ABSTRACT
Objective To evaluate the efficacy of the traditional Chinese medicine NAOAN capsule in primary prevention of stroke in high?risk populations. Methods A multicenter, randomized controlled study was performed in community setting, involving 1 088 individuals at high risk of stroke, with cerebrovascular function scores<75 and 10?year Framingham stroke risk ≥6%. Subjects were recruited in communities at Beijing, Shanghai, Changsha, and Chengdu communities, through resident committees or the village unit. A total of 559 subjects were randomized into a group treated with the NAOAN capsule, and 529 subjects in an aspirin treatment group. Follow?up was performed every 2 months for 2 years. At the mid?point and end of the intervention, we compared cerebrovascular function differences between the 2 groups. Results During the 2?year community trial, 531 subjects in the NAOAN capsule group and 465 in the aspirin group followed the protocol. Cerebrovascular function scores increased from 45.2±19.7 at baseline to 61.7±26.5 after the 2?year trial (t=－12.931, P<0.001) in the NAOAN capsule group, and from 47.2±18.9 at baseline to 53.7 ± 25.1 (t=－5.058, P<0.001) in the aspirin group; greater increases in cerebrovascular function scores were found in the NAOAN capsule group than that in the aspirin group (t=4.906, P<0.001). Conclusions Cerebrovascular function in individuals at high risk of stroke was improved by taking NAOAN capsule. Cerebrovascular function scores improved more with NAOAN capsules than with aspirin.
ABSTRACT
Stroke is the leading cause of death in China and confers a huge burden and effort on patients and health professionals. China has the world's largest population and has been experiencing a rapid economic development. In this article, we review the current status of stroke epidemiological features and risk factors, and the recently ongoing stroke epidemiological survey in China. Epidemiological studies suggested that stroke incidence increases with age and that the elderly population is expected to increase over time in China. Stroke mortality increased gradually from 1990 to 2000 but declined since the beginning of the 21st century, probably related to better control of vascular risk factors and the advances in acute stroke care. The Chinese lifestyle has changed rapidly during the past 3 decades. Moreover, China is a big country with substantial geographic disparities. The geographical variation and chronological trend of vascular risk factors may determine changes in the prevalence and subtypes of stroke in China. In this review, the current Chinese researches on the critical management of stroke and the potential direction and support of the Chinese government are discussed.
Subject(s)
Aged , Humans , Asian People , Cause of Death , China , Economic Development , Epidemiologic Studies , Health Occupations , Incidence , Life Style , Prevalence , Risk Factors , StrokeABSTRACT
BACKGROUND: In treatment of traditional acute myocardial infarction,patients were required to lie on the bed resting for 1-4 weeks. Recently research showed that early rehabilitation exercise in myocardial infarction patients could ameliorate the reservation of cardio function, increase exercise tolerance, augment myocardial hemoperfusion, decrease myocardial ischemia and reduce the anxious and depressive emotion.OBJECTIVE: To observe the influence of early rehabilitation movement on activity of daily living, duration of hospital stay, mean hospitalized cost,incidence rate of arrhythmia and recurrence rate of myocardial infarction in two years.DESIGN: Non-randomized concurrent control analysis.SETTING: Beijing Tiantan Hospital.PARTICIPANTS: Totally 80 patients with acute myocardial infarction,who were hospitalized at Department of Circulation, Beijing Tiantan Hospital from August 2002 to October 2003, were enrolled. They were all at most 70 years old with stable pathogenetic condition. Left ventricular ejection fraction (LVEF) was over 35%. They were not combined with severe hypertension, severe pulmonary disease, nerve and disease of locomotor system.METHODS: The selected cases based on patients' will were assigned into two groups (n=40), ①early rehabilitation group: They were treated with routine drugs, absolute bed rest for 24 hours. At day 2 the head stock was rose about 30°to do passive exercise of extremity joint. At days 3-5, the patients sat on the bed, 3 times per day. At days 6-7,the patients stood at bedside, 3 times per day. At days 8-9, the patients moved joints of extremities at bedside and walked slowly in room. At days 10-14, the patients exercised walking. If there were angina pectoris attacks, serious cardiac arrhythmias or dyspneic respiration, etc., the movement should be suspended or the exercise intensity came back to that in the former stage. ②Absolute bed rest group: The patients were absolute bed rest, and only treated with routine drug without any rehabilitation training.MAIN OUTCOME MEASURES: Barthel index (full mark was 100 points, and ＜ 60 points represented unable self-care) was used to assess activity of daily living of patients. Mean duration of hospital stay, mean hospitalized cost, incidence rate of arrhythmia and recurrence rate of my ocardial infarction in two years were compared between the two groups.RESULTS: A total of 80 patients that conducted the therapy and follow up were involved in the result analysis. ①Mean duration of hospital stay and mean hospitalized cost in the early rehabilitation group were less than those in the absolute bed rest group (17.1 days vs 24.5 days; 9 021.23 yuan vs 12 383.45 yuan; P ＜ 0.05). ②Barthel index: There was insignificant difference before treatment between the two groups. It was significantly higher in the early rehabilitation group than that in the absolute bed rest group before discharge (81.43±13.57,70.68±11.48,P ＜ 0.05). ③Six and seven patients had the onset of arrhythmia in the early rehabilitation group and the absolute bed rest group, respectively. ④Follow-up observation was performed for two years. The recurrence rate of myocardial infarction in the early rehabilitation group (5% ,2/40) was obviously lower than that in the absolute bed rest group (22 %,9/40).CONCLUSION: The early rehabilitation training is of benefit to elevate activity of daily living of myocardial infarction patients, reduce mean duration of hospital stay and mean hospitalized cost and decrease recurrence rate.