经颅直流电刺激联合镜像疗法对脑卒中后非流利性失语患者的疗效观察

Observation on the Effect of Transcranial Direct Current Stimulation Combined with Mirror Therapy on Patients with Nonfluent Aphasia Output After Stroke

目的观察经颅直流电刺激联合镜像疗法对脑卒中后非流利性失语患者的疗效。方法选取2019年10月-2021年12月在徐州市中心医院诊治的62例脑卒中后非流利性失语患者为研究对象,采用随机数字表法分为对照组和观察组,各31例。对照组常规治疗加经颅直流电刺激,观察组在对照组基础上给予镜像疗法治疗。比较两组治疗前和治疗4周时的临床疗效、言语功能评分、失语指数、交流能力评分、失语症分级及事件相关脑电位N400。结果观察组总有效率为93.55%,高于对照组的80.65%(P<0.05);两组治疗后自发言语、理解、复述、命名各维度评分均高于治疗前,且观察组高于对照组(P<0.05);两组失语指数、交流能力评分均高于治疗前,且观察组高于对照组(P<0.05);观察组失语症5级、4级所占比例均大于对照组,2级、1级所占比例均小于对照组(P<0.05),3级与对照组比较,差异无统计学意义(P>0.05);观察组治疗后N400潜伏期小于对照组,波幅大于对照组(P<0.05)。结论经颅直流电刺激联合镜像疗法治疗脑卒中后非流利性失语效果确切,可提高治疗总有效率,显著提升患者言语功能、交流能力、认知功能评分,改善失语症程度分级和N400,具有重要的临床应用价值。

Objective To observe the effect of transcranial direct current stimulation combined with mirror therapy on patients with nonfluent aphasia output after stroke.Methods A total of 62 patients with nonfluent aphasia output after stroke who were treated in Xuzhou Central Hospital from October 2019 to December 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,with 31 cases in each group.The control group received routine treatment plus transcranial direct current stimulation,and the observation group received mirror therapy on the basis of the control group.The clinical efficacy,speech function score,aphasia index,communication ability score,aphasia grading and event-related brain potential N400 were compared between the two groups before and 4 weeks after treatment.Results The total effective rate of the observation group was 93.55%,which was higher than 80.65%of the control group(P<0.05).After treatment,the scores of spontaneous speech,understanding,retelling and naming in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group(P<0.05).The aphasia index and communication ability scores of the two groups were higher than those before treatment,and those in the observation group was higher than those in the control group(P<0.05).The proportion of aphasia grade 5 and grade 4 in the observation group was higher than that in the control group,and the proportion of grade 2 and grade 1 was lower than that in the control group(P<0.05).There was no significant difference in the proportion of grade 3 between observation group and control group(P>0.05).After treatment,the latency of N400 in the observation group was less than that in the control group,and the amplitude was greater than that in the control group(P<0.05).Conclusion Transcranial direct current stimulation combined with mirror therapy is effective in the treatment of patients with nonfluent aphasia output after stroke,which can improve the total effective rate of treatment,improve the scores of speech function,communication ability and cognitive function,and improve the degree of aphasia and N400.It has important clinical application value.