“开窍解喑”法针刺联合重复经颅磁刺激治疗卒中后失语症:随机对照试验

Kaiqiao Jieyin acupuncture combined with repetitive transcranial magnetic stimulation for post-stroke aphasia: a randomized controlled trial

目的:观察“开窍解喑”法针刺联合重复经颅磁刺激(r TMS)对卒中后失语症(PSA)患者语言能力及日常生活交流能力的影响。方法:将56例PSA患者随机分为观察组和对照组,各28例。两组均进行常规对症治疗。对照组采用言语康复训练和r TMS治疗;观察组在对照组的基础上采用“开窍解喑”法针刺治疗,穴取言语一区、风池、通里、廉泉、旁廉泉等,两侧旁廉泉连接电针(断续波,频率2Hz)。以上治疗均每日1次,连续治疗5 d后休息2 d,共治疗2周。比较两组患者治疗前后西方失语症成套测验(WAB)评分[包括自发言语、听理解、复述、命名评分及失语指数(AQ)评分]和日常生活交流能力(CADL)评分。结果:治疗后,两组患者自发言语、听理解、复述、命名、AQ评分均较治疗前升高(P<0.05),且观察组升高幅度大于对照组(P<0.05);两组患者CADL评分均较治疗前升高(P<0.05)。结论:“开窍解喑”法针刺联合r TMS可改善PSA患者的语言能力和日常生活交流能力。

Objective To observe the effect of Kaiqiao Jieyin acupuncture(acupuncture for opening orifices and relieving aphasia) combined with repetitive transcranial magnetic stimulation(rTMS) on language ability and daily life communication ability in patients with post-stroke aphasia(PSA). Methods Fifty-six patients with PSA were randomly divided into an observation group and a control group, 28 cases in each group. Both groups received routine symptomatic treatment. The control group was treated with speech rehabilitation training and rTMS. On the basis of the treatment in the control group, the observation group was treated with Kaiqiao Jieyin acupuncture at the speech area Ⅰ, Fengchi(GB 20),Tongli(HT 5), Lianquan(CV 23), Panglianquan(Extra), etc. Panglianquan(Extra) on both sides were connected to electroacupuncture, with intermittent wave, 2 Hz in frequency. The above treatment was performed once a day for 5consecutive days, followed by 2 days of rest for 2 weeks. The scores of western aphasia battery(WAB, including scores of spontaneous speech, auditory comprehension, repetition, naming and score of aphasia quotient [AQ]) and communication abilities in daily living(CADL) in the two groups were compared before and after treatment. Results After treatment, the spontaneous speech, auditory comprehension, repetition, naming scores and AQ scores in both groups were higher than those before treatment(P<0.05), and the increase in the observation group was greater than the control group(P<0.05). The CADL scores of the two groups were higher than those before treatment(P<0.05). Conclusion Kaiqiao Jieyin acupuncture combined with rTMS can improve the language ability and daily life communication ability of PSA patients.