头电针配合言语训练治疗脑卒中后失语的临床研究

Clinical study of scalp electroacupuncture combined with language training on post-stroke aphasia patients

目的:研究头电针配合言语训练对脑卒中后失语症患者语言功能的影响。方法:采用随机数字表法将90例患者分为试验组和对照组,试验组采取语言康复训练配合头电针治疗,对照组仅采用言语训练治疗,言语训练采用Schuell刺激法对患者进行一对一的训练,对不同类型的失语症患者训练类型有所侧重。每次30min,每周5次,2周为1个疗程。针灸治疗选取头部穴位,运动性失语取运动区,感觉性失语取感觉区,完全性失语取语言三区,并且配合百会、风府、哑门等穴位。每周治疗5次,2周为1个疗程,共治疗1个疗程。语言功能评分采用《汉语失语成套测验》,就自发说话、语言理解、复述和命名四方面内容对患者治疗前后的评分进行比较。失语程度采用波士顿诊断性失语症检查法(Boston diagnostic aphasia examination,BDAE)分级标准进行评价,总疗效比较采用波士顿诊断性失语症检查法。结果:试验组患者治疗前后自发说话、言语理解、复述及命名的评分及失语程度评分的比较,差异有显著性意义(P分别为0.01、0.03、0.02、0.02、0.02,P均<0.05),对照组患者治疗前后自发说话、言语理解、复述及命名的评分及失语程度评分的比较,差异有显著性意义(P分别为0.02、0.03、0.01、0.02、0.03,P均<0.05),且治疗后两组患者自发说话、言语理解、复述及命名的评分及失语程度评分比较有显著性差异(P分别为0.03、0.03、0.03、0.02、0.03,P均<0.05)。两组总疗效比较差异有显著性意义(P为0.03,P<0.05)。结论:头电针配合言语训练能明显改善脑卒中患者自发说话、言语理解、复述及命名的评分及失语程度,疗效优于单纯言语训练。

Objective： To study the scalp electroacupuncture combined with language training on the language function of post-stroke aphasia patients. Method： Ninety patients were divided into experimental group and control group by random number table method. The patients in the experimental group were treated by language rehabilitation training combined with electroacupuncture, while the control group was treated only by verbal training. Schuell stimulation was performed by one to one training and different types of aphasia patients focued on the different types of training. A course of treatment consisted of 2 weeks training with 30mins for each time, 5 times a week. For acupuncture treatment, scalp acupuncture points were employed with motor area for motor aphasia, sensory area for sensory aphasia and three language areas for complete language aphasia, also combined with Baihui, wind House, dumb gate and other points. All patients received a course of treatment. The language function was evaluated by using ＂Chinese Aphasia Test＂ and the scores of spontaneous speech, language comprehension, repetition and nomenclature were compared before and after treatment. The degree of aphasia was assessed by the Boston Diagnostic Aphasia Examination （BDAE）. The total efficacy was compared by Boston Diagnostic Aphasia. Result： There were significant differences in spontaneous speech, verbal comprehension, repetition, nomenclature and aphasia scores in the experimental group before and after treatment（P=0.01,0.03,0.02,0.02,0.02,P〈0.05） There were significant differences（P=0.02,0.03,0.01,0.02,0.03, P〈0.05） in the spontaneous speech, verbal comprehension, repetition and nomenclature and aphasia scores in the control group before and after treatment. There were significant differences in spontaneous speech, verbal comprehension, repetition, nomenclature and aphasia scores between the two groups（P=0.03,0.03,0.03,0.02,0.03, P〈0.05）. There was significant difference in the total curative effect between the two groups（P=0.03,P〈0.05）. Conclusion： The scalp electroacupuncture combined with language training can significantly improve spontaneous speech, verbal comprehension, repetition and naming degree score and aphasia for post-stroke patients, and has better curative effect than pure language training.