重复经颅磁刺激联用语言康复训练治疗脑卒中后言语功能障碍患者的临床观察

Clinical observation of repeated transcranial magnetic stimulation combined with speech rehabilitation training in the treatment of speech dysfunction after stroke

目的探讨重复经颅磁刺激(rTMS)联合语言康复训练治疗脑卒中后言语功能障碍患者的临床疗效。方法选取2016年2月至2019年5月于本院住院治疗的74例患者作为研究对象,采用随机数字表法分为观察组与对照组,每组37例。观察组rTMS联合语言康复训练治疗,对照组采用语言康复训练治疗。比较两组治疗前后言语功能情况、失语症严重程度及大脑语言功能区激活范围变化情况。结果治疗4周后,两组CRRCAE评分略高于治疗前,但差异无统计学意义;治疗8周后,两组CRRCAE评分高于治疗前,且观察组明显高于对照组(P<0.05)。治疗8周后,观察组AQ指数高于对照组(P<0.05)。治疗8周后,观察组BOLD-fMRI检测显示大脑右侧半球区域激活区较左侧半球明显缩小(P<0.05)。结论重复经颅磁刺激联合语言康复训练可改善脑卒中后言语功能障碍患者的言语功能。

Objective To investigate the clinical effects of repeated transcranial magnetic stimulation(rTMS)combined with speech rehabilita-tion training on speech dysfunction after stroke.Methods 74 patients hospitalized in our hospital from February 2016 to May 2019 were selected as the study subjects,and they were divided into observation group and control group according to random number table method,with 37 patients in each group.The observation group was treated with rTMS combined with speech rehabilitation training,while the control group was treated with speech rehabilitation training.The terms of speech function,the severity of aphasia and the changes in the activation range of brain language func-tional areaswere compared before and after treatment between two groups.Results After 4 weeks of treatment,the CRRCAE score of the two groups was slightly higher than that before treatment,but the difference was not statistically significant.After 8 weeks of treatment,the CRRCAE score of the two groups were higher than before treatment,and the observation group was significantly higher than the control group(P<0.05).Af-ter 8 weeks of treatment,AQ index in the observation group was higher than that in the control group(P<0.05).After 8 weeks of treatment,BOLD-FMRI of the observation group showed that the activation area of the right hemisphere was significantly smaller than that of the left hemi-sphere(P<0.05).Conclusion Repeated transcranial magnetic stimulation combined with speech rehabilitation training can improve the speech function of stroke patients with speech dysfunction.