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目的:初步探讨社区干预对脑卒中高危人群的生化指标、中医症状及舌脉的影响,为中医药防治脑卒中提供依据。方法:结合卫计委关于“十二五”医改重大专项“脑卒中高危人群筛查和干预项目”的工作,选取北京市丰台区王佐镇社区卫生服务中心脑卒中高危人群562例,之后对高危人群通过生活方式健康宣教、药物指导、定期复查随访等方面进行社区预防综合干预,观察比较干预前后的生化指标变化及中医症状、舌脉、证类分布的频数特征。结果:社区干预3年后,低密度脂蛋白(LDL-C)水平显著降低(P<0.05),高密度脂蛋白(HDL-C)水平显著升高(P<0.05);按照各症状及舌脉象出现的频次高低排列,出现频率>30%的中医症状及舌脉干预前为12项,干预后为10项。形体肥胖、口唇紫暗、腰膝酸软等检出率干预后显著低于干预前(P<0.01),舌质红、苔薄白等检出率干预后显著低于干预前(P<0.01);脉弱等的检出率干预后明显低于干预前(P<0.01)。结论:脑卒中高危人群社区干预模式有一定效果,对血脂降低有显著影响;气虚血瘀证明显减少,并能有效提高脑卒中发病预警知识的知晓率,改善脑卒中高危人群的生活质量。
OBJECTIVE: To investigate the effects of community intervention on the biochemical indexes, TCM symptoms and tongue veins in high-risk stroke population and provide basis for Chinese medicine in preventing and treating stroke. Methods: In combination with the work of Wei Jian Committee about major projects of “medical reform” and “screening and intervention program of high risk population of stroke”, 562 cases of high risk stroke population in community health service center of Wangzuo Town, Fengtai District, Beijing , Followed by comprehensive community-based intervention in high-risk groups through lifestyle education, drug guidance, regular follow-up and follow-up. The changes of biochemical indexes before and after intervention and the frequency characteristics of TCM symptoms, tongue veins and syndromes were observed and compared. Results: After three years of community intervention, the level of LDL-C decreased significantly (P <0.05) and the level of HDL-C increased significantly (P <0.05). According to the symptoms and tongue The frequency of pulse appearance was arranged in high and low frequency with symptoms of TCM> 30% and 12 before intervention of tongue and 10 after intervention. (P <0.01). The detection rate of tongue red and mossy white were significantly lower than those before intervention (P <0.01) after intervention with the detection rate of physical obesity, dark purple lips, The detection rate of pulse-weakness was significantly lower than that before intervention (P <0.01). CONCLUSION: The community intervention model at high risk of stroke has certain effect, which has a significant effect on the reduction of blood lipid. The deficiency of Qi-deficiency and blood-stasis syndrome is obviously reduced. It can effectively improve the awareness rate of early-warning knowledge of stroke onset and improve the quality of life of high-risk stroke population.