注意训练对卒中后非流畅性失语症患者汉字加工能力的影响  

Influence of Attention Training on Chinese Character Processing Capability in Poststroke Nonfluent Aphasiacs

作　　者：裴倩[1] 张通[2,3] 宋鲁平[2,3] 

机构地区：[1]北京积水潭医院康复医学科,北京市100035 [2]中国康复研究中心北京博爱医院神经康复科,北京市100068 [3]首都医科大学康复医学院,北京市100068

出　　处：《中国康复理论与实践》2015年第3期296-302,共7页Chinese Journal of Rehabilitation Theory and Practice

基　　金：国家自然科学基金项目(No.C030307);中国康复研究中心课题(No.2011-3)

摘　　要：目的探讨注意训练对卒中后非流畅性失语症患者汉字加工能力的影响。方法将60例卒中后非流畅性失语症患者随机分成对照组(n=30)和实验组(n=30),分别给予认知训练和注意训练,每次30 min,每周5次,共4周。比较训练前后汉字加工的反应时差值、错误率差值。结果经过4周训练后,双任务中对于训练前后字形、字义加工的反应时差值和错误率差值比较,两组间有非常高度显著性差异(P<0.001),而字音加工的反应时差值和错误率差值比较,两组间无显著性差异(P>0.05);单任务中,对于训练前后字形、字义、字音加工的反应时差值和错误率差值比较,两组间均无显著性差异(P>0.05)。结论 1.双任务范式中,注意训练较认知训练对卒中后非流畅性失语症患者的字形、字义加工能力改善显著,可能因为注意训练改善注意资源容量或提高注意资源分配能力的效果更显著。2.双任务范式中,两组训练对卒中后非流畅性失语症患者字音加工能力的改善情况无显著性差异,可能因为朗读和默读判断需同时对韵母进行加工,这两个加工过程之间对注意资源的竞争加剧,导致完成任务难度增加。3.单任务范式中,两组训练对卒中后非流畅性失语症患者的字形、字义、字音加工能力的改善情况均无显著性差异,可能因为单任务注意需求小,虽然对照组进行认知训练,但对照组的注意功能改善程度已可满足单任务注意需求。Objective To explore the influence of attention training on Chinese character processing capability in poststroke nonfluent aphasiacs. Methods 60 stroke patients with nonfluent aphasia and cognition dysfunction were divided into control group（n=30） and experimental group（n=30）. The trainings（attention training and cognition training） were respectively 30 minutes each time, 5 times each week for4 weeks. The change of reaction time and error rate were compared before and after they were performing the orthographic, semantic and phonological tasks. Results In the dual-task paradigm the change of reaction time and error rate in orthographic and semantic tasks of the experimental group were all higher than the control group（P〈0.001）. But there was no difference between the two groups in the phonological task（P〉0.05）. In the single task paradigm there was no difference between the two groups（P〉0.05）. Conclusion 1. Attention training can improve the processing capacity significantly in orthographic and semantic tasks in the dual-task paradigm because the volume and distributive ability of attention improve significantly. 2. Attention training can＇t improve the processing capacity in phonological tasks in the dual-task paradigm because reading aloud and judging are required to process the vowel simultaneously. So that the competion intensifies and it is more difficult to finish the task. 3. In the single task paradigm, there is no significant difference between the influence of the two trainings in poststroke nonfluent aphasiac because the single task needs little attention and the change in the control group is enough.

关 键 词：注意训练 脑卒中 非流畅性失语 反应时 错误率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]