| 叶青,杨婷,周亮,等.醒神通窍针法治疗卒中后失语症的临床研究[J].浙江中医药大学学报,2021,45(9):955-961. |
| 醒神通窍针法治疗卒中后失语症的临床研究 |
| Clinical Study on Treatment of Aphasia after Stroke by Xingshen Tongqiao Acupuncture |
| DOI：10.16466/j.issn1005-5509.2021.09.004 |
| 中文关键词: 脑卒中 失语症 注意网络 警觉时间 执行控制 醒神通窍针法 语言功能 疗效 |
| 英文关键词: stroke aphasia attention network alerting time executive control Xingshen Tongqiao acupuncture language function curative effect |
| 基金项目:浙江省中医药科技计划项目(2020ZA015) |
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| 中文摘要: |
| [目的]探讨醒神通窍针法治疗脑卒中后失语症患者的临床疗效及其对注意网络系统的影响。[方法]选取2020年4月至2021年3月浙江省人民医院康复医学中心的60例脑卒中后失语症患者，采用随机数字表法将其分为对照组(30例)和研究组(30例)，同时根据患者自发言语的流畅性与否，进一步将研究组分为流畅性失语组16例与非流畅性失语组14例。两组失语症患者均接受常规言语语言治疗(speech language therapy，SLT)，对照组采用常规针刺法治疗，研究组采用醒神通窍针法治疗。治疗前和治疗4周结束后采用注意网络测试(attention network test，ANT)和中国康复研究中心汉语标准失语症检查(China Rehabilitation Research Center aphasia examination，CRRCAE)进行评定。[结果]治疗前两组患者ANT及CRRCAE的各项评分比较，差异无统计学意义(P＞0.05)。治疗4周后研究组患者警觉时间增加，执行控制时间及总反应时间减少，正确率提高，与治疗前比较差异有统计学意义(P＜0.05)；对照组ANT各项指标治疗前后比较差异无统计学意义(P＞0.05)。与对照组比较，研究组警觉时间、执行控制时间、总反应时间及正确率治疗前后差值差异有统计学意义(P＜0.05)，研究组优于对照组；在定向时间方面，差异无统计学意义(P＞0.05)。治疗4周后研究组和对照组患者的CRRCEA各项评分与治疗前比较均有提高，差异有统计学意义(P＜0.05)；研究组治疗后CRRCAE各项评分优于对照组，差异有统计学意义(P＜0.05)。与对照组比较，研究组听理解、复述、命名和阅读方面治疗前后差值差异均有统计学意义(P＜0.05)，研究组优于对照组。治疗4周后研究组亚组分析中，流畅性失语组与非流畅性失语组患者的CRRCEA各项治疗后评分与治疗前比较均有提高，差异有统计学意义(P＜0.05)，治疗后流畅性失语组听理解、复述、阅读方面评分优于非流畅性失语组，差异有统计学意义(P＜0.05)；在命名方面两组治疗后评分比较，差异无统计学意义(P＞0.05)。与非流畅性失语组比较，流畅性失语组治疗听理解、复述和阅读方面前后的差值，差异有统计学意义(P＜0.05)，流畅性失语组优于非流畅性失语组；在命名方面，差异无统计学意义(P＞0.05)。[结论]醒神通窍针法可提高脑注意网络的警觉时间及执行控制能力，促进失语症患者语言功能的恢复，在流畅性失语患者中更为明显，其效果优于常规针刺法。 |
| 英文摘要: |
| [Objective] To explore the clinical efficacy of Xingshen Tongqiao acupuncture in treating patients with aphasia after stroke and its influence on the attention network. [Methods] From April 2020 to March 2021， 60 patients with aphasia after stroke in Rehabilitation Medicine Center of Zhejiang Provincial People's Hospital were selected and divided into control group(30 cases) and study group(30 cases) with the use of random number tables. And then， according to the fluency of the patients' spontaneous speech， the study group was further divided into fluent aphasia group(16 cases) and non-fluent aphasia group(14 cases).Both groups of patients received conventional speech language therapy(SLT). Patients of control group were treated with conventional acupuncture， while patients of study group were treated with Xingshen Tongqiao acupuncture. Before and after 4 weeks of treatment， the attention network test(ANT) and China Rehabilitation Research Center aphasia examination(CRRCAE) were used for assessment. [Results] Before treatment， no significant difference was indicated in the scores of ANT and CRRCAE between the two groups(P＞0.05). In study group， the alert time increased， executive control response time and the total response time decreased， and the accuracy rate was improved. The differences before and after the treatment indicated statistical significance(P＜0.05).In control group， there was no statistically significant difference in ANT indicators before and after treatment(P＞0.05). Before and after treatment， the difference between study group and control group was statistically significant in terms of alert time， execution control time， total response time and accuracy rate(P＜0.05); in terms of orientation time， the difference was not statistically significant(P＞0.05). The scores of CRRCEA of study group and control group were significantly improved compared with those before treatment(P＜0.05). The scores of study group were better than those of control group after treatment， and the differences were statistically significant(P＜0.05). Compared with control group， the difference of listening comprehension， retelling， naming and reading between before and after treatment was statistically significant in study group(P＜0.05). In the subgroup analysis of study group after 4 weeks of treatment， the CRRCEA scores of patients both in fluent aphasia group and non-fluent aphasia group improved compared with those before the treatment， and the difference was statistically significant(P＜0.05). Among them， the scores of listening comprehension， retelling， and reading of fluent aphasia group after treatment were better than those of the non-fluent aphasia group， and the difference between the two groups was statistically significant(P＜0.05); in terms of naming， there was no difference in the scores after treatment between the two groups(P＞0.05). Before and after treatment， the difference between the fluent aphasia group and the non-fluent aphasia group was statistically significant in listening comprehension， retelling and reading(P＜0.05); in terms of naming， the difference was not statistically significant(P＞0.05). [Conclusion] The Xingshen Tongqiao acupuncture can improve the alertness of the brain attention network and the efficiency of executive control and promote the recovery of the patient's speech function. It is more obvious in patients with fluent aphasia， and its curative effect is better than conventional acupuncture. |
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