θ爆发式经颅磁刺激联合言语训练对脑卒中失语症的疗效  

Therapeutic effect of theta burst transcranial magnetic stimulation combined with speech training on aphasia after stroke

作　　者：曾贞 陆春华 王凯 张琴 ZENG Zhen;LU Chunhua;WANG Kai;ZHANG Qin(Department of Neuralogical Rehabilitation,Shanghai Fourth Rehabilitation Hospital,Shanghai 200042,China)

机构地区：[1]上海市第四康复医院神经康复科,上海200042

出　　处：《内科理论与实践》2024年第4期231-235,共5页Journal of Internal Medicine Concepts & Practice

基　　金：上海市静安区卫生科研课题(2023MS13)。

摘　　要：目的:分析持续短阵φ脉冲刺激(continuous theta burst stimulation,cTBS)、φ爆发式经颅磁刺激间歇性爆发式φ脉冲刺激(intermittent theta burst stimulation,iTBS)联合言语训练对脑卒中失语症(post-stroke aphasia,PSA)的临床疗效。方法:对本院2022年2月至2023年1月接诊的90例PSA患者,根据治疗方法的不同将其分为3组,各30例,基础组给予言语训练,观察1组给予cTBS联合言语训练,观察2组给予iTBS联合言语训练,比较3组临床疗效、西方失语症成套测验(western aphasia battery,WAB)评分、视图命名测试结果、波士顿诊断性失语症检查(Boston diagnostic aphasia examination,BDAE)分级、脑卒中失语症生活质量量表(stroke aphasia quality of life scale,SAQOL-39g)评分。结果:观察1组、观察2组临床总有效率(96.67%、93.33%)均高于基础组(60.00%)(均P<0.05)。观察1组、观察2组治疗后WAB评分、视图命名测试正确数和反应时间、BDAE分级改善程度、SAQOL-39g评分均优于基础组(均P<0.05)。观察1组、观察2组临床总有效率、治疗后WAB评分、视图命名测试正确数、反应时间、BDAE分级改善效果、SAQOL-39g评分比较,差异无统计学意义(P>0.05)。结论:cTBS、iTBS联合言语训练均可改善PSA患者失语症状,提高视图命名能力及生存质量,两者临床疗效相当,均优于单一言语训练。Objective Analyzing the clinical treatment efficacy of continuous theta burst stimulation(cTBS),theta burst stimulation(TBS)combined with speech training on post stroke aphasia(PSA).Methods In this study,90 PSA patients admitted to our hospital from February 2022 to January 2023 were divided into three groups according to different treatment methods,each 30 cases in each group.The basic group was given speech training,the observation group 1 was given cTBS combined speech training,and the observation group 2 was given iTBS combined speech training.The clinical efficacy,western aphasia battery(WAB)score,view naming test results,Boston diagnostic aphasia examination(BDAE)rating,stroke aphasia quality of life scale(SAQOL⁃39g)score were compared among the three groups.Results The total clinical effective rate(96.67%,93.33%)in observation group 1 and observation group 2 were higher than that in basic group(60.00%)(P<0.05).After treatment,WAB score and correct number of view naming test in observation group 1 and observation group 2 were higher than those in basic group(P<0.05).The reaction time of view naming test in observation group 1 and observation group 2 were shorter than that in basic group(P<0.05).The improvement degree of BDAE grade in observation group 1 and observation group 2 after treatment were better than that in basic group(P<0.05).The SAQOL⁃39g score in observation group 1 and observation group 2 after treatment was higher than that in basic group(P<0.05).The total clinical response rate,WAB score after treatment,correct number of view naming tests,response time,improvement effect of BDAE classification,and SAQOL⁃39g score didn’t show significant difference between observation group 1 and group 2(P>0.05).

关 键 词：持续短阵脉冲刺激 间歇性爆发式脉冲刺激 言语训练 脑卒中失语症 经颅磁刺激 

分 类 号：R541.75[医药卫生—心血管疾病]