低频重复经颅磁刺激联合旋律语调疗法治疗脑卒中恢复期非流畅性失语的临床疗效  

Efficacy of low frequency repetitive transcranial magnetic stimulation combined with melodic intonation therapy in the treatment of non-fluent aphasia in the convalescent stage of stroke

作　　者：钟红丽[1] 王江波[1] 蔡琛[1] 杜振峰[1] Zhong Hongli;Wang Jiangbo;Cai Chen(Department of Rehabilitation Medicine,The People’s Hospital of Zhengzhou,Zhengzhou 450003,China)

机构地区：[1]郑州人民医院康复医学科,郑州450003

出　　处：《中国康复》2023年第1期4-8,共5页Chinese Journal of Rehabilitation

基　　金：国家重点研发计划项目(2017YFC1308504)。

摘　　要：目的:探讨低频重复经颅磁刺激(LF-rTMS)联合旋律语调疗法治疗脑卒中恢复期非流畅性失语患者的治疗效果。方法:选取2019年1月~2020年8月在郑州人民医院治疗的124例脑卒中恢复期非流畅性失语患者,随机分为观察组和对照组各62例。2组患者均接受脑卒中常规药物治疗,对照组在此基础上给予LF-rTMS治疗,观察组给予LF-rTMS联合旋律语调疗法治疗,连续治疗4周。采用西方失语症成套测验(WAB)、失语商(AQ)及汉语标准失语症检查法(CRRCAE)评估治疗前后2组患者语言功能及失语症状改善情况;采用蒙特利尔认知评估量表(MoCA)评估患者认知功能;采用诱发电位仪检测事件相关电位P300(ERP-P300)评估脑组织高级思维功能。结果:治疗后,2组患者WAB中自发言语、复述、命名及听理解4项及CRRCAE中动作说明和画面说明2项、AQ、MoCA评分均较治疗前增加(均P<0.05),且观察组各项均高于对照组(均P<0.05);2组患者ERP-P300的潜伏期均较治疗前明显缩短(均P<0.05),且观察组短于对照组(P<0.05);2组患者ERP-P300的波幅均较治疗前明显增加(均P<0.05),且观察组大于对照组(P<0.05)。结论:LF-rTMS联合旋律语调疗法可明显改善脑卒中恢复期非流畅性失语患者的语言功能,提高其认知水平。Objective:To investigate the efficacy of low frequency repetitive transcranial magnetic stimulation(LF-rTMS)combined with melodic intonation therapy in the treatment of non-fluent aphasia in the convalescent stage of stroke.Methods:A total of 124 patients with non-fluency aphasia during stroke recovery who were treated in Zhengzhou People’s Hospital from January 2019 to August 2020 were divided into two groups according to a random number table,with 62 cases in each group.The two groups of patients were treated with routine stroke treatment,the control group was treated with LF-rTMS on the basis of drug treatment,and the observation group was given LF-rTMS combined with melodic intonation therapy.The treatment lasted for 4 weeks.The improvement of aphasia symptoms and the score of aphasia quotient(AQ)were evaluated by Western Aphasia Battery(WAB)before and after treatment,the language function was evaluated by Chinese rehabilitation research center aphasia examination(CRRCAE),and the cognitive function was evaluated by Montreal Cognitive Assessment Scale(MoCA).Evoked potentiometer was used to detect event related potential P300 to evaluate the advanced thinking function of brain tissue.Results:Compared with before treatment,the scores of self-speech,retelling,naming and listening comprehension in WAB and the scores of action description and picture description items in CRRCAE after treatment in the two groups significantly increased,and the scores in the observation group were higher than those in the control group(all P<0.05).Compared with before treatment,the scores of AQ and MOCA after treatment in the two groups significantly increased,and those in the observation group were higher than those in the control group(all P<0.05).Com-pared with before treatment,the latency of ERP-P300 after treatment in the two groups was significantly shortened,and that in the observation group was shorter than that in the control group(all P<0.05).The amplitude of ERP-P300 in the two groups significantly increased,and that in

关 键 词：低频重复经颅磁刺激 旋律语调疗法 脑卒中恢复期 非流畅性失语 语言功能 

分 类 号：R49[医药卫生—康复医学] R743.3[医药卫生—临床医学]