针灸联合言语康复治疗缺血性脑卒中后运动性失语患者的效果

Effect of acupuncture combined with speech rehabilitation in patients with motor aphasia after ischemic stroke

目的探究针灸联合言语康复治疗缺血性脑卒中后运动性失语(MAS)患者的效果。方法选取郑州人民医院收治的115例缺血性MAS患者(2019年6月至2020年11月)作为研究对象,按照随机数字表法分成A组(N=58)、B组(N=57),B组接受言语康复治疗,A组接受针灸联合言语康复治疗。比较两组治疗有效率,治疗前、治疗28 d中国康复研究中心失语症检查法(CRRCAE)、美国国立卫生研究院卒中量表(NIHSS)、生活质量综合评定问卷(GQOLI-74)评分、神经营养因子[脑源性神经营养因子(BDNF)、碱性成纤维细胞生长因子(bFGF)、胰岛素样生长因子-1(IGF-1)、神经生长因子(NGF)]水平。结果A组治疗有效率89.66%(52/58)较B组75.44%(43/57)高,差异有统计学意义(P<0.05);治疗28 d A组NIHSS评分较B组低,GQOLI-74评分较B组高,差异有统计学意义(P<0.05);治疗28 d A组命名、朗读、复述及表达评分较B组高,差异有统计学意义(P<0.05);治疗28 d A组血清BDNF、bFGF、NGF、IGF-1水平较B组高,差异有统计学意义(P<0.05)。结论针灸联合言语康复应用于缺血性MAS患者效果显著,可通过调节血清BDNF、bFGF水平,改善神经功能,提高言语功能及生活质量。

Objective To explore the effect of acupuncture combined with speech rehabilitation on motor aphasia(MAS)patients after ischemic stroke.Methods Selected 115 patients with ischemic MAS in our hospital(from June 2019 to November 2020)as the research objects,and divided them into group A(N=58)and group B(N=57)according to the random number table method.Group B received speech rehabilitation,and group A received acupuncture combined with speech rehabilitation.The two groups were compared for the effective rate of treatment.Before treatment and 28 days after treatment,China Rehabilitation Research Center Aphasia Examination(CRRCAE),National Institutes of Health Stroke Scale(NIHSS),Comprehensive Assessment Questionnaire for Quality of Life(GQOLI-74),neurological Levels of nutritional factors[brain-derived neurotrophic factor(BDNF),basic fibroblast growth factor(bFGF),insulin-like growth factor-1(IGF-1),nerve growth factor(NGF)].Results The effective rate of treatment in group A was 89.66%(52/58)higher than 75.44%(43/57)in group B,and the difference was statistically significant(P<0.05);On the 28th day of treatment,the NIHSS score of group A was lower than that of group B,and the score of GQOLI-74 was higher than that of group B,and the difference was statistically significant(P<0.05);On the 28th day of treatment,the NIHSS score of group A was lower than that of group B,and the GQOLI-74 score was higher than that of group B,and the difference was statistically significant(P<0.05).The difference was statistically significant(P<0.05);The serum levels of BDNF,bFGF,NGF and IGF-1 in group A were higher than those in group B on 28 days of treatment,and the difference was statistically significant(P<0.05).Conclusion Acupuncture combined with speech rehabilitation has a significant effect on ischemic MAS patients.It can improve neurological function,speech function and quality of life by regulating serum BDNF and bFGF levels.