头针调衡电刺激治疗脑梗死后运动性失语疗效观察  

Therapeutic effect of electric-balance stimulation with scalp acupuncture for motor aphasia after cerebral infarction

作　　者：楼喜强[1] 刘襄[1] 刘春花 林华俭 刘鸿[1] 凌军[2] LOU Xi-qiang;LIU Xiang;LIU Chun-hua;LIN Hua-jian;LIU Hong;LING Jun(Department of Acupuncture-Moxibustion,Lishui 323000,Zhejiang Province,China;Department of Neurology,Lishui Hospital of TCM,Lishui 323000,Zhejiang Province,China)

机构地区：[1]浙江省丽水市中医院针灸科,丽水323000 [2]浙江省丽水市中医院神经内科,丽水323000

出　　处：《中国针灸》2021年第11期1211-1215,共5页Chinese Acupuncture & Moxibustion

基　　金：2020年浙江省中医药管理局科技计划项目:2021ZT008。

摘　　要：目的:比较头针调衡电刺激与常规头针治疗脑梗死亚急性期运动性失语的临床疗效。方法:将54例脑梗死亚急性期运动性失语患者随机分为观察组(27例,脱落1例)和对照组(27例,脱落2例)。两组均予常规药物治疗和语言训练。观察组选取双侧顶颞前斜线下2/5、颞前线予头针治疗,得气后脑梗侧予疏密波(兴奋)电刺激、非脑梗侧予连续波(抑制)电刺激,对照组于患侧顶颞前斜线下2/5、颞前线予常规头针治疗,每日1次,5次为一疗程,共治疗2个疗程。观察两组患者治疗前后汉语标准失语症检查法(ABC)评分、波士顿失语症严重程度(BDAE)分级,采用近红外脑功能成像仪(f NIRS)实时测定两组患者治疗前后局部大脑皮层区氧合血红蛋白(Hb O2)、脱氧血红蛋白(D-Hb)和总血红蛋白(T-Hb)水平,并比较两组临床疗效。结果:治疗后,两组患者听理解、复述、命名、自发谈话评分及BDAE分级均较治疗前改善(P<0.01,P<0.05),且观察组优于对照组(P<0.05)。与治疗前比较,治疗后两组患者Hb O2、T-Hb水平升高(P<0.01),D-Hb水平降低(P<0.01),且观察组患者Hb O2、T-Hb水平高于对照组(P<0.05),D-Hb水平低于对照组(P<0.05)。观察组总有效率为92.3%(24/26),高于对照组的84.0%(21/25,P<0.05)。结论:头针调衡电刺激可改善脑循环,激活脑皮质特定功能区域,促进大脑语言功能的重建和恢复,其疗效优于常规头针。Objective To compare the clinical efficacy between scalp acupuncture electrical stimulation and routine scalp acupuncture for motor aphasia in subacute stage of cerebral infarction. Methods A total of 54 patients with motor aphasia in subacute stage of cerebral infarction were randomly divided into an observation group(27 cases, 1 case dropped off) and a control group(27 cases, 2 cases dropped off). Both groups were treated with routine medication and language training. In the observation group, scalp acupuncture was given at bilateral lower 2/5 of the parietal and temporal anterior oblique line and temporal frontline;after the arrival of qi, the electrical stimulation with disperse-dense wave was given at the affected side and continuous wave was given at healthy side. The control group was treated with routine scalp acupuncture at lower 2/5 of the parietal and temporal anterior oblique line and temporal frontline of the affected side, once a day, five times as a course, totaling two courses of treatment. The aphasia battery of Chinese(ABC) score and Boston diagnostic aphasia examination(BDAE) grade were observed before and after treatment. The levels of oxygenated hemoglobin(Hb O2),deoxyhemoglobin(D-Hb) and total hemoglobin(T-Hb) in local cerebral cortex of the two groups were measured in real time using functional near-infrared spectroscopy(f NIRS) before and after treatment. The clinical efficacy of the two groups was compared. Results After treatment, the scores of listening comprehension, retelling, naming, spontaneous conversation and BDAE grade in the two groups were improved compared with those before treatment(P<0.01, P<0.05), and those in the observation group were better than the control group(P<0.05). Compared before treatment, the levels of Hb O2 and T-Hb were increased(P<0.01), and the levels of D-Hb were decreased(P<0.01) after treatment in the two groups. The levels of Hb O2 and T-Hb in the observation group were higher than those in the control group(P<0.05), and the level of D-Hb was lower than

关 键 词：脑梗死 亚急性期 运动性失语 头针 电刺激 

分 类 号：R246.1[医药卫生—针灸推拿学]