电针结合高频重复经颅磁刺激治疗脑卒中后运动性失语

Electro-acupuncture Combined with High Frequency Repetitive Transcranial Magnetic Stimulation in the Treatment of Motor Aphasia After Atroke

目的:观察电针结合高频重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗脑卒中后运动性失语的疗效。方法:选择符合纳入标准的44例脑卒中后运动性失语患者,按随机数字表法分为治疗组、对照组。对照组采用电针治疗,治疗组在对照组的基础上增加高频rTMS治疗,刺激频率为5 Hz,30个序列,每个序列50次脉冲,序列间隔15 s,刺激强度为80%MT,一般为40%~80%。每日1次,每次约12 min,每周5次,共20次,总疗程共4周。分别于入组前、入组4周后进行简化版《汉语失语成套测验》(aphasia battery of Chinese,ABC)、改良Barthel指数(modified barthel index,MBI)、汉密尔顿抑郁量表(hamilton depression scale,HAMD)评分比较,以判定疗效。结果:两组治疗后各评分较治疗前均显著改善,差异有统计学意义(P<0.01),且治疗组自发谈话、复述、命名以及MBI、HAMD评分改善较对照组明显,差异有统计学意义(P<0.05)。结论:电针结合高频rTMS治疗脑梗死后运动性失语有良好疗效。

Objective:To observe the effect of electro-acupuncture combined with repetitive transcranial magnetic stimulation(rTMS)on motor aphasia after stroke.Methods:From October 2017 to December 2018,44 patients with motor aphasia after stroke were selected from the Acupuncture and Rehabilitation Department and Encephalopathy Center of Affiliated Hospital of Nanjing University of Chinese Medicine.They were divided into treatment group and control group according to random number table method.The control group was treated with electro-acupuncture,while the treatment group was treated with high frequency rTMS on the basis of the control group.The stimulation frequency was 5 Hz,30 sequences,50 pulses per sequence,15 seconds interval,and the stimulation intensity was 80%MT,generally 40%-80%.They were treated once a day,about 12 minutes each time,five times a week,a total of 20 times,the total course of treatment for 4 weeks.Before and 4 weeks after admission,the simplified aphasia battery of Chinese(ABC),modified barthel index(MBI)and hamilton depression scale(HAMD)were compared to determine the efficacy.Results:The scores of both groups were improved after treatment.The difference was significant(P<0.01).The improvement of spontaneous conversation,repetition,naming,MBI and HAMD score in the treatment group was more obvious than that in the control group.The difference was significant(P<0.05).Conclusion:Electro-acupuncture combined with high frequency rTMS has a good effect on motor aphasia after stroke.