.Objective　To construct a patient-centered secondary TCM prevention model for ischemic stroke，and lay the foundation for the secondary prevention and management of ischemic stroke in the community.Methods　A retrospective study was conducted to summarize current researches on secondary prevention of stroke in China and abroad from CNKI，Wanfang Data Knowledge Service Platform，Web of Science，PubMed Database in August，2018.Expert consultation was carried out in September 2018，and the collection of secondary prevention tools for ischemic stroke at home and abroad was evaluated and screened.Based on the results of expert consultation，the basic framework of TCM intervention model for secondary prevention of ischemic stroke was constructed in October，2018.Results　The Community TCM intervention model for patients with ischemic stroke mainly consisted of three steps.First，TCM health practitioners in communities conducted health education for patients with ischemic stroke，to raise awareness of secondary prevention in the community；second，community health practitioners conducted Essen risk assessment and TCM intervention，and referred suspected patients with recurrent stroke to the hospital；third，after confirming the diagnosis by imaging examination and treating in the general hospital，patients in stable recovery period were referred to the corresponding community health service center，and included in the high risk reservoir management of ischemic stroke recurrence.Conclusion　The establishment of community TCM intervention model in patients with ischemic stroke has formed a practical and feasible implementation scheme，which has realized the patient-centered and rational application of TCM intervention and improved the secondary prevention of ischemic stroke in communities.

Key words: Ischemic stroke, Secondary prevention, Recurrence, TCM therapy, Essen model, Flowcharts

摘要： 背景　目前社区在探索脑卒中患者的中医干预方面已取得诸多成效，但中医干预流程多缺乏科学性、规范性，也缺乏权威循证支撑，同时，社区对于如何建立中医干预模式缺乏可供借鉴的流程。目的　构建以患者为中心的缺血性脑卒中二级预防中医干预模式，为社区缺血性脑卒中二级预防管理工作奠定基础。方法　于2018年8月，检索中国知网、万方数据知识服务平台、Web of Science、PubMed数据库，对国内外缺血性脑卒中二级预防进行检索；于2018年9月，通过开展专家会议咨询，对国内外缺血性脑卒中二级预防工具集合进行评议，并进行筛选；基于专家咨询结果，于2018年10月，构建缺血性脑卒中二级预防中医干预模式基本框架。结果　缺血性脑卒中患者社区中医干预模式主要包括3个步骤。第一，通过社区中医医师对社区缺血性脑卒中患者进行健康宣教，提高社区缺血性脑卒中患者二级预防的意识；第二，由社区中医医师进行Essen风险评估和中医干预，并将疑似再卒中患者向上转诊；第三，通过综合医院的影像学检查进行确诊并进行治疗，治疗后稳定的恢复期患者转诊至相应社区卫生服务中心，并纳入缺血性脑卒中复发高危库管理。结论　缺血性脑卒中患者社区中医干预模式的建立，形成了切实可用的执行方案，实现了以患者为中心，中医干预技术的合理应用，完善了社区缺血性脑卒中二级预防工作。

关键词: 缺血性脑卒中, 二级预防, 复发, 中医疗法, Essen模型, 流程图

TAO Qiongying,TANG Wei. Construction and Significance of Traditional Chinese Medicine Intervention Model in Patients with Ischemic Stroke in Communities　[J]. Chinese General Practice, 2019, 22(20): 2488-2494. DOI: 10.12114/j.issn.1007-9572.2019.00.184.
陶琼英,汤伟. 缺血性脑卒中患者社区中医干预模式的构建与意义研究[J]. 中国全科医学, 2019, 22(20): 2488-2494. DOI: 10.12114/j.issn.1007-9572.2019.00.184.

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