督脉取穴针刺联合重复经颅磁刺激对卒中后失语患者大脑脚非对称性比例、语言功能及生活质量的影响  

Effect of Du Meridian combined with repetitive transcranial magnetic stimulation on the asymmertry rate of cerebral peduncle,language function and quality of life in patients with post-stroke aphasia

作　　者：陈春燕[1] 李嫣 CHEN Chunyan;LI Yan(Department of Nursing,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210031;Department of Rehabilitation Medicine,the Fourth Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210031)

机构地区：[1]南京医科大学第四附属医院护理部,江苏南京210031 [2]南京医科大学第四附属医院康复医学科,江苏南京210031

出　　处：《河北中医》2023年第8期1363-1366,共4页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察督脉取穴针刺联合重复经颅磁刺激(rTMS)治疗卒中后失语(PSA)的疗效及对患者大脑脚非对称性比例、语言功能及生活质量的影响。方法将87例PSA患者按照随机数字表法分为2组。对照组43例予rTMS治疗,每日1次,每周6次,共3周;治疗组44例在对照组治疗基础上联合督脉取穴针刺治疗,每日1次,15天为1个疗程,共3个疗程。比较2组治疗前后大脑脚非对称性比例(ARCP)、波士顿诊断性失语症检查(BDAE)评分、西部失语症成套检验量表(WAB)评分、失语商(AQ)及脑卒中失语症患者生活质量量表(SAQOL-39)评分变化,并比较2组临床疗效及不良反应发生情况。结果治疗组总有效率95.45%(42/44),对照组总有效率79.07%(34/43),治疗组疗效优于对照组(P<0.05)。治疗后,2组ARCP均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后,2组BDAE评分、WAB各维度评分、AQ及SAQOL-39各项评分及总分均较本组治疗前升高(P<0.05),且治疗组均高于对照组(P<0.05)。2组治疗期间均未出现明显不良反应。结论督脉取穴针刺联合rTMS能促进PSA患者双侧大脑半球间平衡的恢复,提高语言功能,改善生活质量,且安全性良好。Objective To observe the curative effect of acupuncture at Du Meridian combined with repetitive transcranial magnetic stimulation(rTMS)on post-stroke aphasia(PSA)and its influence on the asymmertry rate of cerebral peduncle,language function and quality of life.Methods A total of 87 PSA patients were randomly assigned into the treatment group(n=44)and the control group(n=43).The patients in the control group were managed by rTMS(qd,6 times a week for 3 weeks),and those in the treatment group were treated with acupuncture at Du Meridian based on the control group(qd,15 days for a course,continued for 3 courses).The asymmetry rate of cerebral peduncle(ARCP),Boston Diagnostic Aphasia Examination(BDAE),Western Aphasia Battery(WAB),aphasia quotient(AQ),Stroke and Aphasia Quality of Life Scale 39(SAQOL-39)were included as comparators.The curative effect and adverse reactions were assessed.Results The overall effective rate in the treatment group was better than that in the control group(95.45%[42/44]vs 79.07%[34/43],[P<0.05],respectively).After treatment,ARCP in the two groups was significantly decreased(P<0.05),which in the treatment group was significantly lower than that in the control group(P<0.05).The scores of BDAE,WAB,AQ,SAQOL-39 in the two groups were significantly increased compared with before treatment(P<0.05),the increase in the treatment group was more prevalent(P<0.05).No obvious adverse reactions were found.Conclusion For PSA patients,acupuncture at Du Meridian combined with rTMS can promote the restoration of balance between bilateral cerebral hemispheres,improve language function and quality of life,and with good safety.

关 键 词：卒中 失语 针刺疗法 穴位 督脉 经颅磁刺激 

分 类 号：R743.305[医药卫生—神经病学与精神病学] R245.311[医药卫生—临床医学] R454.18