头针联合镜像神经元训练改善脑卒中后非流利性失语症的作用

Effect of Scalp Acupuncture Combined with Mirror Neuron Activation Training on Nonfluent Aphasia after Stroke

目的探讨头针联合镜像神经元激活训练对脑卒中后非流利性失语症的临床疗效。方法选取2019年4月~2020年1月上海市第二康复医院住院治疗的脑卒中后非流利性失语患者45例,随机分为头针组、镜像神经元组和联合治疗组。在每天30 min的常规言语治疗基础上,分别给予头针治疗、镜像神经元系统治疗及头针结合镜像神经元的联合治疗。观察治疗前后3组的西方失语症成套测试(western aphasia battery,WAB)、命名测试、BDAE失语症严重程度(the boston diagnostic aphasia,BDAE)、非语言认知评估量表(non-language-based cognitive assessment,NLCA)评分变化。通过问卷调查各组疗效满意度,并进行随访评估。结果治疗后3组的失语商(aphasi quotieat,AQ)、操作商(performance quotient,PQ)、NLCA、命名得分、BDAE等级较同组治疗前明显改善(P<0.05)。3组间比较,联合治疗组WAB疗效、患者满意度、NLCA改善幅度均高于其他组,其BDAE改善幅度明显优于其他组(P<0.05);镜像神经元治疗组命名改善最佳。结论在常规语言训练和头针治疗基础上辅以镜像神经元训练,可提高脑卒中后非流利性失语患者语言、认知功能。

Objective To investigate the clinical effect of scalp acupuncture combined with mirror neuron activation on non-fluency aphasia after stroke.Methods 45 patients with post-stroke non-fluency aphasia from The Second Rehabilitation Hospital of Shanghai from April 2019 to January 2020 were randomly divided into scalp acupuncture group,mirror nerve tuple and combined treatment groups.Based on the routine speech therapy of 30 min per day,three groups were treated with scalp acupuncture,mirror neuron system therapy and combined therapy with mirror neuron respectively.The scores of Western Aphasia(WAB),naming,BDAE Aphasia severity grading and nonverbal cognitive assessment scale(NLCA)were observed in the three groups before and after 4 weeks treatment.After 4 weeks,the satisfaction degree of each group was investigated by questionnaire.After two weeks of treatment,a follow-up evaluation was performed using BDAE.Results The AQ score,PQ score,NLCA score,naming score and BDAE grade of the three groups were significantly improved after treatment(P<0.05).The efficacy of WAB,patient satisfaction and NLCA improvement of the combined treatment group were higher than other two groups,and the BDAE improvement was significantly better than that of the other two groups(P<0.05);The mirror neuron treatment group improved most in naming.Conclusion The language and cognitive function of non-fluency aphasia patients after stroke can be further improved by training with mirror neurons based on conventional language training and scalp acupuncture.