改良六字诀联合督脉电针法对脑卒中后构音障碍患者的声学参数、语言清晰度及认知水平的影响  

Effects of modified six-character formula combined with Du meridian electroacupuncture on acoustic parameters,language clarity and cognitive level of dysarthria after stroke

作　　者：任敏[1] 庄燕[1] 孟宪忠[1] 蒋琳玲[1] REN Min;ZHUANG Yan;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6期652-656,共5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督脉电针法对脑卒中后构音障碍患者的声学参数、语言清晰度及认知水平的影响。方法前瞻性选取2022年3月至2024年4月上海市浦东新区人民医院康复科住院治疗的脑卒中后构音障碍患者118例,按照住院号奇偶数法分成观察组与对照组,每组各59例。对照组进行常规康复训练与督脉电针法治疗,观察组在对照组基础上联合改良六字诀训练。观察对比两组治疗前与治疗12周后言语功能[改良Frechay构音障碍评价量表(m-FDA)]、语音清晰度(SI)、声学参数[第一共振峰(F1)、第二共振峰(F2)、音高、音强、元音空间面积(VSA)、元音清晰度指数(VAI)、共振峰集中率(FCR)、下颌距]、认知水平[蒙特利尔认知评估量表(MoCA)]及神经功能缺损(NIHSS)情况差异。结果治疗12周后,两组m-FDA、SI评分均较治疗前增高,观察组治疗12周后m-FDA、SI评分分别为(34.43±2.80)、(0.82±0.12)分,均高于对照组[(31.48±2.75)、(0.77±0.11)分],差异均有统计学意义(P<0.05)。治疗12周后,两组F1、FCR均较治疗前降低,F2、高音、音强、VAI、下颌距均较治疗前升高,且观察组的F2、高音、音强、VAI、下颌距分别为(1576.04±179.52)Hz、(179.08±31.20)Hz、(77.27±4.71)dB、0.97±0.09、(435.89±77.21)Hz,均高于对照组[(1470.24±183.43)Hz、(167.41±29.06)Hz、(71.55±5.32)dB、0.86±0.14、(400.21±92.10)Hz],F1、FCR分别为(506.33±95.35)Hz、1.17±0.11,均低于对照组[(541.65±92.74)Hz、1.22±0.14],差异均有统计学意义(P<0.05)。治疗12周后,两组MoCA评分均较治疗前增高,NIHSS评分均较治疗前降低,且观察组的MoCA评分为(28.72±1.48)分,高于对照组[(25.92±1.67)分],NIHSS评分为(0.77±0.49)分,低于对照组[(1.53±0.87)分],差异均有统计学意义(P<0.05)。结论在督脉电针法的基础上联合改良六字诀可改善脑卒中后构音障碍声学参数,提高语言清晰度,改善认知水平,利于神经功能恢复。Objective To explore the effect of modified six-character formula combined with Du meridian electroacupuncture on acoustic parameters,language clarity and cognitive level of dysarthria after stroke.Methods A total of 118 patients with post-stroke dysarthria who were hospitalized in the Department of Rehabilitation,Shanghai Pudong New Area People's Hospital from March 2022 to April 2024 were prospectively selected and divided into the observation group and the control group according to the odd-even method of hospitalization number,with 59 cases in each group.The control group was treated with routine rehabilitation training and Du meridian electroacupuncture.The observation group was combined with modified Liuzijue training on the basis of the control group.The speech function[modified Frechay dysarthria assessment scale(m-FDA)],speech intelligibility(SI),acoustic parameters[first formant(F1),second formant(F2),pitch,intensity,vowel space area(VSA),vowel intelligibility index(VAI),formant concentration rate(FCR),mandibular distance],cognitive level[Montreal cognitive assessment(MoCA)scale]and neurological deficit[neurological deficit(NIHSS)]were observed and compared between the two groups before and after 12 weeks of treatment.Results After 12 weeks of treatment,the m-FDA and SI scores of the two groups increased,the m-FDA and SI scores of the observation group were(34.43±2.80),(0.82±0.12)points,respectively,which were higher than those of the control group[(31.48±2.75),(0.77±0.11)points],the differences were statistically significant(P<0.05).After 12 weeks of treatment,the F1 and FCR of the two groups were lower than those before treatment,and the F2,treble,sound intensity,VAI and mandibular distance were higher than those before treatment,the F2,treble,sound intensity,VAI and mandibular distance of the observation group were(1576.04±179.52)Hz,(179.08±31.20)Hz,(77.27±4.71)dB,0.97±0.09,(435.89±77.21)Hz,respectively,which were higher than those in the control group[(1470.24±183.43)Hz,(167.41±29.06)Hz,(

关 键 词：脑卒中 构音障碍 改良六字诀 督脉电针法 声学参数 语言清晰度 认知水平 

分 类 号：R743.3[医药卫生—神经病学与精神病学]