比较不同频率重复经颅磁刺激对卒中后失语症患者听词-指图的影响  

Effects of Repetitive Transcranial Magnetic Stimulation with Different Frequency in Auditory Word-picture Matching of Aphasia in Patients with Stroke

作　　者：王安娟 李霖荣 陆芳[1] 张悦[1] 孔旭 姚黎清[1] 樊红[1] WANG An-juan;LI Lin-rong;LU Fang;ZHANG Yue;KONG Xu;YAO Li-qing;FAN Hong(Second Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650101)

机构地区：[1]昆明医科大学第二附属医院,云南昆明650101

出　　处：《按摩与康复医学》2021年第4期17-20,共4页Chinese Manipulation and Rehabilitation Medicine

基　　金：云南省教育厅科学研究基金项目,项目编号:2015Z087;云南省卫生科技计划项目任务书,项目编号:2016NS293。

摘　　要：目的:比较不同频率重复经颅磁刺激(rTMS)对卒中后失语症患者听词-指图的临床疗效。方法:纳入病程2~4个月之间的脑卒中后失语症患者36例。随机分为A、B、C、D四组,A组只进行语言治疗,B组在语言治疗的基础上联合rTMS低频1HZ治疗右侧半球Broca区2周,C组在语言治疗的基础上联合rTMS高频5HZ治疗左侧半球Broca区2周,D组在语言治疗的基础上联合rTMS高频10HZ治疗左侧半球Broca区2周,四组在治疗前、治疗两周以后,分别进行汉语失语症心理语言评价中的听词-指图测试。结果:对患者进行单纯语言治疗后,听词-指图成绩提高,差异有统计学意义(P<0.05);不同频率重复经颅磁刺激治疗联合语言治疗后,患者听词-指图成绩较治疗前相比均有提高,差异有统计学意义(P<0.05);不同频率重复经颅磁刺激治疗联合语言治疗后,患者听词-指图成绩较单纯语言治疗后相比均有提高,差异有统计学意义(P<0.05);rTMS低频1HZ与高频5HZ及高频10HZ治疗后两两比较,有差异但无统计学上的意义(P>0.05)。结论:在语言治疗的基础上进行rTMS低频治疗及rTMS高频治疗均可显著提高患者的听词-指图成绩且治疗效果优于单纯语言治疗。rTMS低频1HZ与rTMS高频5HZ及10HZ治疗后患者听词-指图成绩分别进行比较,无统计学上差异(P>0.05)。单纯语言治疗可提高患者的听词-指图成绩,改善患者的语言功能。Objective:To compare the effect of repetitive transcranial magnetic stimulation(rTMS)with different frequencies for patients with stroke in auditory word-picture matching.Method:36 patients with aphasia at 2 to 4 months after stroke were enrolled,they were randomly assigned to A,B,C and D group.A group was two-week simple speech therapy.B group was the simple speech therapy in combination with low-frequency rTMS(1HZ)to stimulate the right hemisphere Broca area.C group was the simple speech therapy in combination with high-frequency(5HZ)rTMS to stimulate the left hemisphere Broca area.D group was the simple speech therapy in combination with high-frequency(10HZ)rTMS to stimulate the left hemisphere Broca area.Before and after the treatment for two weeks,the auditory word-picture matching test in psycholinguistic assessment in Chinese aphasia was conducted.Result:There was significant change in auditory word-picture matching scores after simple language therapy and rTMS.There was also significant difference between rTMS and simple language therapy(P<0.05).There was no significant statistical difference in auditory word-picture matching scores(P>0.05)in low(1HZ)and highfrequency(5HZ),low(1HZ)and high-frequency(10HZ),high-frequency(5HZ)and high-frequency(10HZ)rTMS.Conclusion:Simple language therapy may improve the correct rate of the auditory word-picture matching in patients and improve the language function of the patients.The therapeutic effect of simple language therapy combined with low and high frequency rTMS is better than speech rehabilitation alone,and the speed of recovery of the patients with stroke.However,the difference between low(1HZ)and high frequency(5HZ,10HZ)rTMS efficacy of this experiment employed is not obvious.

关 键 词：脑卒中 失语症 重复经颅磁刺激 

分 类 号：R743.3[医药卫生—神经病学与精神病学]