语义导航策略训练对失语症患者词汇命名泛化效应的影响

A semantic navigation strategy promotes naming in patients with aphasia

目的研究语义导航策略训练对失语症患者词汇命名泛化效应的影响。方法采用随机数字表法将14例失语症患者分为语义导航策略组和语义无关训练组。选用中文联想词汇库中的122个词汇，语义导航策略组按照语义联想关系自动生成的词汇顺序进行训练，语义无关训练组则以随机词汇顺序进行训练。2组患者均每天进行1次言语训练，每天记录命名正确数以绘制学习曲线。于治疗前及治疗10d后要求2组患者对46张未训练图片进行命名以评估其泛化效应。结果从治疗后第6天开始，发现语义导航策略组的训练词汇命名正确数显著多于语义无关训练组，其学习曲线随时间进展逐渐增高；治疗10d后该组对未训练词汇的正确反应数显著多于治疗前及语义无关训练组水平，对未训练词汇的无反应数较治疗前以及语义无关训练组也有降低趋势。结论语义导航策略训练在改善失语症患者学习曲线的同时，还能显著提高患者对词汇的命名泛化效应。

Objective To explore the generalization effect of a semantic navigation strategy （SNS） on naming in patients with aphasia. Methods Fourteen patients with aphasia were randomly divided into an SNS group （n =7） and an unrelated semantic （US） group （n = 7）. One hundred and twenty-two words chosen from Chinese word association norms were used in this study. The presentation sequence of words was generated automatically with network analysis techniques for the SNS group and randomly without network analysis techniques for the US group. After baseline tests using the western aphasia battery （WAB） and the mini-mental status examination （MMSE） , all patients received language training once a day for 10 consecutive days. The amount of correct responses was recorded every day in order to draw the learning curve. The generalization effect was evaluated with 46 untrained items before and after training with all patients. Results The average learning curve of the SNS group was steeper than that of the US group. Correct responses on trained items were significantly more frequent in the SNS group than in the US group after the 6th day of training. After 10 days the frequency of correct responses on untrained items in the SNS group was significantly higher than it had been before training, and higher than the frequency after training in the US group, The frequency of no response on untrained items in the SNS group had declined, and it had declined more than in the US group. Conclusion A semantic navigation strategy may promote significant generalization while improving the learning curve in naming among patients with aphasia.