中文朗读训练对非痴呆型血管性认知障碍患者认知功能的影响  

Effect of Chinese reading aloud training on cognitive function in patients with vascular cognitive impairment no dementia

作　　者：李文英 史婧 朱红叶 张艳锋 张岚 韩辉 Li Wenying;Shi Jing;Zhu Hongye;Zhang Yanfeng;Zhang Lan;Han Hui(Department of Neurology,General Hospital of Xingtai Mining Group,Xingtai 054000,China)

机构地区：[1]邢台矿业集团总医院神经内科,054000

出　　处：《中华行为医学与脑科学杂志》2020年第1期44-49,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：邢台市科技计划项目(2016ZC256)。

摘　　要：目的探讨中文朗读训练对非痴呆型血管性认知障碍(vascular cognitive impairment no dementia,VCIND)患者的认知功能及日常生活能力的作用。方法招募2018年1月至2019年1月就诊于邢台矿业集团总医院的VCIND患者80名,随机分为朗读训练组(n=43)和空白对照组(n=37),试验组每天朗读当日报纸新闻,5d/周,共12周。干预前后分别采用蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)、数字连线测验(trail making test,TMT)、听觉词语学习测验(audit ory verb learn test,AVLT)、数字符号转换测试(digit symbol substitution test,DSST)及改良Barthel指数(modified Barthel index,MBI)进行评估。结果中文朗读训练干预12周后,朗读训练组在MoCA总分[4.00(2.00)分,1.50(0.50)分,Z=3.012,P=0.003]、MoCA-视空间执行[2.00(1.00)分,0.00(2.00)分,Z=2.787,P=0.008]、MoCA-注意[1.00(1.00)分,0.00(0.50)分,Z=2.369,P=0.022]、MoCA-语言[1.00(1.00)分,0.00(0.75)分,Z=3.049,P=0.000]、MoCA-延迟回忆[2.00(2.00)分,0.00(1.00)分,Z=2.043,P=0.014]、TMT-A[-8.00(23.00)分,10.50(30.25)分,Z=2.120,P=0.039]、AVLT-学习[3.00(2.00)分,0.50(0.75)分,Z=2.266,P=0.019]、AVLT-延迟回忆[2.00(1.00)分,0.00(1.00)分,Z=2.974,P=0.003]、AVLT-再认[2.00(0.00)分,0.50(1.50)分,Z=3.054,P=0.000]及DSST[(4.96±0.71)分,(2.39±0.78)分,t=2.572,P=0.014]差值较对照组差异有统计学意义;在MoCA其他分项测试、TMT-B及MBI方面差异无统计学意义(均P>0.05);DSST的分数增加与朗读训练次数呈正相关关系(r=0.205,P=0.006)。结论中文朗读训练对VCIND患者的总体认知功能有改善作用,尤其在信息处理速度、执行功能、注意力及听觉记忆方面效果明显。Objective To investigate the effect of Chinese reading aloud training(c-RAT)on cognitive function and activities of daily living in patients with vascular cognitive impairment no dementia(VCIND).Methods From January 2018 to January 2019,totally 80 patients with VCIND in the General Hospital of Xingtai Mining Group were enrolled.Subjects were randomized grouped into c-RAT group(n=43)and control group(n=37).The c-RAT group was asked to read aloud the Chinese paper for 5 days a week for 12 weeks.At the time of enrollment and 12 weeks after the intervention,the Montreal cognitive assessment(MoCA),trail making test(TMT),auditory verb learn test(AVLT),digit symbol substitution test(DSST)and modified Barthel index(MBI)were filled out.Results Compared with control group,the difference of D-value in c-RAT group was statistically significant in MoCA total scores(4.00(2.00),1.50(0.50),Z=3.012,P=0.003),scores of MoCA-Visual space execution(2.00(1.00),0.00(2.00),Z=2.787,P=0.008),MoCA-attention(1.00(1.00),0.00(0.50),Z=2.369,P=0.022),MoCA-language(1.00(1.00),0.00(0.75),Z=3.049,P=0.000)and MoCA-delayed recall(2.00(2.00),0.00(1.00),Z=2.043,P=0.014),TMT-A scores(-8.00(23.00),10.50(30.25),Z=2.120,P=0.039),AVLT scores(1earning)(3.00(2.00),0.50(0.75),Z=2.266,P=0.039),AVLT scores(recall)(2.00(1.00),0.00(1.00),Z=2.974,P=0.003)、AVLT scores(recognition)(2.00(0.00),0.50(1.50),Z=3.054,P=0.000)and DSST scores((4.96±0.71),(2.39±0.78),t=2.572,P=0.014),while there were no significant differences in the rest parts of MoCA,TMT-B and MBI(P>0.05).The increased scores in DSST were positively correlated(r=0.205,P=0.006)with the number of reading aloud tasks finished.Conclusion C-RAT can improve general cognition,especially in information processing speed,executive function,attention and auditory memory.

关 键 词：学习疗法 轻度认知功能障碍 血管性痴呆 信息处理速度 

分 类 号：R74[医药卫生—神经病学与精神病学]