应用语言障碍诊治仪ZM2.1治疗运动性失语的效果评估

Outcome evaluation of language disorder diagnosis apparatus ZM2.1 in treatment of Broca's aphasia

目的:采用语言障碍诊治仪ZM2.1(简称语言障碍ZM2.1)对运动性失语患者进行语言功能训练,观察其疗效。方法:选择2003-01/2004-12在暨南大学医学院第一附属医院语言障碍中心的15例运动性失语患者(治疗组)和广州市番禺人民医院神经内科的15例运动性失语患者(非治疗组)。治疗组通过其康复系统进行个体化综合训练,包括发音器官训练、语言训练、口语表达、听康复、视康复、学老师平台等。入院时和治疗2个月时使用汉语失语检查法作为评分标准,对两组患者进行表达、复述、命名、听理解的评估,评定亚项包括信息量、流利性、复述、词命名、色命名、反应命名、是否、听辨认、执行指令。治疗组在完成失语检查法后,采用语言障碍诊治仪ZM2.1诊断系统在训练前后进行评估,评定亚项包括简单指令、复杂指令、是否、表达语音、表达语义、复述语音、复述语义、命名、简单理解、复杂理解、听读字、计算、记忆、匹配、简单常识、复杂常识、定向力、比较。各亚项分数为完成百分率×100,满分为100分。结果:30例患者均进入结果分析。①治疗2个月时两组汉语失语检查法各亚项评分:治疗组信息量、流利性、复述、词命名、色命名、反应命名、是否、听辨认、执行指令评分高于非治疗组犤(38.12±15.21)分,(12.02±8.74)分;(34.51±14.93)分,(14.21±7.51)分;(32.54±9.65)分,(10.95±4.96)分;(38.00±12.56)分,(6.96±8.64)分;(29.72±15.34)分,(7.82±6.75)分;(37.56±10.41)分,(12.43±7.56)分;(35.01±8.78)分,(21.41±6.89)分;(48.36±11.41)分,(20.32±7.94)分;(45.32±12.71)分,(24.43±7.69)分,t=2.134～2.498,P<0.05犦。②治疗组训练前后语言障碍ZM2.1诊断系统各亚项评分:训练后复杂指令、是否、表达语音、表达语义、复述语音、复述语义、命名、复杂理解、听读字、计算、回忆、匹配、简单常识、复杂常识、定向力、比较评分高于训练前犤(68.31±18.31)分,(40.34±21.21)分;(85.39±22.40)分,(61.34±16.31)分;(38.31±18.99)分,(19.32±12.35)分;(65.36±20.31)分,(40.63±21.56)分;(21.36±13.56)分,(9.96±10.69)分;(50.75±20.17)分,(37.54±14.56)分;(46.25±14.36)分,(28.35±16.35)分;(69.34±21.31)分,(40.35±12.36)分;(65.24±19.93)分,(38.65±13.56)分,(63.34±29.14)分,(35.69±23.31)分;(59.14±18.93)分,(39.31±12.56)分;(62.21±20.11)分,(39.23±13.56)分;(80.21±13.56)分,(60.12±10.34)分;(75.12±11.31)分,(45.63±16.31)分;(50.23±17.15)分,(31.56±15.34)分;(54.36±18.96)分,(28.62±14.36)分,t=2.236～2.985,P<0.05犦,而简单指令、简单理解评分与训练前接近犤(75.12±18.51)分,(68.46±12.64)分;(65.35±20.26)分,(58.35±15.63),P>0.05犦。结论:①应用语言障碍ZM2.1康复系统进行综合训练后汉语失语检查法各亚项评分增高,表明了康复治疗能最大限度地减轻语言交流障碍。②训练后语言障碍ZM2.1诊断系统评估除简单指令、简单理解二项外,各项评分显著升高,表明了语言障碍ZM2.1康复系统促了进运动性失语症患者的语言恢复。而简单指令、简单理解的变化不大考虑与运动性失语患者本身简单理解能力相对好有关。

AIM： To study the therapeutic effect of language disorder diagnosis apparatus ZM2.1 （Language disorders ZM2.1） with language functional training in patients with Broca＇s aphasia. METHODS： Fifteen Broca＇s ahasia patients from Department of Rehabilitation of First Affiliated Hospital of Jinan University （treatment group） and fifteen patients from Department of Neurology of Guangzhou Panyu People＇s Hospital （non-treatment group） from January 2003 to December 2004 were selected. The patients in treatment group were trained individually and synthetically with the rehabilitation system, including vocal organ training, language training, spoken Chinese expression, listening rehabilitation, visual rehabilitation and following teacher time,etc. Chinese logaguosia inspection method was used as score standard at admission and after 2 months treatment, including evaluation of expression, recitation, denomination and listening comprehension. Sub-items needed in the evaluation included amount of information, fluency, recitation, denomination of word, denomination of color, denomination of reaction, whether or not, listening identification and instruction performance. After logagnosia inspection method, language disorders ZM2.1 was conducted in the treatment group before and after training to evaluate. Sub-item included simple instruction, complicated instruction, whether or not, pronunciation expression, meaning expression, pronunciation recitation, meaning recitation, denomination, simple comprehension, complicated comprehension, listening and reading of character, calculation, memory, matching, simple common knowledge, complicated common knowledge, orientation and comparison. Scores of each sub-item were that percentage multiplies 100, and full mark was 100 points.RESULTS： Totally 30 patients were involved in the analysis of results. ① Scores of every sub-item two months after Chinese logagnosia inspection method： Scores of amount of information, fluency, recitation, denomination of word, denomination of color, denomination of reaction, whether or not, listening identification and instruction performance in treatment group were higher than those of non-treatment group [（38.12±15.21）,（12.02±8.74）; （34.51±14.93） ,（14.21±7.51） ;（32.54±9.65） ,（10.95±4.96） ;（38.00±12.56） ,（6.96±8.64） ;（29.72±15.34） ,（7.82±6.75）;（37.56±10.41） ,（12.43±7.56） ;（35.01±8.78） ,（21.41±6.89） ;（48.36±11.41） ,（20.32±7.94） ;（45.32±12.71） ,（24.43±7.69） points, （t=2.134-2.498,P 〈 0.05）]. ② Scores of every sub-item before and after the treatment by language disorder ZM2.1 diagnosis system： Scores ofcomplicatedinstruction, whether or not, pronunciation expression, meaning expression, pronunciation recitation, meaning recitation, denomination, complicated comprehension, listening and reading of character, calculation, memory, matching, simple common knowledge, complicated common knowledge, orientation and comparison post training were higher than those of pre-training [（68.31±18.31）, （40.34±21.21）; （85.39 ±22.40）, （61.34±16.31）; （ 38.31±18.99）,（19.32±12.35） ;（65.36±20.31） ,（40.63±21.56） ;（21.36±13.56） ,（9.96±10.69） ;（50.75±20.17） ,（37.54±14.56） ;（46.25±14.36） ,（28.35±16.35） ;（69.34＋21.31） ,（40.35±12.36）;（65.24±19.93） ,（38.65±13.56）, （63.34±29.14）, （35.69±23.31）; （59.14±18.93）,（39.31±12.56）; （62.21±20.11）,（39.23±13.56） ;（80.21±13.56） ,（60.12±10.34）; （75.12± 11.31 ） ,（45.63±16.31 ） ;（50.23±17.15） ,（31.56±15.34） ;（54.36±18.96） ,（28.62±14.36） points] （t =2.236-2.985,P 〈 0.05）, while the scores of simple order and simple knowledge was close to that before training [（75.12±18.51）, （68.46±12.64） ; （65.35±20.26） ,（58.35±15.63） points, P 〉 0.05]. CONCLUSION： ① The scores of each sub-item of Chinese logagnosia inspection method increase after combined training using rehabilitation system of language disorder ZM2.1, which shows that the rehabilitation treatment can decrease maximally language communication disorder. ② After the training of language disorder ZM2.1 diagnosis system, the scores of every item become higher, except simple instruction and simple comprehension, which shows that the rehabilitation system of the language disorder ZM2.1 improves the language recovery in patients with Broca＇s aphasia. The changes of simple instruction and simple comprehension are insignificant, which has correlation with perfection of simple comprehension ability of patients with Broca＇s aphasia.