邵氏五针法联合语言康复训练治疗脑卒中后运动性失语症患者的临床研究

Clinical Efficacy of Shao's Five-Needle Methods Combined with Speech Rehabilitation Training on Patients with Post-Stroke Motor Aphasia

目的探讨邵氏五针法联合语言康复训练治疗脑卒中后运动性失语症患者的临床疗效及其可能的作用机制。方法选择2017年9月至2019年6月河南省中医院康复科收治的脑卒中后运动性失语症住院患者100例,采用随机数字表法将其分成观察组与对照组,每组50例。2组均给予相同的常规内科治疗及语言康复训练,观察组在此基础上联合邵氏五针法治疗。2个疗程后对2组临床疗效进行评估,并记录治疗过程中不良反应情况。治疗前后进行失语测验评分以及美国国立卫生研究院卒中量表(NIHSS)评分,ELISA法检测2组患者血清降钙素基因相关肽(CGRP)、内皮素-1(ET-1)水平,并采用经颅多普勒超声测定大脑前、中、后动脉的平均血流速度(Vm)。结果治疗后,观察组总有效率为90.00%,与对照组的72.00%相比显著升高(P<0.05);2组理解、复述、命名及自发谈话评分均显著上升(P<0.01),观察组升高更显著(P<0.01);观察组治疗1、2个疗程后NIHSS评分均显著低于同期对照组(P<0.01);2组血清CGRP浓度显著升高(P<0.01),血清ET-1含量显著降低(P<0.01),观察组优于对照组(P<0.01);2组大脑前、中、后动脉Vm均显著加快(P<0.01),观察组改善更显著(P<0.01)。所有对象均未见明显副作用。结论邵氏五针法联合语言康复训练能安全有效地改善脑卒中后运动性失语症患者的语言功能及神经功能,其作用机制可能与上调血清CGRP水平、下调血清ET-1水平及改善脑部血流灌注有关。

OBJECTIVE To explore the clinical efficacy of Shao's five-needle methods combined with speech rehabilitation training in the treatment of post-stroke motor aphasia and its possible mechanism of action.METHODS A total of 100 patients with post-stroke motor aphasia who were hospitalized in the rehabilitation department of Henan Province Hospital of TCM from September 2017 to June 2019 were selected and divided into observation group and control group by random number table.Both groups were given the same conventional medical treatment and speech rehabilitation training,while the observation group was treated with an extra Shao's five-needle method.The clinical efficacy of the two groups was evaluated at the end of the total treatment course,and the adverse reactions during the treatment were recorded.The aphasia test and the National Institutes of Health Stroke Scale(NIHSS)were used before and after treatment.The calcitonin gene-related peptide(CGRP)and endothelin-1(ET-1)levels were measured by ELISA,and the mean velocity(Vm)of the anterior,middle and posterior cerebral arteries were measured by transcranial doppler sonography.RESULTS After treatment,the total effective rate in the observation group,which was significantly higher than in the control group(P<0.05).Besides,comprehension,repetition,naming and spontaneous talk scores were significantly increased in both groups(P<0.01),but the increase was more significant in the observation group(P<0.01).The NIHSS scores were significantly decreased in the observation group than in the control group during the same period after 1 and 2 sessions of the treatment(P<0.01).In addition,serum concentration of CGRP was significantly increased(P<0.01)and ET-1 at serum level was significantly decreased(P<0.01)in both groups,and the results in the observation group were better than the control group(P<0.01).Vm of anterior,middle,and posterior cerebral arteries was significantly accelerated in the 2 groups(P<0.01),and the improvement was more significant in the observation group(P<0.01).In the end of treatment,no significant side effects were observed in all subjects.CONCLUSION Shao's five-needle method combined with speech rehabilitation training can safely and effectively improve linguistic function and neurological function in patients with post-stroke motor aphasia,and its mechanism of action may be related to the upregulation of serum CGRP,downregulation of serum ET-1 and improvement of cerebral blood flow.