通督调神针配合词联导航言语训练治疗卒中后失语症效果观察  

Observation on the Effect of Tongdu Tiaoshen Acupuncture Combined with Word Association Navigation Training on Post⁃stroke Aphasia

作　　者：吴萌萌 杨坤[1] 张君宇[1] 代飞 贺成功[1] 王琳[1] 朱才丰[1] WU Mengmeng;YANG Kun;ZHANG Junyu;DAI Fei;HE Chenggong;WANG Lin;ZHU Caifeng(Department of Geriatrics,the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine,Hefei 230000,China)

机构地区：[1]安徽中医药大学第二附属医院老年病科,合肥230000

出　　处：《临床误诊误治》2024年第9期95-100,共6页Clinical Misdiagnosis & Mistherapy

基　　金：安徽中医药大学第二附属医院“三新技术(项目)”(2022-SXXM09);安徽省医疗卫生重点专科建设项目(皖卫函[2021]273号);2023年度安徽省高校自然科学研究项目(2023AH050739)。

摘　　要：目的 观察通督调神针配合词联导航言语训练在卒中后失语症患者中的应用效果。方法 选取2022年1月-2024年1月收治的卒中后失语症68例,采用随机数字表法分为观察组和对照组,每组34例。对照组在常规治疗基础上采取词联导航言语训练,观察组在对照组基础上联合通督调神针治疗,连续干预10 d。观察2组临床疗效,干预前后西方失语症评定量表(WAB)评分、日常生活交流能力、神经认知功能[蒙特利尔认知评估量表(MoCA)、美国国立卫生研究院卒中量表(NIHSS)评分]、生活质量[失语症生活质量量表(SAQOL-39g)评分]变化及安全性。结果 干预后观察组总有效率[88.24%(30/34)]高于对照组[67.65%(23/34)](P<0.05);干预5、10 d, 2组失语商评分、WAB各项评分升高,且观察组高于对照组(P<0.05,P<0.01);干预10 d后,2组日常生活交流能力、SAQOL-39g各维度评分升高,且观察组高于对照组(P<0.05,P<0.01);干预10 d后,2组NIHSS、MoCA评分改善,且观察组NIHSS评分低于对照组,MoCA评分高于对照组(P<0.05,P<0.01);治疗期间,观察组无不良反应出现,对照组有1例出现皮肤瘙痒。结论 通督调神针联合词联导航言语训练不仅能促进卒中后失语症患者言语功能恢复,增强日常生活交流能力,在改善患者神经认知功能方面也有一定效果。Objective To observe the application effect of Tongdu Tiaoshen acupuncture combined with word associa-tion navigation training(WANT)in patients with post-stroke aphasia.Methods From January 2022 to January 2024,68 pa-tients with post-stroke aphasia were selected and divided into the observation group and the control group,with 34 cases in each group,by random number table method.The control group received WANT on the basis of conventional treatment,and the observation group was combined with Tongdu Tiaoshen acupuncture on the basis of control group.They received continuous intervention for 10 d.The clinical effect,changes in Western Aphasia Rating Scale(WAB)score,daily communication abili-ty,neurocognitive function[Montreal Cognitive Assessment Scale(MoCA),National Institutes of Health Stroke Scale(NIHSS)score],quality of life[Stroke and Aphasia Quality of Life Scale(SAQOL-39g)score]before and after intervention and safety were observed.Results After intervention,the total effective rate of the observation group was 88.24%(30/34),which was higher than that of the control group[67.65%(23/34)](P<005).At 5 and 10 d after intervention,aphasia quotient score and WAB scores of the two groups were increased,which were higher in the observation group than in the con-trol group(P<005,P<001).At 10 d after intervention,the scores of daily communication ability and SAQOL-39g in the two groups were increased,which were higher in the observation group than in the control group(P<005,P<001).At 10 d after intervention,NIHSS and MoCA scores of the two groups were improved,and NIHSS score of observation group was lower than that of control group,while MoCA score was higher than that of control group(P<005,P<001).During the treatment period,there was no adverse reaction in the observation group and 1 patient with pruritus in the control group.Con-clusion Tongdu Tiaoshen acupuncture combined with WANT can not only promote the recovery of speech function and en-hance daily communication ability in patients with post-stroke aphasia,bu

关 键 词：卒中 失语症 词联导航言语训练 通督调神针 生活质量 神经功能缺损 

分 类 号：R743.3[医药卫生—神经病学与精神病学]