低频电脉冲刺激结合针刺治疗对急性脑梗死后痉挛型构音障碍的临床观察

Curative effect of acupuncture combined with low frequency electrical stimulation on spastic dysarthria in acute cerebral infarction patients

目的探讨低频电脉冲刺激结合针刺治疗对急性脑梗死后痉挛型构音障碍的临床疗效。方法选择2011年1月至2014年10月廊坊市第四人民医院神经内科住院治疗的160例急性脑梗死后痉挛型构音障碍患者为研究对象,按入院顺序随机分为对照组和观察组,每组80例,对照组在灯盏细辛活血祛瘀、阿司匹林抗血小板聚集等一般治疗的基础上进行言语训练康复治疗,观察组在对照组基础上实施针刺治疗和功能性低频电脉冲刺激治疗。采用神经功能评分(NIHSS)评定神经功能,采用修订的Barthel指数(MBI)评价日常生活能力,采用Frenchay构音障碍评定法评价构音障碍等级。结果治疗前两组患者NIHSS评分、MBI指数比较,差异无统计学意义(P>0.05);治疗后两组NIHSS评分及MBI指数均较同组治疗前明显改善(P<0.05);治疗后观察组NIHSS评分低于对照组、MBI指数高于对照组,差异均有统计学意义(t=2.687,P<0.05;t=7.013,P<0.05)。治疗后两组患者Frenchay评分较同组治疗前明显改善(P<0.05),观察组改善程度明显好于对照组,差异均有统计学意义(Z=-2.308,P<0.05)。结论低频电脉冲刺激结合针刺治疗急性脑梗死后痉挛型构音障碍,可有效降低NIHSS评分和提高MBI评分,改善患者的构音能力。

Objective To discuss the curative effect of acupuncture combined with low frequency electrical stimulation on spastic dysarthria in acute cerebral infarction patients. Methods 160 cases of acute cerebral infarction patients with spastic dysarthria were chosen as the research objects in Department of Neurology,the Fourth People′ s Hospital of Langfang city between January 2011 and October 2014. According to admission order,an odd number into the control group,even number into the observation group,80 cases in each group. The patients were given traditional Chinese medicine treatment as erigeron breviscapus and aspirin,and speech training rehabilitation in control group; the acupuncture treatment and functional low frequency electric pulse stimulation treatment was performed on the basis of general Chinese medicine treatment and speech training rehabilitation. Nerve function,daily life ability and dysarthria were evaluated by using national institutes of healthstroke scale（NIHSS）,modified barthel index（MBI）,Frenchay dysarthria assessment method. Results NIHSS score and MBI index were compared before treatment in two groups; there were no statistically significant difference（P〈0.05）.NIHSS score and MBI index were improved significantly after treatment in two groups（P〈0.05）. NIHSS score was lower than that in the control group and MBI index was higher than that in the control group after treatment; the difference was significant（t=2.687,P〈0.05; t=7.013,P〈0.05）. Frenchay scores were obviously improved after treatment in two groups（P〈0.05）; the degree of improvement in observation group was obviously better than that in the control group; the difference was statistically significant（Z=-2.308,P〈0.05）. Conclusion Treatment of acupuncture combined with low frequency electrical stimulation for spastic dysarthria in acute cerebral infarction patients has good curative effect,and can effectively reduce the NIHSS score and MBI index.