点刺放血联合重复经颅磁刺激治疗卒中后非流利型失语症临床观察  

Clinical observation on pricking and bloodletting combined with repetitive transcranial magnetic stimulation in the treatment of non-fluent aphasia after strolce

作　　者：刘振华[1] 尹昱[2] 张卫国[3] 赵振彪[2] 张磊[1] LIU Zhenhua;YIN Yu;ZHANG Weiguo(Department of Chinese Medicine Rehabilitation Physical Therapy,PLA Army 82 Group Military Hospital,Baoding,Heibei 071000)

机构地区：[1]中国人民解放军陆军第八十二集团军医院中医康复理疗科,河北保定071000 [2]河北省人民医院康复科,河北石家庄050051 [3]河北医科大学《临床荟萃》编辑部,河北石家庄050017

出　　处：《河北中医》2020年第6期837-841,847,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：2012年度医学适用技术跟踪项目(编号:GL2012004)。

摘　　要：目的观察点刺放血联合重复经颅磁刺激治疗卒中后非流利型失语症的临床疗效。方法将100例卒中后非流利型失语症患者按照随机数字表法分为2组。对照组50例予重复经颅磁刺激治疗,治疗组50例在对照组治疗基础上应用点刺放血治疗。2组均连续治疗2周。比较2组疗效;比较2组治疗前后视图命名得分及反应时间;比较2组治疗前后语言功能评分变化;比较2组治疗前后5-羟色胺(5-HT)、多巴胺(DA)及脑源性神经营养因子(BDNF)水平变化;比较2组治疗前后焦虑自评量表(SAS)、抑郁自评量表(SDS)评分变化。结果治疗组总有效率94.00%(47/50),对照组总有效率82.00%(41/50),治疗组疗效优于对照组(P<0.05)。2组治疗后视图命名得分均较本组治疗前升高(P<0.05),反应时间均较本组治疗前降低(P<0.05),且治疗组治疗后视图命名得分高于对照组(P<0.05),反应时间低于对照组(P<0.05)。2组治疗后语言功能复述能力、书写能力、理解能力、阅读能力评分均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。2组治疗后5-HT、BDNF均较本组治疗前升高(P<0.05),DA降低(P<0.05),且治疗组治疗后5-HT、BDNF均高于对照组(P<0.05),DA低于对照组(P<0.05)。2组治疗后SAS、SDS评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论点刺放血联合重复经颅磁刺激治疗卒中后非流利型失语症,能提高患者语言功能,改善实验室指标,缓解抑郁、焦虑状况,临床疗效优于单纯应用重复经颅磁刺激治疗。Objective To observe the effect of pricking and bloodletting combined with repetitive transcranial magnetic stimulation in the treatment of non-fluent aphasia.Methods 100 patients with non-fluent aphasia were divided into two groups according to the random number table method.50 patients in the control group received repetitive transcranial magnetic stimulation.50 patients in the treatment group received the pricking and bloodletting combined with repetitive transcranial magnetic stimulation on basis of the control group.Both groups were treated for 2 weeks.The effects of the two groups were compared.The view naming score and reaction time,changes in language function scores,changes in levels of 5-hydroxytryptamine(5-HT),dopamine(DA)and brain-derived neurotrophic factor(BDNF)as well as changes in self-rating anxiety scale(SAS)and self-rating depression scale(SDS)scores of patients in two groups were compared before and after treatment.Results The total effective rate of the treatment group and control group was 94.00%(47/50)and 82.00%(41/50)respectively.The clinical curative effect of the treatment group was better than that of the control group(P<0.05).After treatment,the score of view naming in both groups was higher than that in the group before treatment(P<0.05),and the reaction time was lower(P<0.05);the score of view naming in the treatment group was higher than that in the control group(P<0.05),and the reaction time was lower than that in the control group(P<0.05).After treatment,the scores of retelling ability,writing ability,comprehension ability and reading ability of the two groups were increased compared with those in the goup before treatment(P<0.05),and the increase in the treatment group was more obvious(P<0.05).After treatment,5-HT and BDNF in both groups were higher than those in the group before treatment(P<0.05),and DA was lower(P<0.05);5-HT and BDNF in treatment group were higher than those in the control group(P<0.05),and DA was lower than that in control group(P<0.05).After treatment,SAS and

关 键 词：点刺放血 重复经颅磁刺激 非流利型失语症 

分 类 号：R245.3[医药卫生—针灸推拿学] R767.64[医药卫生—中医临床基础]