重复经颅磁刺激治疗对后循环卒中后共济失调型构音障碍的影响  

Effect of Repetitive Transcranial Magnetic Stimulation on Ataxia Dysarthria after Posterior Circulation Stroke

作　　者：张雪艺 李金萍 张海甜 梁寿一[1] 林廷樾[1] 陈中华 ZHANG Xueyi;LI Jinping;ZHANG Haitian;LIANG Shouyi;LIN Tingyue;CHEN Zhonghua(Maoming People’s Hospital,Guangdong Province,Maoming 525000,China;不详)

机构地区：[1]广东省茂名市人民医院,广东茂名525000

出　　处：《中国医学创新》2022年第26期6-10,共5页Medical Innovation of China

基　　金：广东省茂名市科技计划项目(210420084550277)。

摘　　要：目的:探讨重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)治疗对后循环卒中后共济失调型构音障碍的影响。方法:选取2020年3月-2022年1月在茂名市人民医院康复医学科住院治疗的86例卒中患者为研究对象,采用随机数字表法将其分为观察组43例(行传统构音训练+rTMS治疗)和对照组43例(行传统构音训练)。比较两组患者的治疗效果、构音障碍情况(采用改良Frenchay构音障碍评估法评估)、语言清晰度及口部运动功能。结果:观察组的治疗总有效率为90.70%,较对照组的51.16%更高(P<0.05);治疗后,两组患者Frenchay量表中语言理解、反射、呼吸等维度评分和总分均较治疗前显著上升,其中观察组均高于对照组(P<0.05);治疗后2周、1个月,两组患者的语言清晰度均高于治疗前,其中观察组均高于对照组(P<0.05);治疗后,两组患者口部功能量表(唇运动、下颚运动、舌运动)评分较治疗前均显著上升,其中观察组均高于对照组(P<0.05)。结论:rTMS能有效改善后循环卒中患者共济失调型构音障碍,有助于提高患者语音清晰度、构音运功功能及构音语言能力,值得推广应用。Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on ataxia dysarthria after posterior circulation stroke.Method:A total of 86 posterior circulation stroke patients who were hospitalized in the Department of Rehabilitation Medicine of Maoming People’s Hospital from March 2020 to January 2022 were selected as the research objects,they were divided into the observation group of 43 cases (traditional articulation training + rTMS therapy were performed) and the control group of 43 cases (traditional articulation training) by random number table method.The treatment effect,dysarthria (assessed by the modified Frenchay dysarthria assessment),speech intelligibility and oral motor function were compared between the two groups.Result:The total effective rate of the observation group was 90.70%,which was higher than 51.16% of the control group (P<0.05);after treatment,the scores of language comprehension,reflexes,breathing and other dimensions of Frenchay scale and the total scores of the two groups were significantly higher than those before treatment,and those of the observation group were higher than those of the control group (P<0.05);at 2 weeks and 1 month after treatment,the language clarity of the two groups were higher than those before treatment,and those of the observation group were higher than those of the control group (P<0.05);after treatment,the scores of oral function scale (lip movement,jaw movement,tongue movement) in the two groups were significantly higher than those before treatment,and those of the observation group were higher than those of the control group (P<0.05).Conclusion:rTMS treatment can effectively improve ataxia-type dysarthria in patients with posterior circulation stroke,and it can help to improve patients’ speech intelligibility,articulatory motor function and articulation language ability,and at the same time,which is worthy of popularization and application.

关 键 词：重复经颅磁刺激 后循环卒中 共济失调型构音障碍 语音清晰度 构音运动功能 构音语言能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]