目的探究醒神开窍针刺法联合经颅磁刺激(Transcranial Magnetic Stimulation,TMS)应用于脑卒中后患者的临床疗效及对患者认知、运动功能的改善作用。方法选取2019年1月—2020年3月期间淮安市中医院收治的94例脑卒中后患者,按随机数字表...目的探究醒神开窍针刺法联合经颅磁刺激(Transcranial Magnetic Stimulation,TMS)应用于脑卒中后患者的临床疗效及对患者认知、运动功能的改善作用。方法选取2019年1月—2020年3月期间淮安市中医院收治的94例脑卒中后患者,按随机数字表法分为常规康复联合醒神开窍针法治疗的对照组与醒神开窍针刺法联合TMS治疗的观察组,每组各47例。治疗1个月后,观察比较两组患者临床疗效,治疗前后中医证候积分(神志昏蒙、偏瘫、言语謇涩、口舌歪斜、头痛、胸胁胀满、共济失调等7项),神经功能评分[美国国立卫生研究院脑卒中量表(National Institute of Health stroke scale,NIHSS)],认知功能评分[蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)、简易智能精神状态检查量表(Mini-mental State Examination,MMSE)],生活质量评分[脑卒中专门化生存质量量表(SS-QOL)],生活能力评分[改良Barthel指数(MBI)],肢体功能评分[Fugl-Meyer运动功能(Fugl-Meyer motor function assessment,FMA)、上肢动作研究量表(Action ResearchArm Test,ARAT)与Berg平衡量表(Berg balance scale,BBS)],并统计两组患者不良反应发生情况。结果治疗后观察组总有效率97.87%(46/47)较对照组明显升高82.98%(39/47),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分、NIHSS评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者MoCA、MMSE、SS-QOL、MBI、FMA、ARAT、BBS评分均较治疗前升高,差异有统计学意义(P<0.05);且观察组均高于对照组,差异有统计学意义(P<0.05)。治疗期间两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论将醒神开窍针法与TMS联合应用于康复期脑卒中患者的治疗中能够明显改善患者认知与运动功能,提高其生活质量。展开更多
Objective:To observe the effects of acupuncture at the Governor Vessel acupoints plus language training on the language function and cerebral blood flow in patients with motor aphasia after ischemic stroke.Methods:Eig...Objective:To observe the effects of acupuncture at the Governor Vessel acupoints plus language training on the language function and cerebral blood flow in patients with motor aphasia after ischemic stroke.Methods:Eighty-six patients were randomized into a control group and an observation group,with 43 cases in each group.Conventional symptomatic treatment was offered to both groups.Besides,the control group received language training,while the observation group received language training plus additional acupuncture at the Governor Vessel acupoints.Before and after treatment,the aphasia battery of Chinese(ABC)and Chinese functional communication profile(CFCP)were tested,and the mean velocity(Vm)and resistance index(Rl)of the left middle cerebral artery(MCA)were detected.Results:The total effective rate was higher in the observation group than in the control group(P<0.05).After treatment,the observation group gained higher scores in oral expression,comprehension,repeating,naming objects,reading,and writing,as well as the general score of ABC(all P<0.Q5)f higher than those in the control group(all P<0.05).The CFCP score increased in both groups after intervention,showing significant intra-group differences(both P<0.05),and the CFCP score was higher in the observation group than in the control group(P<0.05).After treatment,Vm of the left side MCA in creased in the con trol group(P<0.05),while no significant change was observed in Rl(P>0.05);in the observation group,Vm of the left side MCA increased and Rl decreased signfiicantly compared with the baseline(both P<0.05),and were markedly different from those in the control group(both P<0.05).Conclusion:Acupuncture at the Governor Vessel acupoints plus language training can produce valid efficacy in treating motor aphasia after ischemic stroke;it can notably improve the language function,everyday oral communication ability,and in crease cere bral perfusion of the patients.展开更多
文摘目的探究醒神开窍针刺法联合经颅磁刺激(Transcranial Magnetic Stimulation,TMS)应用于脑卒中后患者的临床疗效及对患者认知、运动功能的改善作用。方法选取2019年1月—2020年3月期间淮安市中医院收治的94例脑卒中后患者,按随机数字表法分为常规康复联合醒神开窍针法治疗的对照组与醒神开窍针刺法联合TMS治疗的观察组,每组各47例。治疗1个月后,观察比较两组患者临床疗效,治疗前后中医证候积分(神志昏蒙、偏瘫、言语謇涩、口舌歪斜、头痛、胸胁胀满、共济失调等7项),神经功能评分[美国国立卫生研究院脑卒中量表(National Institute of Health stroke scale,NIHSS)],认知功能评分[蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)、简易智能精神状态检查量表(Mini-mental State Examination,MMSE)],生活质量评分[脑卒中专门化生存质量量表(SS-QOL)],生活能力评分[改良Barthel指数(MBI)],肢体功能评分[Fugl-Meyer运动功能(Fugl-Meyer motor function assessment,FMA)、上肢动作研究量表(Action ResearchArm Test,ARAT)与Berg平衡量表(Berg balance scale,BBS)],并统计两组患者不良反应发生情况。结果治疗后观察组总有效率97.87%(46/47)较对照组明显升高82.98%(39/47),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分、NIHSS评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者MoCA、MMSE、SS-QOL、MBI、FMA、ARAT、BBS评分均较治疗前升高,差异有统计学意义(P<0.05);且观察组均高于对照组,差异有统计学意义(P<0.05)。治疗期间两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论将醒神开窍针法与TMS联合应用于康复期脑卒中患者的治疗中能够明显改善患者认知与运动功能,提高其生活质量。
文摘Objective:To observe the effects of acupuncture at the Governor Vessel acupoints plus language training on the language function and cerebral blood flow in patients with motor aphasia after ischemic stroke.Methods:Eighty-six patients were randomized into a control group and an observation group,with 43 cases in each group.Conventional symptomatic treatment was offered to both groups.Besides,the control group received language training,while the observation group received language training plus additional acupuncture at the Governor Vessel acupoints.Before and after treatment,the aphasia battery of Chinese(ABC)and Chinese functional communication profile(CFCP)were tested,and the mean velocity(Vm)and resistance index(Rl)of the left middle cerebral artery(MCA)were detected.Results:The total effective rate was higher in the observation group than in the control group(P<0.05).After treatment,the observation group gained higher scores in oral expression,comprehension,repeating,naming objects,reading,and writing,as well as the general score of ABC(all P<0.Q5)f higher than those in the control group(all P<0.05).The CFCP score increased in both groups after intervention,showing significant intra-group differences(both P<0.05),and the CFCP score was higher in the observation group than in the control group(P<0.05).After treatment,Vm of the left side MCA in creased in the con trol group(P<0.05),while no significant change was observed in Rl(P>0.05);in the observation group,Vm of the left side MCA increased and Rl decreased signfiicantly compared with the baseline(both P<0.05),and were markedly different from those in the control group(both P<0.05).Conclusion:Acupuncture at the Governor Vessel acupoints plus language training can produce valid efficacy in treating motor aphasia after ischemic stroke;it can notably improve the language function,everyday oral communication ability,and in crease cere bral perfusion of the patients.
