针刺联合低频重复经颅磁刺激治疗脑卒中后失语症的效果

Clinical Effect of Acupuncture Combined with Low Frequency Repetitive Transcranial Magnetic Stimulation on Aphasia after Stroke

目的 观察脑卒中后失语症患者经低频重复经颅磁刺激联合针刺治疗后的临床疗效。方法 选取南通市第三人民医院在2018年7月至2021年2月收治的脑卒中后失语症患者临床资料。根据治疗方法不同分为对照组(40例,语言治疗)和研究组(41例,语言治疗与低频重复经颅磁刺激联合针刺治疗),两组均治疗4周。观察两组患者临床疗效、不良反应情况及两组患者治疗前、治疗4周后的磁共振波谱指标、失语程度及生活质量变化情况。结果 研究组的临床总有效率高于对照组(P<0.05)。治疗4周后,两组胆碱(Cho)/肌酸(Cr)、乳酸(Lac)/Cr较治疗前降低,N-乙酰天冬氨酸(NAA)/Cr较治疗前升高,且研究组的改善幅度均大于对照组(P均<0.05)。治疗4周后,两组自发言语、复述、听理解、命名、失语商(AQ)这5个维度评分较治疗前升高,且研究组的改善幅度均大于对照组(P均<0.05)。治疗4周后,两组患者生理、沟通、心理社会维度评分较治疗前升高,且研究组的改善幅度均大于对照组(P均<0.05)。所有患者治疗期间均未出现严重不良反应。结论 低频重复经颅磁刺激联合针刺治疗可改善脑卒中后失语症患者症状及生活质量。

Objective To observe the clinical effect of low frequency repetitive transcranial magnetic stimulation combined with acupuncture in patients with aphasia after stroke.Methods Patients with aphasia after stroke treated in Nantong Third People’s Hospital from July 2018 to February 2021 were selected.According to different treatment methods,they were randomly divided into control group(40 cases,language therapy)and study group(41 cases,language therapy and lowfrequency repetitive transcranial magnetic stimulation combined with acupuncture).Both groups were treated for 4 weeks.The curative effect and adverse reactions were observed,and the changes of magnetic resonance spectroscopy indexes,aphasia degree and quality of life before and 4 weeks after treatment were compared between the two groups.Results The total clinical effective rate of the study group was higher than that of the control group(P<0.05).After 4 weeks of treatment,choline(Cho)/creatine(Cr),lactic acid(Lac)/Cr decreased and N-acetylaspartic acid(NAA)/Cr increased in the two groups,and the improvement range of the study group was greater than that of the control group(P all<0.05).After 4 weeks of treatment,the scores of self speech,repetition,listening comprehension,naming and aphasia quotient(AQ)in the two groups were higher than those before treatment,and the improvement range of the study group was greater than that of the control group(P all<0.05).After 4 weeks of treatment,the scores of physiology,communication and psychosocial dimensions in the two groups were higher than those before treatment,and the improvement range of the study group was greater than that of the control group(P all<0.05).All patients had no serious adverse reactions during treatment.Conclusion After low frequency repetitive transcranial magnetic stimulation combined with acupuncture,the symptoms of patients with aphasia after stroke were significantly improved and the quality of life was further improved,which may be related to the regulation of brain metabolite level.