基于^(1)H-MRS评价头针结合失语症(维吾尔语)训练系统治疗卒中后失语患者的临床研究

Clinical Study of Scalp Electro-Acupuncture Combined with Aphasia(Uighur)Training in Treating Uighur Aphasia Based on ^(1)H-MRS

目的:讨论头针+失语症(维吾尔语)训练系统影响卒中后维吾尔族失语症病人言语功能状况。方法:试验对象为与纳入标准相符的60名患者,经随机方式均等分配至下述各组,A组行头针电针+失语症(维吾尔语)训练系统,B组采用失语症(维吾尔语)训练系统,C组采用单一头针电针治疗,分别在干预前后利用维吾尔语失语症检查法(ABU量表)对患者言语功能进行疗效评价,利用磁共振波谱成像(MRS)对Broca失语或Wernicke失语患者Broca区和Wernicke区进行分析,并对NAA(N-乙酰天门冬氨酸)、Cho(胆碱)、Cr(肌酸)与Lac(乳酸)展开测定,就脑梗死(CI)病灶区和未病侧组织的Cho/Cr、Lac/Cr及NAA/Cr指标进行对比。结果:在干预后的ABU各亚项评分上,对比3组发现皆存在显著不同表现,差异具有统计学意义(P<0.05),相较另两组,A组表现出显著优势,差异具有统计学意义(P<0.01)。在Wernicke区(或Broca区)的NAA/Cr此项指标上,相比未干预时,干预后的3组皆为显著偏高表现,差异具有统计学意义(P<0.05);相比未干预时,3组干预后的Cho/Cr与Lac/Cr这两项指标则为显著偏低表现,差异具有统计学意义(P<0.05)。结论:电针头针结合失语症(维吾尔语)训练系统不仅可以改善患者语言功能,而且可引起患者相应脑部代谢产物发生变化,研究结果表明这些代谢产物的变化可能与患者言语功能的恢复有关。

Objective:To study the clinical efficacy of scalp electro-acupuncture combined with aphasia(uighur)training in the treatment of the uygur patients with aphasia after stroke.Methods:60 patients who met the inclusion criteria were randomly divided into group A,group B and group C,with 20 patients in each group.Group A was treated with scalp electro-acupuncture combined with aphasia(uighur)training,group B was treated with aphasia(uighur)training,and group C was treated with scalp electro-acupuncture.All eligible patients were evaluated before the training and after the intervention,ABU scale was used to evaluate the speech function and magnetic resonance spectroscopy(MRS)was used to analyse the Broca and Wernicke regions in patients with Broca aphasia or Wernicke aphasia,and N-acetylaspartate(NAA),choline(Cho),creatine(Cr)and lactic acid(Lac)were detected to compare the differences of Cho/Cr,Lac/Cr and NAA/Cr between the lesions of cerebral infarction and contralateral normal tissues.Results:In terms of the scores of ABU sub-items,there were statistical differences among the three groups(P<0.05),of which group A showed significant advantages compared to group B and group C(P<0.01).NAA/Cr of the Broca and Wernicke regions was significantly higher(P<0.05),and Cho/Cr and Lac/Cr were significantly lower after the interventions than those before the interventions in the three groups(P<0.05).Conclusion:Scalp electro-acupuncture combined with aphasia(uighur)training can not only improve language function,but also cause the changes of corresponding brain metabolism in the patients.The study prove that the changes of these metabolites may be associated with the improvement of speech function.