The Effect Of Clinical Pathway With Combination Of Chinese Medicine And Western Medicine In Acute Ischemic Stroke

ObjectiveEvaluate the effect of clinical pathway with combination of Chinese medicine and western medicine in acute ischemic stroke patients through the randomized controlled trial research.MethodsIt was a prospective controlled trial.94 acute ischemic stroke patients were separately assigned to the clinical pathway group and traditional group. Pathway group applied the standard procedure according to the protocol while patients in the traditional group accept the routine treatment. Patients in both groups can be discharged if they meet the discharge criteria and the patients in pathway group can quit the pathway if sever complications occur. Follow up will be 30 days and 90 days after discharge. The primary end point was the mRs score of 90 days after treatment. Secondary end points were, the mRs score, NIHSS score and GCS score when discharged, the incidence of in-hospital complications, length of stay, hospitalization cost and compliance of protocol.ResultsFrom 2th, June 2015 to 3th, November,2015,139 patients were screened,94 patients fullf illing the inclusion and exclusion criteria. Finally, there were 80 patients in the final analysis. There were 40 of the participants in CP group and 40 of the participants in control group. The mRs≤l level of 90 days has significant differences between two groups(P=0.029<0.05). The mRs≤ 1 level, NIHSS score and GCS score of discharged and 30 days have no different between clinical pathway group and traditional group (P>0.05).There were 6 patients with complications.The incidence of complication didn’t differ in two groups. The hospitalization cost of clinical pathway group was 13025.78 ±3778.55 Yuan and traditional group was 15493.13±10131.21 Yuan. The length of stay of clinical pathway group was 11.00±2.79 days, the traditional group was 12.23±3.75 days. There was no significant differences between the two groups(P>0.05). The adherence of key part of protocol didn’t differ in two groups. The variation of drug between two groups has significant differences(P<0.05). Single factor analysis showed that traditional Chinese medicine treatment can improve the rate of 90 days good outcome. But there was no significant differences between the two groups in logistic analysis.The state of illness, complications, DSA examination, use of drugs influenced the hospitalization cost. The occurrence of complications and the implementation of the DSA examination affect the length of hospital stay.ConclusionThe application and evaluation of clinical pathway with combination of Chinese medicine and western medicine could improve the mRs level at 90 days after stroke onset. There was no significant differences of incidence of complication, length of stay, hospitalization cost. The key part of the protocol has good adherence, but clinical pathway group using drugs more standardize the rational.