针刺联合语言康复训练对卒中后失语病人非语言认知功能影响的Meta分析  

Acupuncture Combined with Speech and Language Therapy for the Treatment of Nonverbal Cognition in Post-stroke Aphasia:a Meta-analysis

作　　者：孔乔 常静玲[2] 黄幸 何鋆怡 KONG Qiao;CHANG Jingling;HUANG Xing;HE Junyi(Beijing University of Chinese Medicine,Beijing 100029,China;Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东直门医院,北京100700 [3]北京中医药大学第三附属医院,北京100029

出　　处：《中西医结合心脑血管病杂志》2024年第2期353-360,共8页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：中央高校校级重点攻关基金项目(No.2020-JYB-ZDGG-110-2);中央高校基本科研业务费专项基金(No.2022-JYB-XJSJJ-093)。

摘　　要：目的:评价针刺联合语言康复训练对卒中后失语(PSA)病人非语言认知功能的影响及其对语言功能的改善,探索PSA病人语言和非语言认知功能改善间的关联。方法:计算机检索PubMed、EMbase、the Cochrane Library、Web of Science、EBSCO、Scopus、中国期刊全文数据库(CNKI)、万方数据库(WanFang Data)、维普中文科技期刊数据库(VIP)从建库至2022年6月1日发表的针刺联合语言康复训练改善PSA病人非语言认知功能的随机对照试验(RCT)研究,由2位研究者独立完成文献筛选、数据提取、研究偏倚风险评估工作,采用RevMan 5.4.1软件进行Meta分析。结果:共纳入15项RCT,涉及1 192例病人。Meta分析结果显示:针对语言功能方面,针刺联合语言康复训练治疗PSA的有效率优于对照组[OR=5.15,95%CI(3.10, 8.58),P<0.000 01],失语商高于对照组[MD=10.87, 95%CI(8.16, 13.59),P<0.000 01];针对非语言认知功能方面,针刺联合语言康复训练治疗后PSA病人蒙特利尔认知评估量表(MoCA)评分[MD=3.98, 95%CI(3.43, 4.53),P<0.000 01]、简易智力状态检查量表(MMSE)评分[MD=3.35, 95%CI(0.87, 5.82),P=0.008]均高于对照组,汉密尔顿抑郁量表(HAMD)评分[MD=-8.22, 95%CI(-8.68,-7.75),P<0.000 01]、汉密尔顿焦虑量表(HAMA)评分[MD=-7.47, 95%CI(-7.82,-7.13),P<0.000 01]、脑卒中失语抑郁量表(SADQ)评分[MD=-3.95, 95%CI(-5.51,-2.39),P<0.000 01]均低于对照组。结论:现有证据表明,针刺联合语言康复训练能有效改善PSA病人的非语言认知功能,缓解其焦虑、抑郁情绪,非语言认知功能的改善可能伴随着语言功能的改善。Objective:To evaluate the efficacy of acupuncture combined with speech and language therapy for enhancing nonverbal cognitive function in patients with post-stroke aphasia(PSA).Methods:Randomized controlled trials(RCTs)of acupuncture combined with speech and language therapy for improving nonverbal cognitive function in patients with PSA were retrieved from PubMed,EMbase,the Cochrane Library,Web of Science,EBSCO,Scopus,China National Knowledge Infrastructure(CNKI),WanFang Database,and China Science and Technology Journal Database(VIP)databases from inception to June 1,2022.Two researchers independently completed literature screening,data extraction,and research bias risk assessment.Meta-analysis was performed using RevMan 5.4.1 software.Results:A total of 15 RCT studies were included with 1192 patients.The results of Meta-analysis showed that in terms of language function,the effective rate of acupuncture combined with speech and language therapy for the treatment of PSA was better than that of the control group(OR=5.15,95%CI 3.10-8.58,P<0.00001),and the aphasia quotient(AQ)(MD=10.87,95%CI 8.16-13.59,P<0.00001)was higher than that of control group.The Montreal Cognitive Assessment(MoCA)score(MD=3.98,95%CI 3.43-4.53,P<0.00001)and Mini-mental State Examination(MMSE)score(MD=3.35,95%CI 0.87-5.82,P=0.008)of PSA patients after acupuncture combined with speech and language therapy were higher than those of control group;Hamilton Depression Scale(HAMD)score(MD=-8.22,95%CI-8.68--7.75,P<0.00001),Hamilton Anxiety Scale(HAMA)score(MD=-7.47,95%CI-7.82--7.13,P<0.00001),and Stroke Aphasia Depression Questionnaire(SADQ)score(MD=-3.95,95%CI-5.51--2.39,P<0.00001)in treatment group were lower than those in control group.Conclusion:The available evidence suggests that acupuncture combined with speech and language therapy can effectively improve the nonverbal cognitive function of PSA patients,concurrently alleviating their levels of anxiety and depression.The improvement of nonverbal cognitive function may be accompanied by the imp

关 键 词：卒中后失语 针刺 语言康复训练 非语言认知 情绪障碍 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]