针刺治疗卒中后失语的机制探讨

Mechanism of Acupuncture for Post-stroke Aphasia

卒中后失语是目前卒中后遗留的主要功能障碍之一,严重影响患者日常生活及心理状态。针刺治疗卒中后失语在临床上确有疗效,诸多学者对其机制进行了不同角度的探索。从中医学的角度而言,失语属脑神失司,言语不利,针刺治疗可以发挥疏通经络,引导气血,从而疏通卒中后巅顶气血,发挥传统针刺治疗的优势。从现代医学而言,卒中后多对语言功能区具有直接性的损伤,恢复其局部的血流,改善缺血半暗带,促进神经重塑,改善言语功能。机制多为语言功能区的梗死为主,目前研究亦证实针刺可以改善Wernicke及Broca区的血流,促进两区联通,实现语言功能的恢复,然而其机制并非仅此而已,仍与炎症、免疫、代谢等诸多因素有关,仍需现代基础研究不断深入探索。文章从中医学及现代医学两个角度,结合针刺临床疗效,分别探讨了针刺治疗卒中后失语的可能机制,然因其确切机制目前国内及国际尚未明确,未能穷尽其源,后续仍需要大量的临床及基础研究不断深入探索卒中后失语的内在机制,从而更好地服务于临床,减轻社会负担。

Poststroke aphasia is one of the main dysfunction left after stroke,which seriously affects the daily life and psychological state of patients.In recent years,acupuncture treatment after stroke aphasia has a clinical effect,and many scholars have explored the mechanism from different angles.From the perspective of traditional medicine,aphasia is a loss of brain god and unfavorable speech.The acupuncture treatment can play to dredge the meridians and guide qi and blood,so as to dredge the top qi and blood after stroke,and give play to the advantages of traditional acupuncture treatment.From the perspective of modern medicine,stroke has direct damage to language function areas,restoring local blood flow,improving ischemic penumbra,promoting neural remodeling and improving speech function.Most of the mechanism is mainly infarction in language function areas.Current studies have also confirmed that acupuncture can improve the blood flow in Wernicke and Broca regions,promote the connection between the two regions,and realize the recovery of language function.However,the mechanism is not alone,still related to many factors such as inflammation,immunity and metabolism,and still needs continuous in-depth exploration of modern basic research.This paper from the perspective of traditional medicine and modern medicine,combined with the clinical curative effect of acupuncture,respectively discusses the possible mechanism of aphasia after stroke,but because of its exact mechanism of the domestic and international has not been clear,the author failed to exhaust its source,subsequent still need a lot of clinical and basic research continuously explore the internal mechanism of aphasia after stroke,so as to better serve the clinical and patients,reduce the social burden.