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目的:观察头穴电针结合言语训练治疗脑卒中患者言语失用症伴口颜面失用的疗效。方法:将60例脑卒中言语失用症伴口颜面失用的患者随机分为观察组和对照组各30例。观察组采用言语康复训练结合解剖定位下头穴电针治疗,对照组给予单纯言语康复训练。应用“汉语失语症心理语言评价与治疗系统”中的言语运动计划模块中的评定项目为诊断和疗效判定依据,治疗前后分别观察2组患者数数、唱音阶、发音、单音节词复述、双音节词复述及口颜面动作检查的变化。结果:治疗4周后,2组言语失用各项评分均较治疗前明显提高(P<0.05),且观察组自数、跟数两项评分更高于对照组(P<0.05),单音节词、双音节复述两项评分显著高于对照组(P<0.01),2组自唱、跟唱、拼音字母复述等评分比较均差异无统计学意义。治疗4周后,2组口面动作评分中执行能力评分均较治疗前明显提高(P<0.01),2组间比较差异无统计学意义;观察组模仿能力评分较治疗前及对照组均明显提高(P<0.01),对照组治疗前后比较差异无统计学意义。结论:解剖定位头穴电针结合言语训练治疗能够明显纠正脑卒中患者的言语失用症,同时改善口颜面失用。
Objective: To observe the therapeutic effect of acupoint electroacupuncture combined with verbal training on speech disorders associated with oral facial disability in stroke patients. Methods: Sixty patients with silent speech disorder accompanied by facial deformity were randomly divided into observation group and control group with 30 cases each. The observation group received speech rehabilitation training combined with anatomical positioning electroacupuncture under the head acupuncture, while the control group was given verbal rehabilitation training. Appraisal items in speech exercise planning module of “Chinese aphasia psycho-linguistic evaluation and treatment system” were used as basis for diagnosis and therapeutic effect. Before and after treatment, the number of patients, singing scales, pronunciation and monosyllabic words were reiterated , Disyllabic words repeat and mouth facial movements check changes. Results: After 4 weeks of treatment, the scores of speech impairment in both groups were significantly higher than those before treatment (P <0.05), and the scores of two groups in the observation group were higher than those in the control group (P <0.05) Two scores of syllable words and two-syllables repetition were significantly higher than those of the control group (P <0.01). There was no significant difference between the two groups in singing, singing, repetition of phonetic alphabet and other scores. After 4 weeks of treatment, the scores of executive ability in the two groups of mouth motion scores were significantly higher than those before treatment (P <0.01), and there was no significant difference between the two groups after treatment; the scores of imitation ability of the observation group were significantly higher than those before treatment and the control group (P <0.01). There was no significant difference in the control group before and after treatment. Conclusion: Electroacupuncture combined with speech training in the treatment of head acupoints can obviously correct verbal aphasia in stroke patients and improve oral and facial disability.