改良六字诀联合执行功能训练在脑卒中后构音障碍及认知障碍治疗中的价值  

Value of modified six-character formula combined with executive function training in the treatment of dysarthria and cognitive impairment after stroke

作　　者：庄燕[1] 任敏[1] 孟宪忠[1] 蒋琳玲[1] ZHUANG Yan;REN Min;MENG Xian-zhong(Department of Rehabilitation,Shanghai Pudong New Area People's Hospital,Shanghai 201299,China)

机构地区：[1]上海市浦东新区人民医院康复科,上海201299

出　　处：《临床和实验医学杂志》2025年第2期156-161,共6页Journal of Clinical and Experimental Medicine

基　　金：上海市浦东新区卫健委优秀青年医学人才培养计划(编号:PWRq2020-65);上海市卫生健康委员会科研课题面上项目(编号:202150003)。

摘　　要：目的探讨改良六字诀联合执行功能训练对脑卒中后构音障碍及认知障碍患者言语功能、呼吸控制功能、认知功能、情绪状态、日常生活能力的影响。方法前瞻性选取2020年10月至2023年2月上海市浦东新区人民医院康复医学科住院治疗的脑卒中后构音障碍合并认知障碍患者72例作为研究对象,按照随机数字表法将其分为观察组与对照组,各36例。对照组在常规康复治疗基础上进行传统呼吸训练及执行功能训练,观察组在对照组治疗基础上联合改良六字诀训练。观察对比两组治疗前和治疗8周后的言语功能[改良Frechay构音障碍评价量表(m-FDA)、语音清晰度(SI)、日常生活交流能力量表(CADL)、中国康复研究中心汉语标准失语症检查量表(CRRCAE)]、呼吸控制功能[最长发音时间(MMPT)、最大吸气压(MIP)、最大呼气压(MEP)及胸廓活动度]、认知功能[蒙特利尔认知评估量表(MoCA)、简易智力状态检查(MMSE)量表评分]、情绪状态[汉密尔顿抑郁量表(HAMD)]、日常生活能力[改良Barthel指数(MBI)、功能独立性评定量表(FIM)]的差异。结果(1)言语功能:治疗8周后,两组m-FDA、SI、CADL、CRRCAE评分均较治疗前升高,且观察组的m-FDA、SI、CADL、CRRCAE评分均高于对照组,差异均有统计学意义(P<0.05)。(2)呼吸控制功能:治疗8周后,两组MMPT、MIP、MEP、胸廓活动度均升高,且观察组的MMPT、MIP、MEP、胸廓活动度均高于对照组,差异均有统计学意义(P<0.05)。(3)认知功能:治疗8周后,两组MMSE量表评分、MoCA评分均较治疗前升高,且观察组的MMSE量表评分、MoCA评分均高于对照组,差异均有统计学意义(P<0.05)。(4)HAMD及日常生活能力:治疗8周后,两组HAMD评分均较治疗前降低,MBI与FIM评分均治疗前升高,且观察组的HAMD评分低于对照组,MBI、FIM评分高于对照组,差异均有统计学意义(P<0.05)。结论改良六字诀联合执行功能训练可提高脑卒中Objective To explore the effects of modified six-character formula combined with executive function training on speech function,respiratory control function,cognitive function,emotional state,and daily living ability in patients with dysarthria and cognitive impairment after stroke.Methods A total of 72 patients with post-stroke dysarthria and cognitive impairment who were hospitalized in the Department of Rehabilitation,Shanghai Pudong New Area People's Hospital from October 2020 to February 2023 were prospectively selected as the study subjects.They were divided into the observation group and the control group according to the random number table method,with 36 cases in each group.The control group received traditional breathing training and executive function training on the basis of conventional rehabilitation treatment,while the observation group received modified six-character formula on the basis of the control group's treatment.The differences of speech function[modified Frechay dysarthria assessment scale(m-FDA),speech intelligibility(SI),communication ability of daily living(CADL),China Rehabilitation Research Center Chinese Standard Aphasia Examination Scale(CRRCAE)],respiratory control function[maximum pronunciation time(MMPT),maximal inspiratory pressure(MIP),maximal expiratory pressure(MEP)and thoracic mobility],cognitive function[Montreal cognitive assessment scale(MoCA),mini-mental state examination(MMSE)scale score],emotional state[Hamilton depression scale(HAMD)score],daily living ability[modified Barthel index(MBI)score,functional independence measure(FIM)score]were observed and compared between the two groups before treatment and after 8 weeks of treatment.Results(1)Speech function:after 8 weeks of treatment,the m-FDA,SI,CADL and CRRCAE scores of the two groups were higher than those before treatment,and the m-FDA,SI,CADL and CRRCAE scores of the observation group were higher than those of the control group,the differences were statistically significant(P<0.05).(2)Respiratory control function:

关 键 词：脑卒中 构音障碍 认知障碍 改良六字诀 执行功能训练 

分 类 号：R74[医药卫生—神经病学与精神病学]