镜像疗法联合常规言语训练治疗急性脑梗死后皮质下失语疗效观察  

Therapeutic Effect of Mirror Therapy Combined with Conventional Speech Training on Subcortical Aphasia after Acute Cerebral Infarction

作　　者：陈庆梅[1] 蔡秀英[1] 柯俊 沈丹 范可可 杨卫新[1] 李莉[1] 方琪[1] CHEN Qingmei;CAI Xiuying;KE Jun;SHEN Dan;FAN Keke;YANG Weixin;LI Li;FANG Qi(The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州大学附属第一医院,江苏苏州215000

出　　处：《康复学报》2020年第3期220-225,共6页Rehabilitation Medicine

基　　金：国家自然科学基金青年项目(81701669);江苏省社会发展-重点病种规范化诊疗项目(BE2016670);江苏省自然科学基金青年项目(BK20170368)。

摘　　要：目的:观察镜像疗法联合常规言语训练治疗急性脑梗死后皮质下失语的临床疗效。方法:将纳入急性脑梗死后皮质下失语患者34例随机分成治疗组和对照组各17例。2组患者均于发病后第7天开始接受2周的常规言语训练,治疗组在常规言语治疗基础上加用镜像治疗,对照组仅给予常规言语治疗,评估2组治疗前、病程第3周及病程第12周失语商(AQ)、美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表(mRS)。以3个月AQ提高≥30分为言语功能明显改善,改良mRS 0~2分为神经功能预后良好。结果:治疗前2组各项指标比较差异无统计学意义(P>0.05);经过2周治疗后,2组病程第3周和第12周NIHSS、AQ、AQ各项(自发言语、听理解、复述及命名)及mRS得分均较治疗前改善,差异有统计学意义(P<0.05);病程第3周和第12周治疗组的AQ、自发言语、听理解、复述、命名、NIHSS及mRS改善优于对照组(P<0.05);治疗组的言语功能明显改善率(82.35%)较对照组(35.29%)更为显著(P=0.013)。校正混杂因素后,干预方式及年龄与言语功能明显改善相关(P<0.05)。结论:镜像疗法结合常规言语训练有助于急性脑梗死后皮质下失语患者言语和神经功能的康复,同时促进患者3个月言语功能的明显改善。Objective:To observe the effect of combined mirror therapy and conventional speech training on the rehabilitation of subcortical aphasia after acute cerebral infarction.Methods:A total of thirty-four patients with subcortical aphasia after cerebral infarction were randomly divided into treatment group and control group.The treatment group received conventional speech therapy combined with mirror therapy,and patients in the control group were only given conventional speech therapy.Both groups received conventional speech therapy for acute cerebral infarction on the 7th day after onset.The aphasia quotient(AQ)in the western aphasia test,National Institutes of Health Stroke Scale(NIHSS)and the Modified Rankin Scale(mRS)were assessed before treatment,and at the third and 12th week of disease.AQ which increased≥30 scores within three months was regarded as significant improvement of speech function,and mRS scores of 0-2 were considered to have a good prognosis for neurological function.Results:There was no significant difference between the two groups before the treatment in all the indicators(P>0.05).After 2 weeks'treatment,NIHSS,AQ,and AQ(spontaneous speech,listening comprehension,retelling and naming)and mRS scores of the two groups were improved at the third and 12th week of disease,which were statistically significalt differences compared with before treatment(P<0.05).The scores of aphasia,spontaneous speech,listening comprehension,retelling,naming,NIHSS and mRS in the treatment group at the third and 12th week of disease were better than those in the control group(P<0.05).The significant improvement rate of speech function was better in the treatment group(82.35%)than that in the control group(35.29%)(P=0.013).After adjusting for confounding factors,the intervention factor and age were correlated with aphasia function significant improvement(P<0.05).Conclusion:Mirror therapy combined with conventional speech therapy can help speech and neurological function rehabilitation after acute cerebral infarction in pat

关 键 词：急性脑梗死 皮质下失语 镜像疗法 常规言语训练 言语功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]