Stroke is the leading cause of mortality and disability in China. Chinese medicine integrated with conventional medicine is current widely used in the prevention and treatment of stroke. A clinical practice guideline for application of integrative medicine in stroke was urgently required. This guideline was developed according to the World Health Organisation Handbook for Guideline Development and the Guideline Development Handbook for Diagnosis and Therapy of Integrative Medicine. The systematic reviews were conducted following the Cochrane handbook. The quality of evidence and strength of recommendations were evaluated using the GRADE approach. The reporting of guideline followed the RIGHT statement. A multi-disciplinary working team was established. Eleven research questions from 15 clinical questions were identified by questionnaire surveys, face-to-face meetings, and analysis by the working team. Fourteen recommendations regarding integrative medicine for ischaemic stroke, haemorrhagic stroke, and complications of stroke were formulated from systematic reviews of the benefits, harms, cost-effectiveness, quality of evidence, the values and preferences of patients and their family members, feedback on proposed recommendations from medical practitioners from a variety of disciplines, and a face-to-face consensus meeting. This guideline focuses on clinical treatments that are specific to integrative medicine for stroke and can be used by medical practitioners at all levels in medical institutions and rehabilitation facilities.
Citation: Neurology Chapter of China Association of Chinese Medicine, Neurology Committee of Guangdong Provincial Association of Chinese Medicine, Stroke Committee of Guangdong Provincial Association of Chinese Integrative Medicine. Evidence-based practice guideline on integrative medicine for stroke 2019. Chinese Journal of Evidence-Based Medicine, 2020, 20(8): 901-912. doi: 10.7507/1672-2531.202001075 Copy
1. | GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 2017, 390(10100): 1151-1210. |
2. | GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol, 2019, 18(5): 459-480. |
3. | Wu S, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol, 2019, 18(4): 394-405. |
4. | 王陇德, 刘建民, 杨弋, 等. 我国脑卒中防治仍面临巨大挑战—《中国脑卒中防治报告2018》概要. 中国循环杂志, 2019, 34(2): 105-119. |
5. | 巢宝华, 刘建民, 王伊龙, 等. 中国脑卒中防治: 成就, 挑战和应对. 中国循环杂志, 2019, 34(7): 625-631. |
6. | Kim AS, Cahill E, Cheng NT. Global stroke belt: geographic variation in stroke burden worldwide. Stroke, 2015, 46(12): 3564-3570. |
7. | 袁晶, 朱以诚, 姚明, 等. 急性卒中患者中药服用情况横断面调查. 中华神经科杂志, 2015, 48(4): 284-287. |
8. | 中国脑卒中医疗质量评估(QUEST)协作组. 中国急性缺血性脑卒中治疗现状. 中华神经科杂志, 2009, 42(4): 223-228. |
9. | 文碧玲, 贾春生, 刘炜宏, 等. 近10年来针灸学术的发展与思考. 中国针灸, 2009, 29(12): 949-954. |
10. | 毛忠南, 何天有, 雒成林. 从康复角度看脑卒中的针刺治疗. 中国针灸, 2014, 34(3): 293-296. |
11. | Institute of Medicine (US) Committee on Standards for Developing Trustworthy Clinical Practice Guidelines. Clinical practice guidelines we can trust. Washington (DC): National Academies Press (US), 2011. |
12. | Grilli R, Magrini N, Penna A, et al. Practice guidelines developed by specialty societies: the need for a critical appraisal. Lancet, 2000, 355(9198): 103-106. |
13. | Intercollegiate Stroke Working Party (UK). National clinical guideline for stroke. Fifth edition. London: Royal College of Physicians, 2016. |
14. | 中华医学会神经病学分会. 2016版中国脑血管病诊治指南与共识. 北京: 人民卫生出版社, 2016. |
15. | World Health Organization. WHO handbook for guideline development, 2nd ed. Available from: https://apps.who.int/iris/handle/10665/145714. |
16. | 卢传坚, 杨克虎. 中西医结合诊疗指南制定手册. 北京: 人民卫生出版社, 2016. |
17. | Chen Y, Yang K, Marušic A, et al. A reporting tool for practice guidelines in health care: the RIGHT statement. Ann Intern Med, 2017, 166(2): 128-132. |
18. | Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care. J Clin Epidemiol, 2010, 63(12): 1308-1311. |
19. | Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol, 2007, 7: 10. |
20. | Pollock M, Fernandes RM, Hartling L. Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions. BMC Med Res Methodol, 2017, 17(1): 48. |
21. | Higgins JPT, Green S (editors). Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration, 2011. Available from: www.cochrane-handbook.org. |
22. | Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926. |
23. | Schünemann H, Brożek J, Guyatt G, et al. GRADE handbook. The GRADE Working Group. Available from: www.guidelinedevelopment.org/handbook. |
24. | 陈耀龙, 姚亮, Susan Norris, 等. GRADE在系统评价中应用的必要性及注意事项. 中国循证医学杂志, 2013, 13(12): 1401-1404. |
25. | Zhang Y, Coello PA, Brożek J, et al. Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach. Health Qual Life Outcomes, 2017, 15(1): 52. |
26. | 解染, 陈耀龙, 陈昊, 等. 循证指南制定中患者价值观和偏好的研究方法. 中国循证医学杂志, 2015, 15(5): 586-591. |
27. | Vernooij RW, Alonso-Coello P, Brouwers M, et al. Reporting items for updated clinical guidelines: checklist for the reporting of updated guidelines (CheckUp). PLoS Med, 2017, 14(1): e1002207. |
28. | GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol, 2019, 18(5): 439-458. |
29. | 秦海强. 缺血性卒中患者在中国独特的管理模式—来自国家卒中数据库. 中华医学会第十八次全国神经病学学术会议论文汇编(下), 2015: 125. |
30. | Brott T, Adams HP Jr, Olinger CP, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke, 1989, 20(7): 864-870. |
31. | 常思远, 许予明. NIHSS的再评价. 神经损伤与功能重建, 2011, 6(4): 305-308. |
32. | Li JG, Wang LQ, Yang XY, et al. Chinese herbal medicine Dengzhan Xixin injection for acute ischemic stroke: a systematic review and meta-analysis of randomised controlled trials. Complement Ther Med, 2017, 34: 74-85. |
33. | Liu XT, Ren PW, Peng L, et al. Effectiveness and safety of ShenXiong glucose injection for acute ischemic stroke: a systematic review and GRADE approach. BMC Complement Altern Med, 2016, 16: 68. |
34. | 董雯. 补阳还五汤治疗脑梗死不同分期的Meta分析. 西安: 第四军医大学, 2016. |
35. | 刘施, 吴嘉瑞, 蔺梦娟, 等. 基于Meta分析的注射用丹参多酚酸盐治疗急性脑梗死临床评价研究. 药物流行病学杂志, 2017, 26(4): 248-255. |
36. | 刘施, 吴嘉瑞, 张丹, 等. 基于Meta分析的注射用复方丹参注射液治疗急性脑梗死临床评价研究. 药物流行病学杂志, 2017, 26(7): 465-470. |
37. | 刘施, 吴嘉瑞, 段笑娇, 等. 基于Meta分析的丹参酮Ⅱ_A磺酸钠注射液治疗急性脑梗死临床评价研究. 药物流行病学杂志, 2017, 26(12): 803-808. |
38. | 齐家. 三七制剂治疗急性中风临床疗效的系统评价. 北京: 北京中医药大学, 2016. |
39. | Tan D, Wu J, Liu S, et al. Injections of ginkgo in the treatment of cerebral infarction: a systematic review and network meta-analysis. J Tradit Chin Med, 2018, 38(1): 1-11. |
40. | 郑欢. 通腑法治疗急性缺血性脑卒中疗效的Meta分析. 武汉: 湖北中医药大学, 2016. |
41. | Wang P, Wang Y, Zhao X, et al. In-hospital medical complications associated with stroke recurrence after initial ischemic stroke: A prospective cohort study from the China National Stroke Registry. Medicine (Baltimore), 2016, 95(37): e4929. |
42. | He Q, Wu C, Guo W, et al. Hospital-based study of the frequency and risk factors of stroke recurrence in two years in China. J Stroke Cerebrovasc Dis, 2017, 26(11): 2494-2500. |
43. | Yang XY, Wang LQ, Li JG, et al. Chinese herbal medicine Dengzhan Shengmai capsule as adjunctive treatment for ischemic stroke: a systematic review and meta-analysis of randomized clinical trials. Complement Ther Med, 2018, 36: 82-89. |
44. | Jiang B, Sun H, Ru X, et al. Prevalence, incidence, prognosis, early stroke risk, and stroke-related prognostic factors of definite or probable transient ischemic attacks in China, 2013. Front Neurol, 2017, 8: 309. |
45. | 廖映迪, 刘文琛, 倪小佳, 等. 中药防治短暂性脑缺血发作的系统评价与meta分析. 中国卒中学会第五届学术年会暨天坛国际脑血管病会议2019 论文汇编CSA&TISC 2019专刊, 2019, 13(6): 755. |
46. | Furie KL, Jayaraman MV. 2018 guidelines for the early management of patients with acute ischemic stroke. Stroke, 2018, 49(3): 509-510. |
47. | Kidwell CS, Saver JL, Carneado J, et al. Predictors of hemorrhagic transformation in patients receiving intra-arterial thrombolysis. Stroke, 2002, 33(3): 717-724. |
48. | 李江, 励勇, 陈芙庭, 等. 急性缺血性脑卒中溶栓后脑出血. 中华神经医学杂志, 2014, 13(7): 746-748. |
49. | 张晓燕, 苏玲, 胡嘉坤, 等. 中西医结合治疗急性脑梗死的临床观察. 航空航天医学杂志, 2014, 25(1): 39-40. |
50. | 黄水明. 益气活血法联合动脉溶栓治疗急性脑梗死临床研究. 广州: 广州中医药大学, 2012. |
51. | 贾世杰, 王辉, 张新广, 等. 血府逐瘀汤联合阿替普酶静脉溶栓对急性脑梗死患者神经功能及血清炎性因子水平的影响. 临床合理用药杂志, 2015, 8(7): 52-53. |
52. | 于荣. 疏血通注射液联合阿替普酶治疗急性脑梗死疗效观察. 陕西中医, 2017, 38(7): 855-856. |
53. | 孟庆阳, 李爱华, 劳万升. 三七粉联合尿激酶溶栓治疗脑梗死患者的疗效观察. 癫痫与神经电生理学杂志, 2018, 27(2): 97-100. |
54. | 梁思杰, 颜冬润, 余恒旺, 等. 动脉溶栓后辅以中药治疗急性脑梗死的短期疗效观察. 中国脑血管病杂志, 2008, 5(4): 182-183. |
55. | 林润锋, 黄玉明, 林英健, 等. 丹参注射液辅助尿激酶在急性脑梗死动脉溶栓治疗中的疗效研究. 吉林中医药, 2013, 33(5): 480-481. |
56. | 董刚, 贾洪刚. 补阳还五汤联合重组人组织型纤溶酶原激活物静脉溶栓治疗脑梗死的研究. 中华全科医学, 2018, 16(3): 470-472. |
57. | 冯爱花, 陈利. 白芍总苷胶囊结合尿激酶治疗急性缺血性脑梗死临床研究. 国际中医中药杂志, 2017, 39(1): 13-16. |
58. | 宗志涛. 阿替普酶溶栓联合清脑通脉汤治疗超早期急性脑梗死患者的疗效观察. 中国当代医药, 2017, 24(36): 10-12+19. |
59. | 刘丽娜. t-PA静脉溶栓合用麝香四黄颗粒治疗缺血性卒中急性期痰热腑实证临床观察. 济南: 山东中医药大学, 2016. |
60. | Ji B, Zhou F, Han L, et al. Sodium tanshinone ⅡA sulfonate enhances effectiveness Rt-PA treatment in acute ischemic stroke patients associated with ameliorating blood-brain barrier damage. Transl Stroke Res, 2017, 8(4): 334-340. |
61. | Sussman ES, Connolly ES Jr. Hemorrhagic transformation: a review of the rate of hemorrhage in the major clinical trials of acute ischemic stroke. Front Neurol, 2013, 4: 69. |
62. | 邓小东. 中风醒脑液治疗脑梗死出血性转化的多中心随机对照临床试验. 成都: 成都中医药大学, 2012. |
63. | 贾翔. 益气活血化瘀法治疗急性脑梗死后出血转化的临床疗效观察. 中西医结合心脑血管病杂志, 2017, 15(19): 2466-2468. |
64. | van Asch CJ, Luitse MJ, Rinkel GJ, et al. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol, 2010, 9(2): 167-176. |
65. | 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国脑出血诊治指南(2014). 中华神经科杂志, 2015, 48(6): 435-444. |
66. | Li HQ, Wei JJ, Xia W, et al. Promoting blood circulation for removing blood stasis therapy for acute intracerebral hemorrhage: a systematic review and meta-analysis. Acta Pharmacol Sin, 2015, 36(6): 659-675. |
67. | Xu D, Huang P, Yu Z, et al. Efficacy and safety of panax notoginseng saponin therapy for acute intracerebral hemorrhage, meta-analysis, and mini review of potential mechanisms of action. Front Neurol, 2015, 5: 274. |
68. | Wu L, Li Y, Wang X, et al. A systematic review and meta-analysis on the treatment of cerebral hemorrhage with NaoXueShu oral liquid. Biomed Res Int, 2017, 2017: 8542576. |
69. | Vespa P, Hanley D, Betz J, et al. ICES (Intraoperative Stereotactic Computed Tomography-Guided Endoscopic Surgery) for brain hemorrhage: a multicenter randomized controlled trial. Stroke, 2016, 47(11): 2749-2755. |
70. | Hanley DF, Thompson RE, Muschelli J, et al. Safety and efficacy of minimally invasive surgery plus alteplase in intracerebral haemorrhage evacuation (MISTIE): a randomised, controlled, open-label, phase 2 trial. Lancet Neurol, 2016, 15(12): 1228-1237. |
71. | 周粤湘, 倪小佳, 朱庆斌, 等. 活血化瘀中药干预高血压脑出血术后患者的疗效及安全性的系统评价. 中华中医药学会脑病分会2019年学术年会暨全国中医脑病国医大师暨名家学术经验传承研讨会论文汇编, 2019. |
72. | Dromerick A, Reding M. Medical and neurological complications during inpatient stroke rehabilitation. Stroke, 1994, 25(2): 358-361. |
73. | Tong X, Kuklina EV, Gillespie C, et al. Medical complications among hospitalizations for ischemic stroke in the United States from 1998 to 2007. Stroke, 2010, 41(5): 980-986. |
74. | Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet, 1974, 2(7872): 81-84. |
75. | 田超, 袁梦晨, 王晓峰, 等. 醒脑开窍药治疗中风病实验研究进展. 中西医结合心脑血管病杂志, 2018, 16(15): 2158-2161. |
76. | 廖文静, 冯曼莎, 倪小佳, 等. 安宫牛黄丸治疗卒中合并意识障碍的系统评价与Meta分析. 2018年中国中西医结合学会第12届循证医学会议, 2018. |
77. | Ma X, Yang YX, Chen N, et al. Meta-analysis for clinical evaluation of Xingnaojing injection for the treatment of cerebral infarction. Front Pharmacol, 2017, 8: 485. |
78. | 张芬, 郑艳, 庄凤娟. 醒脑静注射液联合盐酸纳洛酮注射液治疗急性脑出血伴昏迷患者疗效的Meta分析. 中国医药导报, 2017, 14(23): 13-17. |
79. | Barer DH. The natural history and functional consequences of dysphagia after hemispheric stroke. J Neurol Neurosurg Psychiatry, 1989, 52(2): 236-241. |
80. | Meng NH, Wang TG, Lien IN. Dysphagia in patients with brainstem stroke: incidence and outcome. Am J Phys Med Rehabil, 2000, 79(2): 170-175. |
81. | Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest, 2003, 124(1): 328-336. |
82. | Sharma JC, Fletcher S, Vassallo M, et al. What influences outcome of stroke--pyrexia or dysphagia? Int J Clin Pract, 2001, 55(1): 17-20. |
83. | Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke, 2005, 36(12): 2756-2763. |
84. | Ye Q, Xie Y, Shi J, et al. Systematic review on acupuncture for treatment of dysphagia after stroke. Evid Based Complement Alternat Med, 2017, 2017: 6421852. |
85. | 林少琴, 刘玲玲, 王慧敏, 等. 中药治疗卒中后吞咽障碍的有效性和安全性: 一项采用GRADE方法进行的系统评价及Meta分析. 中华中医药学会脑病分会2019年学术年会暨全国中医脑病国医大师暨名家学术经验传承研讨会论文汇编, 2019. |
86. | Hackett ML, Pickles K. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. Int J Stroke, 2014, 9(8): 1017-1025. |
87. | Wang Z, Zhu M, Su Z, et al. Post-stroke depression: different characteristics based on follow-up stage and gender-a cohort perspective study from Mainland China. Neurol Res, 2017, 39(11): 996-1005. |
88. | Moncrieff J, Kirsch I. Empirically derived criteria cast doubt on the clinical significance of antidepressant-placebo differences. Contemp Clin Trials, 2015, 43: 60-62. |
89. | Zeng LF, Cao Y, Wang L, et al. Role of medicinal plants for liver-Qi regulation adjuvant therapy in post-stroke depression: a systematic review of literature. Phytother Res, 2017, 31(1): 40-52. |
90. | 高长玉, 吴成翰, 赵建国, 等. 中国脑梗死中西医结合诊治指南(2017). 中国中西医结合杂志, 2018, 38(2): 136-144. |
- 1. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 2017, 390(10100): 1151-1210.
- 2. GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol, 2019, 18(5): 459-480.
- 3. Wu S, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol, 2019, 18(4): 394-405.
- 4. 王陇德, 刘建民, 杨弋, 等. 我国脑卒中防治仍面临巨大挑战—《中国脑卒中防治报告2018》概要. 中国循环杂志, 2019, 34(2): 105-119.
- 5. 巢宝华, 刘建民, 王伊龙, 等. 中国脑卒中防治: 成就, 挑战和应对. 中国循环杂志, 2019, 34(7): 625-631.
- 6. Kim AS, Cahill E, Cheng NT. Global stroke belt: geographic variation in stroke burden worldwide. Stroke, 2015, 46(12): 3564-3570.
- 7. 袁晶, 朱以诚, 姚明, 等. 急性卒中患者中药服用情况横断面调查. 中华神经科杂志, 2015, 48(4): 284-287.
- 8. 中国脑卒中医疗质量评估(QUEST)协作组. 中国急性缺血性脑卒中治疗现状. 中华神经科杂志, 2009, 42(4): 223-228.
- 9. 文碧玲, 贾春生, 刘炜宏, 等. 近10年来针灸学术的发展与思考. 中国针灸, 2009, 29(12): 949-954.
- 10. 毛忠南, 何天有, 雒成林. 从康复角度看脑卒中的针刺治疗. 中国针灸, 2014, 34(3): 293-296.
- 11. Institute of Medicine (US) Committee on Standards for Developing Trustworthy Clinical Practice Guidelines. Clinical practice guidelines we can trust. Washington (DC): National Academies Press (US), 2011.
- 12. Grilli R, Magrini N, Penna A, et al. Practice guidelines developed by specialty societies: the need for a critical appraisal. Lancet, 2000, 355(9198): 103-106.
- 13. Intercollegiate Stroke Working Party (UK). National clinical guideline for stroke. Fifth edition. London: Royal College of Physicians, 2016.
- 14. 中华医学会神经病学分会. 2016版中国脑血管病诊治指南与共识. 北京: 人民卫生出版社, 2016.
- 15. World Health Organization. WHO handbook for guideline development, 2nd ed. Available from: https://apps.who.int/iris/handle/10665/145714.
- 16. 卢传坚, 杨克虎. 中西医结合诊疗指南制定手册. 北京: 人民卫生出版社, 2016.
- 17. Chen Y, Yang K, Marušic A, et al. A reporting tool for practice guidelines in health care: the RIGHT statement. Ann Intern Med, 2017, 166(2): 128-132.
- 18. Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ: advancing guideline development, reporting and evaluation in health care. J Clin Epidemiol, 2010, 63(12): 1308-1311.
- 19. Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol, 2007, 7: 10.
- 20. Pollock M, Fernandes RM, Hartling L. Evaluation of AMSTAR to assess the methodological quality of systematic reviews in overviews of reviews of healthcare interventions. BMC Med Res Methodol, 2017, 17(1): 48.
- 21. Higgins JPT, Green S (editors). Cochrane handbook for systematic reviews of interventions version 5.1.0. The Cochrane Collaboration, 2011. Available from: www.cochrane-handbook.org.
- 22. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650): 924-926.
- 23. Schünemann H, Brożek J, Guyatt G, et al. GRADE handbook. The GRADE Working Group. Available from: www.guidelinedevelopment.org/handbook.
- 24. 陈耀龙, 姚亮, Susan Norris, 等. GRADE在系统评价中应用的必要性及注意事项. 中国循证医学杂志, 2013, 13(12): 1401-1404.
- 25. Zhang Y, Coello PA, Brożek J, et al. Using patient values and preferences to inform the importance of health outcomes in practice guideline development following the GRADE approach. Health Qual Life Outcomes, 2017, 15(1): 52.
- 26. 解染, 陈耀龙, 陈昊, 等. 循证指南制定中患者价值观和偏好的研究方法. 中国循证医学杂志, 2015, 15(5): 586-591.
- 27. Vernooij RW, Alonso-Coello P, Brouwers M, et al. Reporting items for updated clinical guidelines: checklist for the reporting of updated guidelines (CheckUp). PLoS Med, 2017, 14(1): e1002207.
- 28. GBD 2016 Stroke Collaborators. Global, regional, and national burden of stroke, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol, 2019, 18(5): 439-458.
- 29. 秦海强. 缺血性卒中患者在中国独特的管理模式—来自国家卒中数据库. 中华医学会第十八次全国神经病学学术会议论文汇编(下), 2015: 125.
- 30. Brott T, Adams HP Jr, Olinger CP, et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke, 1989, 20(7): 864-870.
- 31. 常思远, 许予明. NIHSS的再评价. 神经损伤与功能重建, 2011, 6(4): 305-308.
- 32. Li JG, Wang LQ, Yang XY, et al. Chinese herbal medicine Dengzhan Xixin injection for acute ischemic stroke: a systematic review and meta-analysis of randomised controlled trials. Complement Ther Med, 2017, 34: 74-85.
- 33. Liu XT, Ren PW, Peng L, et al. Effectiveness and safety of ShenXiong glucose injection for acute ischemic stroke: a systematic review and GRADE approach. BMC Complement Altern Med, 2016, 16: 68.
- 34. 董雯. 补阳还五汤治疗脑梗死不同分期的Meta分析. 西安: 第四军医大学, 2016.
- 35. 刘施, 吴嘉瑞, 蔺梦娟, 等. 基于Meta分析的注射用丹参多酚酸盐治疗急性脑梗死临床评价研究. 药物流行病学杂志, 2017, 26(4): 248-255.
- 36. 刘施, 吴嘉瑞, 张丹, 等. 基于Meta分析的注射用复方丹参注射液治疗急性脑梗死临床评价研究. 药物流行病学杂志, 2017, 26(7): 465-470.
- 37. 刘施, 吴嘉瑞, 段笑娇, 等. 基于Meta分析的丹参酮Ⅱ_A磺酸钠注射液治疗急性脑梗死临床评价研究. 药物流行病学杂志, 2017, 26(12): 803-808.
- 38. 齐家. 三七制剂治疗急性中风临床疗效的系统评价. 北京: 北京中医药大学, 2016.
- 39. Tan D, Wu J, Liu S, et al. Injections of ginkgo in the treatment of cerebral infarction: a systematic review and network meta-analysis. J Tradit Chin Med, 2018, 38(1): 1-11.
- 40. 郑欢. 通腑法治疗急性缺血性脑卒中疗效的Meta分析. 武汉: 湖北中医药大学, 2016.
- 41. Wang P, Wang Y, Zhao X, et al. In-hospital medical complications associated with stroke recurrence after initial ischemic stroke: A prospective cohort study from the China National Stroke Registry. Medicine (Baltimore), 2016, 95(37): e4929.
- 42. He Q, Wu C, Guo W, et al. Hospital-based study of the frequency and risk factors of stroke recurrence in two years in China. J Stroke Cerebrovasc Dis, 2017, 26(11): 2494-2500.
- 43. Yang XY, Wang LQ, Li JG, et al. Chinese herbal medicine Dengzhan Shengmai capsule as adjunctive treatment for ischemic stroke: a systematic review and meta-analysis of randomized clinical trials. Complement Ther Med, 2018, 36: 82-89.
- 44. Jiang B, Sun H, Ru X, et al. Prevalence, incidence, prognosis, early stroke risk, and stroke-related prognostic factors of definite or probable transient ischemic attacks in China, 2013. Front Neurol, 2017, 8: 309.
- 45. 廖映迪, 刘文琛, 倪小佳, 等. 中药防治短暂性脑缺血发作的系统评价与meta分析. 中国卒中学会第五届学术年会暨天坛国际脑血管病会议2019 论文汇编CSA&TISC 2019专刊, 2019, 13(6): 755.
- 46. Furie KL, Jayaraman MV. 2018 guidelines for the early management of patients with acute ischemic stroke. Stroke, 2018, 49(3): 509-510.
- 47. Kidwell CS, Saver JL, Carneado J, et al. Predictors of hemorrhagic transformation in patients receiving intra-arterial thrombolysis. Stroke, 2002, 33(3): 717-724.
- 48. 李江, 励勇, 陈芙庭, 等. 急性缺血性脑卒中溶栓后脑出血. 中华神经医学杂志, 2014, 13(7): 746-748.
- 49. 张晓燕, 苏玲, 胡嘉坤, 等. 中西医结合治疗急性脑梗死的临床观察. 航空航天医学杂志, 2014, 25(1): 39-40.
- 50. 黄水明. 益气活血法联合动脉溶栓治疗急性脑梗死临床研究. 广州: 广州中医药大学, 2012.
- 51. 贾世杰, 王辉, 张新广, 等. 血府逐瘀汤联合阿替普酶静脉溶栓对急性脑梗死患者神经功能及血清炎性因子水平的影响. 临床合理用药杂志, 2015, 8(7): 52-53.
- 52. 于荣. 疏血通注射液联合阿替普酶治疗急性脑梗死疗效观察. 陕西中医, 2017, 38(7): 855-856.
- 53. 孟庆阳, 李爱华, 劳万升. 三七粉联合尿激酶溶栓治疗脑梗死患者的疗效观察. 癫痫与神经电生理学杂志, 2018, 27(2): 97-100.
- 54. 梁思杰, 颜冬润, 余恒旺, 等. 动脉溶栓后辅以中药治疗急性脑梗死的短期疗效观察. 中国脑血管病杂志, 2008, 5(4): 182-183.
- 55. 林润锋, 黄玉明, 林英健, 等. 丹参注射液辅助尿激酶在急性脑梗死动脉溶栓治疗中的疗效研究. 吉林中医药, 2013, 33(5): 480-481.
- 56. 董刚, 贾洪刚. 补阳还五汤联合重组人组织型纤溶酶原激活物静脉溶栓治疗脑梗死的研究. 中华全科医学, 2018, 16(3): 470-472.
- 57. 冯爱花, 陈利. 白芍总苷胶囊结合尿激酶治疗急性缺血性脑梗死临床研究. 国际中医中药杂志, 2017, 39(1): 13-16.
- 58. 宗志涛. 阿替普酶溶栓联合清脑通脉汤治疗超早期急性脑梗死患者的疗效观察. 中国当代医药, 2017, 24(36): 10-12+19.
- 59. 刘丽娜. t-PA静脉溶栓合用麝香四黄颗粒治疗缺血性卒中急性期痰热腑实证临床观察. 济南: 山东中医药大学, 2016.
- 60. Ji B, Zhou F, Han L, et al. Sodium tanshinone ⅡA sulfonate enhances effectiveness Rt-PA treatment in acute ischemic stroke patients associated with ameliorating blood-brain barrier damage. Transl Stroke Res, 2017, 8(4): 334-340.
- 61. Sussman ES, Connolly ES Jr. Hemorrhagic transformation: a review of the rate of hemorrhage in the major clinical trials of acute ischemic stroke. Front Neurol, 2013, 4: 69.
- 62. 邓小东. 中风醒脑液治疗脑梗死出血性转化的多中心随机对照临床试验. 成都: 成都中医药大学, 2012.
- 63. 贾翔. 益气活血化瘀法治疗急性脑梗死后出血转化的临床疗效观察. 中西医结合心脑血管病杂志, 2017, 15(19): 2466-2468.
- 64. van Asch CJ, Luitse MJ, Rinkel GJ, et al. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol, 2010, 9(2): 167-176.
- 65. 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国脑出血诊治指南(2014). 中华神经科杂志, 2015, 48(6): 435-444.
- 66. Li HQ, Wei JJ, Xia W, et al. Promoting blood circulation for removing blood stasis therapy for acute intracerebral hemorrhage: a systematic review and meta-analysis. Acta Pharmacol Sin, 2015, 36(6): 659-675.
- 67. Xu D, Huang P, Yu Z, et al. Efficacy and safety of panax notoginseng saponin therapy for acute intracerebral hemorrhage, meta-analysis, and mini review of potential mechanisms of action. Front Neurol, 2015, 5: 274.
- 68. Wu L, Li Y, Wang X, et al. A systematic review and meta-analysis on the treatment of cerebral hemorrhage with NaoXueShu oral liquid. Biomed Res Int, 2017, 2017: 8542576.
- 69. Vespa P, Hanley D, Betz J, et al. ICES (Intraoperative Stereotactic Computed Tomography-Guided Endoscopic Surgery) for brain hemorrhage: a multicenter randomized controlled trial. Stroke, 2016, 47(11): 2749-2755.
- 70. Hanley DF, Thompson RE, Muschelli J, et al. Safety and efficacy of minimally invasive surgery plus alteplase in intracerebral haemorrhage evacuation (MISTIE): a randomised, controlled, open-label, phase 2 trial. Lancet Neurol, 2016, 15(12): 1228-1237.
- 71. 周粤湘, 倪小佳, 朱庆斌, 等. 活血化瘀中药干预高血压脑出血术后患者的疗效及安全性的系统评价. 中华中医药学会脑病分会2019年学术年会暨全国中医脑病国医大师暨名家学术经验传承研讨会论文汇编, 2019.
- 72. Dromerick A, Reding M. Medical and neurological complications during inpatient stroke rehabilitation. Stroke, 1994, 25(2): 358-361.
- 73. Tong X, Kuklina EV, Gillespie C, et al. Medical complications among hospitalizations for ischemic stroke in the United States from 1998 to 2007. Stroke, 2010, 41(5): 980-986.
- 74. Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet, 1974, 2(7872): 81-84.
- 75. 田超, 袁梦晨, 王晓峰, 等. 醒脑开窍药治疗中风病实验研究进展. 中西医结合心脑血管病杂志, 2018, 16(15): 2158-2161.
- 76. 廖文静, 冯曼莎, 倪小佳, 等. 安宫牛黄丸治疗卒中合并意识障碍的系统评价与Meta分析. 2018年中国中西医结合学会第12届循证医学会议, 2018.
- 77. Ma X, Yang YX, Chen N, et al. Meta-analysis for clinical evaluation of Xingnaojing injection for the treatment of cerebral infarction. Front Pharmacol, 2017, 8: 485.
- 78. 张芬, 郑艳, 庄凤娟. 醒脑静注射液联合盐酸纳洛酮注射液治疗急性脑出血伴昏迷患者疗效的Meta分析. 中国医药导报, 2017, 14(23): 13-17.
- 79. Barer DH. The natural history and functional consequences of dysphagia after hemispheric stroke. J Neurol Neurosurg Psychiatry, 1989, 52(2): 236-241.
- 80. Meng NH, Wang TG, Lien IN. Dysphagia in patients with brainstem stroke: incidence and outcome. Am J Phys Med Rehabil, 2000, 79(2): 170-175.
- 81. Marik PE, Kaplan D. Aspiration pneumonia and dysphagia in the elderly. Chest, 2003, 124(1): 328-336.
- 82. Sharma JC, Fletcher S, Vassallo M, et al. What influences outcome of stroke--pyrexia or dysphagia? Int J Clin Pract, 2001, 55(1): 17-20.
- 83. Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke, 2005, 36(12): 2756-2763.
- 84. Ye Q, Xie Y, Shi J, et al. Systematic review on acupuncture for treatment of dysphagia after stroke. Evid Based Complement Alternat Med, 2017, 2017: 6421852.
- 85. 林少琴, 刘玲玲, 王慧敏, 等. 中药治疗卒中后吞咽障碍的有效性和安全性: 一项采用GRADE方法进行的系统评价及Meta分析. 中华中医药学会脑病分会2019年学术年会暨全国中医脑病国医大师暨名家学术经验传承研讨会论文汇编, 2019.
- 86. Hackett ML, Pickles K. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. Int J Stroke, 2014, 9(8): 1017-1025.
- 87. Wang Z, Zhu M, Su Z, et al. Post-stroke depression: different characteristics based on follow-up stage and gender-a cohort perspective study from Mainland China. Neurol Res, 2017, 39(11): 996-1005.
- 88. Moncrieff J, Kirsch I. Empirically derived criteria cast doubt on the clinical significance of antidepressant-placebo differences. Contemp Clin Trials, 2015, 43: 60-62.
- 89. Zeng LF, Cao Y, Wang L, et al. Role of medicinal plants for liver-Qi regulation adjuvant therapy in post-stroke depression: a systematic review of literature. Phytother Res, 2017, 31(1): 40-52.
- 90. 高长玉, 吴成翰, 赵建国, 等. 中国脑梗死中西医结合诊治指南(2017). 中国中西医结合杂志, 2018, 38(2): 136-144.