失语症的康复治疗:研究与应用

Rehabilitative treatment of aphasia: study and application

目的:探讨失语症的言语语言治疗、药物治疗和影响治疗效果的因素。资料来源:应用计算机检索Pubmed数据库2000-01/2006-01期间的有关失语症方面的文献。检索词为“aphasia,anomia,treat,treatment,therapy,cure,heal”,并限定文章语言种类为English。同时计算机检索CNKI2000-01/2006-01期间的有关失语症方面的文献。检索词为“失语,治疗”,并限定文章语言种类为中文。资料选择:共检索300余篇文献进行筛选。以近3年内研究内容相关且发表在权威杂志上的文章优先,选择了以失语症治疗为主要研究内容的文献24篇。资料提炼:将资料进行分类,其中19篇是关于言语语言治疗的文献,5篇是关于药物治疗的文献。资料综合:言语语言治疗和药物治疗是治疗失语症的主要方法。言语语言治疗主要包括刺激法、阻断去除法、认知心理学的方法、计算机辅助治疗和小组治疗等。但言语语言治疗的有效性尚有争议。药物治疗主要有溴隐停、右苯丙胺、吡拉西坦和中药治疗等。药物治疗虽对失语的恢复有帮助,但治疗机制还不确切。影响失语症恢复的因素很多,发病时失语的严重程度是最主要的因素,失语症的类型,患者的职业,受教育程度,及社会支持等都对言语的恢复有影响。结论:①失语症的治疗强度与其康复效果有关系。要选择合理的治疗方法还需进一步的研究。②药物治疗的效果虽已被证明有效,但适用范围广、副作用小的药物开发还有待于进一步的研究。③治疗时需要综合考虑可能影响康复效果的各种因素来制定个性化的治疗方案。

OBJECTIVE： To investigate the speech-language therapy and phannacotherapy of aphasia, and probe into the influencing factors of therapeutic efficacy. DATA SOURCES： A computer-based search in Pubmed database for related articles on aphasia published from January 2000 to January 2006 were conducted with the key words of ＂aphasia, anomia, treat, treatment, therapy, cure, heal＂ in English. Meanwhile, relevant Chinese articles in CNKI published from January 2000 to January 2006 were searched with computer with the key words of ＂aphasia, therapy＂. STUDY SELECTION： More than 300 related researches were retrieved. and 24 articles mainly about the therapy of aphasia were selected. Related researches published on core journals in the latest 3 years were preferential in selection. DATA EXTRACTION： Data were classified, 19 literatures of which were on speech-language therapy and 5 articles were about pharmacotherapy. DATA SYNTHESIS： Speech-language therapy and pharmacotherapy were main treatments of aphasia. Speech-language mainly included stimulation, blocking removement, cognitive psychological method, computer assisted therapy and group-therapy etc. However, there were still controversy in speech-language therapy. Pharmacotherapy mainly included ergolactin, dextroamphetamine, piacetam and treatment of traditional Chinese medicine. Despite pharmacotherapy had some effects on aphasia, little was known about its therapeutic mechanism, The influencing factors of aphasia recovery are much, while the most important one was the severity of attack. Besides, there were some other influencing factors such as type of aphasia, occupation of patients, education level and social support etc. CONCLUSION： ①Intensity of aphasia therapy turns out to be related with the rehabilitation efficacy. More work must be done on the method of treatment. ②The effectiveness of pharmacotherapy has been proved to be valid, however, drugs with wide applicability and little side-effects need further investigation. ③In the treatment, multiple influencing factors of rehabilitative effects should be comprehensively considered to design an environment concerned therapy.