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
Copyright ? the editorial department of Chinese Journal of Evidence-Based Medicine of West China Medical Publisher. All rights reserved
| 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. | 王隴德, 劉建民, 楊弋, 等. 我國腦卒中防治仍面臨巨大挑戰—《中國腦卒中防治報告2018》概要. 中國循環雜志, 2019, 34(2): 105-119. |
| 5. | 巢寶華, 劉建民, 王伊龍, 等. 中國腦卒中防治: 成就, 挑戰和應對. 中國循環雜志, 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, 朱以誠, 姚明, 等. 急性卒中患者中藥服用情況橫斷面調查. 中華神經科雜志, 2015, 48(4): 284-287. |
| 8. | 中國腦卒中醫療質量評估(QUEST)協作組. 中國急性缺血性腦卒中治療現狀. 中華神經科雜志, 2009, 42(4): 223-228. |
| 9. | 文碧玲, 賈春生, 劉煒宏, 等. 近10年來針灸學術的發展與思考. 中國針灸, 2009, 29(12): 949-954. |
| 10. | 毛忠南, 何天有, 雒成林. 從康復角度看腦卒中的針刺治療. 中國針灸, 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. | 中華醫學會神經病學分會. 2016版中國腦血管病診治指南與共識. 北京: 人民衛生出版社, 2016. |
| 15. | World Health Organization. WHO handbook for guideline development, 2nd ed. Available from: https://apps.who.int/iris/handle/10665/145714. |
| 16. | 盧傳堅, 楊克虎. 中西醫結合診療指南制定手冊. 北京: 人民衛生出版社, 2016. |
| 17. | Chen Y, Yang K, Maru?ic 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. | 陳耀龍, 姚亮, Susan Norris, 等. GRADE在系統評價中應用的必要性及注意事項. 中國循證醫學雜志, 2013, 13(12): 1401-1404. |
| 25. | Zhang Y, Coello PA, Bro?ek 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, 陳耀龍, 陳昊, 等. 循證指南制定中患者價值觀和偏好的研究方法. 中國循證醫學雜志, 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. | 秦海強. 缺血性卒中患者在中國獨特的管理模式—來自國家卒中數據庫. 中華醫學會第十八次全國神經病學學術會議論文匯編(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. | 常思遠, 許予明. NIHSS的再評價. 神經損傷與功能重建, 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. 補陽還五湯治療腦梗死不同分期的Meta分析. 西安: 第四軍醫大學, 2016. |
| 35. | 劉施, 吳嘉瑞, 藺夢娟, 等. 基于Meta分析的注射用丹參多酚酸鹽治療急性腦梗死臨床評價研究. 藥物流行病學雜志, 2017, 26(4): 248-255. |
| 36. | 劉施, 吳嘉瑞, 張丹, 等. 基于Meta分析的注射用復方丹參注射液治療急性腦梗死臨床評價研究. 藥物流行病學雜志, 2017, 26(7): 465-470. |
| 37. | 劉施, 吳嘉瑞, 段笑嬌, 等. 基于Meta分析的丹參酮Ⅱ_A磺酸鈉注射液治療急性腦梗死臨床評價研究. 藥物流行病學雜志, 2017, 26(12): 803-808. |
| 38. | 齊家. 三七制劑治療急性中風臨床療效的系統評價. 北京: 北京中醫藥大學, 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. | 鄭歡. 通腑法治療急性缺血性腦卒中療效的Meta分析. 武漢: 湖北中醫藥大學, 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, 劉文琛, 倪小佳, 等. 中藥防治短暫性腦缺血發作的系統評價與meta分析. 中國卒中學會第五屆學術年會暨天壇國際腦血管病會議2019 論文匯編CSA&TISC 2019專刊, 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, 勵勇, 陳芙庭, 等. 急性缺血性腦卒中溶栓后腦出血. 中華神經醫學雜志, 2014, 13(7): 746-748. |
| 49. | 張曉燕, 蘇玲, 胡嘉坤, 等. 中西醫結合治療急性腦梗死的臨床觀察. 航空航天醫學雜志, 2014, 25(1): 39-40. |
| 50. | 黃水明. 益氣活血法聯合動脈溶栓治療急性腦梗死臨床研究. 廣州: 廣州中醫藥大學, 2012. |
| 51. | 賈世杰, 王輝, 張新廣, 等. 血府逐瘀湯聯合阿替普酶靜脈溶栓對急性腦梗死患者神經功能及血清炎性因子水平的影響. 臨床合理用藥雜志, 2015, 8(7): 52-53. |
| 52. | 于榮. 疏血通注射液聯合阿替普酶治療急性腦梗死療效觀察. 陜西中醫, 2017, 38(7): 855-856. |
| 53. | 孟慶陽, 李愛華, 勞萬升. 三七粉聯合尿激酶溶栓治療腦梗死患者的療效觀察. 癲癇與神經電生理學雜志, 2018, 27(2): 97-100. |
| 54. | 梁思杰, 顏冬潤, 余恒旺, 等. 動脈溶栓后輔以中藥治療急性腦梗死的短期療效觀察. 中國腦血管病雜志, 2008, 5(4): 182-183. |
| 55. | 林潤鋒, 黃玉明, 林英健, 等. 丹參注射液輔助尿激酶在急性腦梗死動脈溶栓治療中的療效研究. 吉林中醫藥, 2013, 33(5): 480-481. |
| 56. | 董剛, 賈洪剛. 補陽還五湯聯合重組人組織型纖溶酶原激活物靜脈溶栓治療腦梗死的研究. 中華全科醫學, 2018, 16(3): 470-472. |
| 57. | 馮愛花, 陳利. 白芍總苷膠囊結合尿激酶治療急性缺血性腦梗死臨床研究. 國際中醫中藥雜志, 2017, 39(1): 13-16. |
| 58. | 宗志濤. 阿替普酶溶栓聯合清腦通脈湯治療超早期急性腦梗死患者的療效觀察. 中國當代醫藥, 2017, 24(36): 10-12+19. |
| 59. | 劉麗娜. t-PA靜脈溶栓合用麝香四黃顆粒治療缺血性卒中急性期痰熱腑實證臨床觀察. 濟南: 山東中醫藥大學, 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. | 鄧小東. 中風醒腦液治療腦梗死出血性轉化的多中心隨機對照臨床試驗. 成都: 成都中醫藥大學, 2012. |
| 63. | 賈翔. 益氣活血化瘀法治療急性腦梗死后出血轉化的臨床療效觀察. 中西醫結合心腦血管病雜志, 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. | 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國腦出血診治指南(2014). 中華神經科雜志, 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. | 周粵湘, 倪小佳, 朱慶斌, 等. 活血化瘀中藥干預高血壓腦出血術后患者的療效及安全性的系統評價. 中華中醫藥學會腦病分會2019年學術年會暨全國中醫腦病國醫大師暨名家學術經驗傳承研討會論文匯編, 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, 袁夢晨, 王曉峰, 等. 醒腦開竅藥治療中風病實驗研究進展. 中西醫結合心腦血管病雜志, 2018, 16(15): 2158-2161. |
| 76. | 廖文靜, 馮曼莎, 倪小佳, 等. 安宮牛黃丸治療卒中合并意識障礙的系統評價與Meta分析. 2018年中國中西醫結合學會第12屆循證醫學會議, 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. | 張芬, 鄭艷, 莊鳳娟. 醒腦靜注射液聯合鹽酸納洛酮注射液治療急性腦出血伴昏迷患者療效的Meta分析. 中國醫藥導報, 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, 劉玲玲, 王慧敏, 等. 中藥治療卒中后吞咽障礙的有效性和安全性: 一項采用GRADE方法進行的系統評價及Meta分析. 中華中醫藥學會腦病分會2019年學術年會暨全國中醫腦病國醫大師暨名家學術經驗傳承研討會論文匯編, 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. | 高長玉, 吳成翰, 趙建國, 等. 中國腦梗死中西醫結合診治指南(2017). 中國中西醫結合雜志, 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. 王隴德, 劉建民, 楊弋, 等. 我國腦卒中防治仍面臨巨大挑戰—《中國腦卒中防治報告2018》概要. 中國循環雜志, 2019, 34(2): 105-119.
- 5. 巢寶華, 劉建民, 王伊龍, 等. 中國腦卒中防治: 成就, 挑戰和應對. 中國循環雜志, 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, 朱以誠, 姚明, 等. 急性卒中患者中藥服用情況橫斷面調查. 中華神經科雜志, 2015, 48(4): 284-287.
- 8. 中國腦卒中醫療質量評估(QUEST)協作組. 中國急性缺血性腦卒中治療現狀. 中華神經科雜志, 2009, 42(4): 223-228.
- 9. 文碧玲, 賈春生, 劉煒宏, 等. 近10年來針灸學術的發展與思考. 中國針灸, 2009, 29(12): 949-954.
- 10. 毛忠南, 何天有, 雒成林. 從康復角度看腦卒中的針刺治療. 中國針灸, 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. 中華醫學會神經病學分會. 2016版中國腦血管病診治指南與共識. 北京: 人民衛生出版社, 2016.
- 15. World Health Organization. WHO handbook for guideline development, 2nd ed. Available from: https://apps.who.int/iris/handle/10665/145714.
- 16. 盧傳堅, 楊克虎. 中西醫結合診療指南制定手冊. 北京: 人民衛生出版社, 2016.
- 17. Chen Y, Yang K, Maru?ic 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. 陳耀龍, 姚亮, Susan Norris, 等. GRADE在系統評價中應用的必要性及注意事項. 中國循證醫學雜志, 2013, 13(12): 1401-1404.
- 25. Zhang Y, Coello PA, Bro?ek 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, 陳耀龍, 陳昊, 等. 循證指南制定中患者價值觀和偏好的研究方法. 中國循證醫學雜志, 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. 秦海強. 缺血性卒中患者在中國獨特的管理模式—來自國家卒中數據庫. 中華醫學會第十八次全國神經病學學術會議論文匯編(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. 常思遠, 許予明. NIHSS的再評價. 神經損傷與功能重建, 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. 補陽還五湯治療腦梗死不同分期的Meta分析. 西安: 第四軍醫大學, 2016.
- 35. 劉施, 吳嘉瑞, 藺夢娟, 等. 基于Meta分析的注射用丹參多酚酸鹽治療急性腦梗死臨床評價研究. 藥物流行病學雜志, 2017, 26(4): 248-255.
- 36. 劉施, 吳嘉瑞, 張丹, 等. 基于Meta分析的注射用復方丹參注射液治療急性腦梗死臨床評價研究. 藥物流行病學雜志, 2017, 26(7): 465-470.
- 37. 劉施, 吳嘉瑞, 段笑嬌, 等. 基于Meta分析的丹參酮Ⅱ_A磺酸鈉注射液治療急性腦梗死臨床評價研究. 藥物流行病學雜志, 2017, 26(12): 803-808.
- 38. 齊家. 三七制劑治療急性中風臨床療效的系統評價. 北京: 北京中醫藥大學, 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. 鄭歡. 通腑法治療急性缺血性腦卒中療效的Meta分析. 武漢: 湖北中醫藥大學, 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, 劉文琛, 倪小佳, 等. 中藥防治短暫性腦缺血發作的系統評價與meta分析. 中國卒中學會第五屆學術年會暨天壇國際腦血管病會議2019 論文匯編CSA&TISC 2019專刊, 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, 勵勇, 陳芙庭, 等. 急性缺血性腦卒中溶栓后腦出血. 中華神經醫學雜志, 2014, 13(7): 746-748.
- 49. 張曉燕, 蘇玲, 胡嘉坤, 等. 中西醫結合治療急性腦梗死的臨床觀察. 航空航天醫學雜志, 2014, 25(1): 39-40.
- 50. 黃水明. 益氣活血法聯合動脈溶栓治療急性腦梗死臨床研究. 廣州: 廣州中醫藥大學, 2012.
- 51. 賈世杰, 王輝, 張新廣, 等. 血府逐瘀湯聯合阿替普酶靜脈溶栓對急性腦梗死患者神經功能及血清炎性因子水平的影響. 臨床合理用藥雜志, 2015, 8(7): 52-53.
- 52. 于榮. 疏血通注射液聯合阿替普酶治療急性腦梗死療效觀察. 陜西中醫, 2017, 38(7): 855-856.
- 53. 孟慶陽, 李愛華, 勞萬升. 三七粉聯合尿激酶溶栓治療腦梗死患者的療效觀察. 癲癇與神經電生理學雜志, 2018, 27(2): 97-100.
- 54. 梁思杰, 顏冬潤, 余恒旺, 等. 動脈溶栓后輔以中藥治療急性腦梗死的短期療效觀察. 中國腦血管病雜志, 2008, 5(4): 182-183.
- 55. 林潤鋒, 黃玉明, 林英健, 等. 丹參注射液輔助尿激酶在急性腦梗死動脈溶栓治療中的療效研究. 吉林中醫藥, 2013, 33(5): 480-481.
- 56. 董剛, 賈洪剛. 補陽還五湯聯合重組人組織型纖溶酶原激活物靜脈溶栓治療腦梗死的研究. 中華全科醫學, 2018, 16(3): 470-472.
- 57. 馮愛花, 陳利. 白芍總苷膠囊結合尿激酶治療急性缺血性腦梗死臨床研究. 國際中醫中藥雜志, 2017, 39(1): 13-16.
- 58. 宗志濤. 阿替普酶溶栓聯合清腦通脈湯治療超早期急性腦梗死患者的療效觀察. 中國當代醫藥, 2017, 24(36): 10-12+19.
- 59. 劉麗娜. t-PA靜脈溶栓合用麝香四黃顆粒治療缺血性卒中急性期痰熱腑實證臨床觀察. 濟南: 山東中醫藥大學, 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. 鄧小東. 中風醒腦液治療腦梗死出血性轉化的多中心隨機對照臨床試驗. 成都: 成都中醫藥大學, 2012.
- 63. 賈翔. 益氣活血化瘀法治療急性腦梗死后出血轉化的臨床療效觀察. 中西醫結合心腦血管病雜志, 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. 中華醫學會神經病學分會, 中華醫學會神經病學分會腦血管病學組. 中國腦出血診治指南(2014). 中華神經科雜志, 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. 周粵湘, 倪小佳, 朱慶斌, 等. 活血化瘀中藥干預高血壓腦出血術后患者的療效及安全性的系統評價. 中華中醫藥學會腦病分會2019年學術年會暨全國中醫腦病國醫大師暨名家學術經驗傳承研討會論文匯編, 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, 袁夢晨, 王曉峰, 等. 醒腦開竅藥治療中風病實驗研究進展. 中西醫結合心腦血管病雜志, 2018, 16(15): 2158-2161.
- 76. 廖文靜, 馮曼莎, 倪小佳, 等. 安宮牛黃丸治療卒中合并意識障礙的系統評價與Meta分析. 2018年中國中西醫結合學會第12屆循證醫學會議, 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. 張芬, 鄭艷, 莊鳳娟. 醒腦靜注射液聯合鹽酸納洛酮注射液治療急性腦出血伴昏迷患者療效的Meta分析. 中國醫藥導報, 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, 劉玲玲, 王慧敏, 等. 中藥治療卒中后吞咽障礙的有效性和安全性: 一項采用GRADE方法進行的系統評價及Meta分析. 中華中醫藥學會腦病分會2019年學術年會暨全國中醫腦病國醫大師暨名家學術經驗傳承研討會論文匯編, 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. 高長玉, 吳成翰, 趙建國, 等. 中國腦梗死中西醫結合診治指南(2017). 中國中西醫結合雜志, 2018, 38(2): 136-144.

