子午流注针刺结合低频重复经颅磁刺激治疗脑梗死后运动性失语疗效观察  

Observations on the efficacy of acupuncture based on midnight-noon and ebb-flow combined with low-frequency rTMS for treating MA after cerebral infarction

作　　者：王立童[1] 代永利 周丹 曹佳林 王利凯 Wang Litong;Dai Yongli;Zhou Dan;Cao Jialin;Wang Likai(Department of Rehabilitation Medicine,the Second Affiliated Hospital of Dalian Medical University,Dalian Liaoning 116033)

机构地区：[1]大连医科大学附属第二医院康复医学科,辽宁大连116033

出　　处：《山西中医药大学学报》2022年第6期554-557,共4页Journal of Shanxi University of Chinese Medicine

基　　金：大连市科技创新基金科技惠民(2020JJ27SN067);辽宁省教育厅基本科研面上项目(LJKMZ20221292)。

摘　　要：目的:探讨子午流注针刺结合低频重复经颅磁刺激(repetitive Transcranial Magnetic Stimulation,rTMS)治疗脑梗死后运动性失语症(Motor Aphasia,MA)患者的临床疗效。方法:90例病例随机分为两组,对照组45例采用普通体针针刺联合低频r TMS治疗,观察组45例采用子午流注头皮针针刺结合低频rTMS治疗,4周为1个疗程。在治疗前后采用汉语标准失语症检查法(Aphasia Battery in Chinese,ABC)、功能性语言沟通能力法(The Chinese Functional Communication,CFCP)评分对两组患者语言能力、日常生活语言沟通能力进行评定,测定大脑前动脉(ACA)的平均血流速度(Vm)。结果:治疗后观察组谈话、理解、复述、命名功能评分及CFCP评分、大脑前动脉Vm均较治疗前明显升高,差异有统计学意义(P<0.01),且上述指标与对照组比较明显升高(P<0.05,P<0.01),差异有统计学意义。对照组治疗后大脑前动脉Vm较治疗前明显加快(P<0.01)。结论:子午流注针刺结合低频rTMS治疗可明显提高脑梗死后伴有MA患者的言语表达能力,其作用机制可能与改善局部血流灌注有关。Objective:To explore the clinical efficacy of acupuncture based on midnight-noon and ebb-flow combined with low-frequency repetitive transcranial magnetic stimulation(rTMS)for treating Motor Aphasia(MA)after cerebral infarction.Methods:The 90 cases were randomly divided into two groups,45 cases in the control group were treated with common body acupuncture combined with low-frequency r TMS,and 45 cases in the observation group were treated with scalp-acupuncture based on midnight-noon and ebb-flow combined with low-frequency rTMS,4 weeks as a course of treatment.The Aphasia Battery in Chinese(ABC)and the Chinese Functional Communication(CFCP)were used before and after treatment to evaluate the language ability and daily life language communication ability of the patients in two groups.And the mean blood flow velocity(Vm)of the anterior cerebral artery(ACA)was measured.Results:After treatment,the scores of talk,comprehension,repetition,naming,CFCP and Vm of anterior cerebral artery in the observation group were significantly higher than those before treatment,and the differences were statistically significant(P <0.01).And the above indexes were significantly higher than those in the control group,and the difference was statistically significant(P<0.05,P<0.01).In the control group,the Vm of the anterior cerebral artery was significantly accelerated after treatment(P<0.01).Conclusion:The acupuncture based on midnight-noon and ebb-flow combined with low-frequency rTMS can significantly improve the speech expression ability of patients with MA after cerebral infarction,and its mechanism may be related to the improvement of local blood perfusion.

关 键 词：运动性失语症 脑梗死 子午流注针刺 RTMS 

分 类 号：R246.6[医药卫生—针灸推拿学]