通督调神针刺法留针时言语训练对脑卒中后失语症的疗效研究

Efficacy of speech training conducted during Tongdu Tiaoshen acupuncture for treating aphasia resulting from ischemic stroke

目的研究通督调神针刺法留针时言语训练对脑卒中后失语症的疗效,为脑卒中后失语患者提供有效的治疗手段。方法选择30例脑卒中后失语症患者,随机分为A、B、C 3组,每组10例。3组均接受常规药物及肢体康复治疗,A组接受言语训练,B组先后进行通督调神针刺法和言语训练,C组同时进行两项治疗。进行西方失语症成套测验(western aphasia battery,WAB)和波士顿诊断性失语症检查法(Boston diagnostic aphasia examination,BDAE)进行言语功能评定。结果治疗后2个月,3组WAB各项指标较治疗前均提高,差异均有统计学意义(P<0.05);治疗后2个月,3组WAB各项指标比较差异均有统计学意义(P<0.05),B组和C组自发言语、听理解、复述、命名和失语商(aphasia quotient,AQ)值均优于A组,C组听理解、复述和AQ值均优于B组,差异均有统计学意义(P<0.05)。治疗后2个月,3组BDAE失语症严重程度分级较治疗前均提高,且C组严重程度分级优于A组和B组,差异均有统计学意义(P<0.05)。结论通督调神针刺法留针时言语训练对脑卒中后失语症患者言语功能的改善程度优于先后进行通督调神针刺法和言语训练。

Objective To evaluate the efficacy of speech training conducted during Tongdu Tiaoshen acupuncture for treating aphasia resulting from ischemic stroke so as to develop more effective method for treating the symptom.Methods Firstly,30 patients with post-stroke aphasia were randomly divided into three groups,namely,group A(n=10),group B(n=10)and group C(n=10).All three groups were treated with regular medicine and physical therapy.Secondly,group A were subjected to speech training;group B were first treated with Tongdu Tiaoshen acupuncture which was then followed by speech training.Group C were subjected to Tongdu Tiaoshen acupuncture and speech training simultaneously.Lastly,all three groups were subjected to western aphasia battery(WAB)and Boston diagnostic aphasia examination(BDAE)for assessment of speech function.Results After two months of treatment,all three groups had significantly higher scores on all points of WAB than before treatment.The differences were statistically significant(P<0.05).Statistically significant differences were also found between the three groups in the scores achieved two months after treatment on all points of WAB.The values of spontaneous speaking,auditory comprehension,retelling,nomenclature,and aphasia quotient(AQ)of group B and group C were better than those of group A.The scores of auditory comprehension,retelling,and AQ of group C were higher than those of group B.The differences were statistically significant(P<0.05).After two months of treatment,the severity of aphasia of all three groups as measured with BDAE were all upgraded,with the grading of severity of aphasia in group C being better than those of group A and group B.The differences were statistically significant(P<0.05).Conclusions Speech training and Tongdu Tiaoshen acupuncture conducted simultaneously can better address the problem of post-stroke aphasia than speech training conducted after Tongdu Tiaoshen acupuncture.