头穴丛刺长留针治疗脑卒中后运动性失语的临床疗效观察  

Clinical Observation on the Efficacy of Long Needling Retention Scalp Acupoint Cluster Needling in the Treatment of Post-Stroke Motor Aphasia

作　　者：姜禄婷 孔艳芳 秦合伟[1] 刘建东 JIANG Luting;KONG Yanfang;QIN Hewei;LIU Jiandong(Henan Province Hospital of TCM,Zhengzhou 450002,China;Zhumadian TCM Hospital,Zhumadian 463000,China)

机构地区：[1]河南省中医院,河南郑州450002 [2]驻马店市中医院,河南驻马店463000

出　　处：《中医药信息》2025年第4期45-50,共6页Information on Traditional Chinese Medicine

基　　金：河南省中医药科学研究专项课题项目(2023ZY2068);河南省中医学“双一流”创建科学研究专项课题项目(HSRP-DFCTCM-2023-3-27);河南省中医药拔尖人才培养项目(2022ZYBJ15);中原英才青年拔尖人才项目(豫组通〔2021〕44号)。

摘　　要：目的:观察头穴丛刺长留针治疗脑卒中后运动性失语的临床疗效。方法:选择符合纳入标准的脑卒中后运动性失语患者166例,依据随机数字表随机分为观察组和对照组,治疗过程中观察组脱落3例,对照组脱落3例,最终观察组纳入80例,对照组纳入80例。对照组采用低频rTMS疗法,观察组在对照组基础上联合头穴丛刺长留针,8周为1个疗程。观察两组患者治疗前后西方失语症成套检查(WAB)及AQ评分的语言能力改善情况,日常生活交流能力测验量表(CADOL-T)评分和神经功能缺损程度(NIHSS)评分改善情况;检测患者治疗前后血清多胺氧化酶(PAO)和心型脂肪酸结合蛋白(H-FABP)水平,并比较临床疗效。结果:治疗后,两组WAB、AQ评分和CADOL-T、NIHSS评分均较治疗前明显改善(P<0.05),且观察组改善程度优于对照组(P<0.05);两组PAO和H-FABP水平均明显低于治疗前(P<0.05),且观察组低于对照组(P<0.05)。观察组总有效率97.5%(78/80),明显高于对照组83.75%(67/80)(P<0.05)。结论:采用头穴丛刺长留针联合低频rTMS疗法能够明显改善脑卒中后运动性失语患者的言语功能,改善神经损伤程度,两者联合具有增效的作用。Objective:To observe the clinical efficacy of long needling retention scalp acupoint cluster needling in the treatment of post-stroke motor aphasia.Methods:A total of 166 patients with post-stroke motor aphasia who met the inclusion criteria were randomly divided into an observation group and a control group using a random number table.During the treatment,3 cases in the observation group and 3 cases in the control group were lost to follow-up,resulting in 80 patients in each group.The control group received low-frequency rTMS therapy,while the observation group received long needling retention scalp acupoint cluster needling combined with low-frequency rTMS therapy,with one treatment course lasting 8 weeks.Language ability improvement was assessed using the Western Aphasia Battery(WAB)and Aphasia Quotient(AQ)scores,daily communication ability using the CADOL-T scale,and neurological impairment using the NIH Stroke Scale(NIHSS).Serum levels of polyamine oxidase(PAO)and heart-type fatty acid-binding protein(H-FABP)were measured before and after treatment,and clinical efficacy was compared.Results:After treatment,WAB,CADOL-T,and NIHSS scores in both groups showed significant improvement compared to baseline(P<0.05),with the observation group showing greater improvement than the control group(P<0.05).PAO and H-FABP levels significantly decreased in both groups compared to pre-treatment levels(P<0.05),with lower levels in the observation group than in the control group(P<0.05).The total efficacy rate in the observation group was 97.5%(78/80),significantly higher than 83.75%(67/80)in the control group(P<0.05).Conclusion:Long needling retention scalp acupoint cluster needling combined with low-frequency rTMS therapy significantly improves speech function and reduces the degree of neurological impairment in patients with post-stroke motor aphasia,indicating a synergistic effect.

关 键 词：脑卒中 运动性失语 头穴丛刺长留针 重复经颅磁刺激 

分 类 号：R246.6[医药卫生—针灸推拿学]