圣愈汤联合针刺对缺血性脑卒中后失语症患者语言功能及生活质量的影响

Effect of Shengyu Decoction combined with acupuncture on language function and quality of life in patients with aphasia after ischemic stroke

目的观察圣愈汤联合针刺对缺血性脑卒中后失语症患者语言功能及生活质量的影响。方法根据随机数字表法将2017年12月—2019年12月就诊于庆阳市人民医院的96例缺血性脑卒中后失语症患者分为2组,所有患者均接受常规治疗,对照组48例在常规治疗基础上接受Schuell语言训练,研究组48例在对照组治疗基础上加用圣愈汤联合针刺治疗,均治疗12周。观察2组治疗前后中医症状积分、语言功能评分、神经功能评分、生活质量评分、颅内血流动力学的变化,比较2组疗效、不良反应。结果2组治疗后中医症状积分、NIHSS评分均明显降低(P均<0.05),且研究组中医症状积分、NIHSS评分均明显低于对照组(P均<0.05);2组治疗后西方失语症评定(WAB)量表各维度评分均明显增加(P均<0.05),且研究组WAB量表中听理解、自发言语、命名、复述、AQ评分均明显高于对照组(P均<0.05);2组治疗后脑卒中失语症生活质量量表(SAQOL-39 g)评分均明显增加(P均<0.05),且研究组SAQOL-39 g量表中生理、沟通及心理社会评分均明显高于对照组(P均<0.05);2组治疗后脑前、中及后动脉流速均加快(P均<0.05),且研究组脑前、中及后动脉流速均快于对照组(P均<0.05);研究组治疗总有效率为95.8%(46/48),明显高于对照组的81.2%(39/48),差异有统计学意义(P<0.05);所有患者治疗期间均未出现严重不良反应。结论圣愈汤联合针刺治疗缺血性脑卒中后失语症患者效果确切,可有效减轻临床症状、体征,促进语言功能康复,改善神经功能和颅内血流动力学及生活质量,且安全。

Objective It is to observe the effect of Shengyu Decoction combined with acupuncture on the language function and quality of life in patients with aphasia after ischemic stroke.Methods 96 patients with post-ischemic stroke aphasia who were admitted to Qingyang People’s Hospital from December 2017 to December 2019 were divided into 2 groups according to the random number table method.All the patients were treated with conventional treatment,48 cases in the control group were treated with Schuell language training on the basis of conventional treatment,and 48 cases in the study group were treated with Shengyu Decoction combined with acupuncture on the basis of the control group.Both groups were treated for 12 weeks.The changes in the scores of TCM symptom score,language function,neurological function and quality of life,intracranial hemodynamics before and after treatment were observed in the two groups,and the efficacy and adverse reactions of the two groups were compared.Results The TCM symptom score and NIHSS score of the two groups were significantly decreased after treatment(P<0.05),and the TCM symptom score and NIHSS score of the study group were lower than those of the control group(P<0.05).The scores of of each dimension of Western Aphasia Battery(WAB)after treatment were significantly increased in the two groups(P<0.05),and the scores of listening comprehension,self-speaking,naming,retelling,and AQ scores in the WAB scale of the study group were higher than those of the control group(P<0.05).The scores of Stroke and Aphasia Quality of Life Scale(SAQOL-39g)were significantly increased after treatment in the two groups(P<0.05),and the scores of physiology,communication,and psychosocial sociology in the SAQOL-39g scale of the study group were higher than those of the control group(P<0.05).After treatment,the flow rates of anterior,middle,and posterior arteries were significantly increased in the two groups(P<0.05),and the flow rates of anterior,middle and posterior arteries of the study group were faster than those of the control group(P<0.05).The total effective rate of treatment in the study group was 95.8%(46/48),which was higher than that 81.2%(39/48)in the control group(P<0.05);no serious adverse reactions occurred during treatment in all patients.Conclusion Shengyu Decoction combined with acupuncture is effective in treating patients with post-ischemic stroke aphasia.It can effectively relive clinical symptoms and signs,promote rehabilitation of language function,improve nerve function,intracranial hemodynamics and quality of life with good safety.