针灸结合语言康复治疗缺血性脑卒中后运动性失语症20例临床观察

Clinical observation on 20 cases of aphemia after ischemic cerebral apoplexy treated by acupuncture combined with language rehabilitation

目的观察针灸结合语言康复治疗缺血性脑卒中后运动性失语症的临床疗效。方法将40例缺血性脑卒中后失语症患者采用随机数字表法分为治疗组和对照组,各20例。对照组给予Schuell语言训练结合假针刺治疗;治疗组给予Schuell语言训练结合针灸治疗,针刺百会、脑户、风池(双侧)、脑空(双侧),同时风池穴予温针灸处理,每日1次,每周5次。治疗8周后比较2组的临床疗效及治疗前后2组患者的语言功能(口语表述、听语理解、阅读能力)评分和功能性语言沟通能力检查法(CFCP)评分。结果2组治疗后口语表述、听语理解、阅读能力评分及CFCP评分均明显升高,与同组治疗前比较差异有统计学意义(P<0.05或P<0.01),且治疗组作用更明显,与对照组治疗后比较差异有统计学意义(P<0.05);治疗组总有效率为95.0%,对照组为75.0%,2组比较差异有统计学意义(P<0.05)。结论针灸结合语言康复治疗缺血性脑卒中后运动性失语症临床疗效显著,可明显改善患者的口语表述、听语理解、阅读能力,并可提高CFCP评分,值得临床推广应用。

Objective To observe the clinical efficacy of acupuncture combined with language rehabilitation in the treatment of motor aphasia after ischemic stroke. Methods Forty patients with aphasia after ischemic stroke were divided into treatment group and control group according to random number table method,with 20 cases in each. The control group was given Schuell language training combined with sham acupuncture treatment;the treatment group was given Schuell language training combined with acupuncture treatment,acupuncture Baihui( GV 20),Naohu( GV 17),Fengchi( bilateral,GB 20) and Naokong( GB 19). Meanwhile,Fengchi( GB 20) was treated with warming needle moxibustion,once a day,five times a week. After 8 weeks of treatment,the clinical efficacy of the two groups and the linguistic function( speaking expression,listening comprehension,reading ability) score and functional language communication ability test( CFCP) score of the two groups before and after treatment were compared. Results The scores of oral expression,listening comprehension,reading ability,and CFCP of the two groups after treatment all significantly increased,and the difference was statistically significant compared with the same group before treatment( P<0.05 or P<0.01),moreover,the effect was more significant in the treatment group,and the difference was statistically significant compared with the control group after treatment( P<0.05). The total effective rate of the treatment group was 95.0%,that of the control group was 75.0%,and the difference was statistically significant between the two groups( P<0.05).Conclusion It has marked clinical efficacy to use acupuncture combined with language rehabilitation to treat aphemia after ischemic cerebral apoplexy,which can significantly improve the oral expression,listening comprehension,reading ability of the patients,and can improve the CFCP score. It is worthy of clinical promotion and application.