调神理气针刺及舌三针对脑卒中运动性失语的影响
发布时间：2018-12-06 17:05
【摘要】：运动性失语又称Broca aphasia综合征,口语表达障碍及电报式语言是其最大特征,是所有失语症当中发病率最高的失语类型,广义上讲是大脑额叶皮质、皮质下和基底节区的言语功能障碍综合征,狭义上讲是大脑优势半球的额下回后部和中央前回下部的病变(即Broca语言区)引起的语言表达障碍综合征。运动性失语多由血管病、炎症、肿瘤、外伤及术后等原因导致,病变累及左下额前语言功能区,而以脑血管意外所致运动性失语最为常见。现代医学对其机制研究已非常深入,治疗方式也在不断探索,但治疗上仍是难题,仍然存在言语功能恢复速度慢及恢复不完全等难题。目的:采用调神理气针刺及舌三针配合言语康复锻炼治疗脑卒中后运动性失语症,并与常规针刺对照,观察调神理气针刺及舌三针对脑卒中后运动性失语患者的影响。方法:将60例符合纳入标准的研究对象,按照随机数字表法分为治疗组和对照组,每组30例,均予基础治疗(常规药物治疗+言语康复训练),治疗组在基础治疗上予调神理气针刺及舌三针治疗,对照组在基础治疗上予常规针刺治疗;每周针刺5次,4周为一个疗程,2个疗程后观察疗效。治疗前后均采用北京医科大学汉语失语成套试验(ABC)和功能性语言沟通能力检查法(CFCP)对患者进行评分比较。结果:2个疗程结束后,两组患者功能性语言沟通能力检查法(CFCP)评分比较:干预前,组间比较差异无统计学意义(P0.05),具有可比性。干预后,两组均与干预前组内比较,均有显著性差异(P0.01),干预后组间比较差异有统计学意义(P0.05),治疗组较对照组改善更显著;干预前后差值比较,差异有统计学意义(P0.05),说明两组治疗均能改善患者的功能性语言沟通能力,但是治疗组较对照组改善更明显。两组患者汉语失语成套试验(ABC)评分比较:干预前比较,差异均无统计学意义(P0.05),具有可比性。两组患者自发谈话流利性、信息量、听理解、阅读、复述、命名、书写七项言语功能与干预前比较,差异均有统计学意义(P0.01);经比较两组患者干预后评分及干预前后差值,自发谈话流利性、复述、听理解三项与对照组比较,均有显著性差异(P0.05),信息量、命名、阅读、书写四项经比较,均无显著性差异(P0.05),治疗组总有效率86.66%,对照组总有效率80%,差异无显著性。说明治疗组在改善患者流利性、复述、听理解三项上,疗效优于对照组,在总临床疗效上无显著性差异。结论:综上所述,两种治疗方式都能改善患者言语功能,调神理气针刺及舌三针治疗方案对患者功能性语言沟通能力及言语流利性、复述、听理解,临床疗效优于常规针刺;信息量、命名、阅读、书写四项两组均有改善,但两组疗效无显著性差异。治疗中风后失语症针灸显效,而研究表明调神理气针刺及舌三针疗法对运动性失语有一定临床使用价值。
[Abstract]:Motor aphasia, also known as Broca aphasia syndrome, is characterized by dysfunctional spoken language and Telegraph language, the most common aphasia type of all aphasia, and broadly speaking the frontal cortex of the brain. The speech dysfunction syndrome in subcortical and basal ganglia regions is, in a narrow sense, a language expression disorder syndrome caused by the lesions in the posterior part of inferior frontal gyrus and the lower part of precentral gyrus (i.e., Broca language area) in the dominant hemisphere of the brain. Motor aphasia is mostly caused by vascular disease, inflammation, tumor, trauma and postoperative causes. The lesions involve the left prefrontal language area, and cerebral vascular accident is the most common cause of motor aphasia. In modern medicine, the research on its mechanism has been very deep, and the treatment method has been explored constantly. However, the treatment is still a difficult problem, and there are still some problems such as slow recovery rate and incomplete recovery of speech function. Objective: to observe the effect of regulating spirit and regulating qi acupuncture and tongue three acupuncture combined with speech rehabilitation exercise on motor aphasia after stroke, and to observe the effect of regulating spirit and regulating qi acupuncture and tongue three acupuncture on motor aphasia after stroke. Methods: sixty patients who met the standard were divided into treatment group and control group according to random digital table method. 30 cases in each group were treated with basic therapy (routine drug therapy speech rehabilitation training). The treatment group was treated with acupuncture of regulating spirit and regulating qi and three acupuncture of tongue on basic treatment, while the control group was treated with routine acupuncture on basic treatment. Acupuncture 5 times a week, 4 weeks as a course of treatment, 2 courses of treatment to observe the efficacy. The scores of the patients were compared before and after treatment with the Chinese aphasia test of Beijing Medical University (ABC) and the functional language communication ability test (CFCP). Results: after two courses of treatment, the (CFCP) score of functional language communication ability test was compared between the two groups: before intervention, there was no significant difference between the two groups (P0.05), which was comparable. After intervention, there was significant difference between the two groups compared with the pre-intervention group (P0.01), the difference between the two groups after intervention was statistically significant (P0.05), the treatment group was more significant than the control group. The difference before and after intervention was statistically significant (P0.05), indicating that both groups could improve the functional language communication ability of patients, but the treatment group improved more obviously than the control group. Comparison of (ABC) scores of Chinese aphasia test between the two groups: before intervention, the differences were not statistically significant (P0.05), comparable. There were significant differences in spontaneous speech fluency, information content, listening comprehension, reading, retelling, naming and writing between the two groups (P0.01). Compared with the control group, there were significant differences between the two groups in score and difference before and after intervention, spontaneous speech fluency, repetition, listening comprehension (P0.05), information content, naming, reading and writing. There was no significant difference (P0.05). The total effective rate was 86.66 in the treatment group and 80 in the control group. The results showed that the curative effect of the treatment group was superior to that of the control group in improving the fluency, repetition and listening comprehension of the patients, but there was no significant difference in the total clinical effect. Conclusion: to sum up, both of the two treatments can improve the speech function of the patients. The therapeutic effects of regulating the spirit, regulating the qi and acupuncture of tongue on the functional language communication ability and speech fluency, repetition, listening comprehension, clinical effect of acupuncture are better than those of routine acupuncture. The information content, naming, reading and writing were all improved, but there was no significant difference between the two groups. Acupuncture and moxibustion are effective in the treatment of aphasia after apoplexy, but the research shows that acupuncture of regulating spirit and regulating qi and three acupuncture of tongue have certain clinical value for motor aphasia.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6
，
本文编号：2366360
[Abstract]:Motor aphasia, also known as Broca aphasia syndrome, is characterized by dysfunctional spoken language and Telegraph language, the most common aphasia type of all aphasia, and broadly speaking the frontal cortex of the brain. The speech dysfunction syndrome in subcortical and basal ganglia regions is, in a narrow sense, a language expression disorder syndrome caused by the lesions in the posterior part of inferior frontal gyrus and the lower part of precentral gyrus (i.e., Broca language area) in the dominant hemisphere of the brain. Motor aphasia is mostly caused by vascular disease, inflammation, tumor, trauma and postoperative causes. The lesions involve the left prefrontal language area, and cerebral vascular accident is the most common cause of motor aphasia. In modern medicine, the research on its mechanism has been very deep, and the treatment method has been explored constantly. However, the treatment is still a difficult problem, and there are still some problems such as slow recovery rate and incomplete recovery of speech function. Objective: to observe the effect of regulating spirit and regulating qi acupuncture and tongue three acupuncture combined with speech rehabilitation exercise on motor aphasia after stroke, and to observe the effect of regulating spirit and regulating qi acupuncture and tongue three acupuncture on motor aphasia after stroke. Methods: sixty patients who met the standard were divided into treatment group and control group according to random digital table method. 30 cases in each group were treated with basic therapy (routine drug therapy speech rehabilitation training). The treatment group was treated with acupuncture of regulating spirit and regulating qi and three acupuncture of tongue on basic treatment, while the control group was treated with routine acupuncture on basic treatment. Acupuncture 5 times a week, 4 weeks as a course of treatment, 2 courses of treatment to observe the efficacy. The scores of the patients were compared before and after treatment with the Chinese aphasia test of Beijing Medical University (ABC) and the functional language communication ability test (CFCP). Results: after two courses of treatment, the (CFCP) score of functional language communication ability test was compared between the two groups: before intervention, there was no significant difference between the two groups (P0.05), which was comparable. After intervention, there was significant difference between the two groups compared with the pre-intervention group (P0.01), the difference between the two groups after intervention was statistically significant (P0.05), the treatment group was more significant than the control group. The difference before and after intervention was statistically significant (P0.05), indicating that both groups could improve the functional language communication ability of patients, but the treatment group improved more obviously than the control group. Comparison of (ABC) scores of Chinese aphasia test between the two groups: before intervention, the differences were not statistically significant (P0.05), comparable. There were significant differences in spontaneous speech fluency, information content, listening comprehension, reading, retelling, naming and writing between the two groups (P0.01). Compared with the control group, there were significant differences between the two groups in score and difference before and after intervention, spontaneous speech fluency, repetition, listening comprehension (P0.05), information content, naming, reading and writing. There was no significant difference (P0.05). The total effective rate was 86.66 in the treatment group and 80 in the control group. The results showed that the curative effect of the treatment group was superior to that of the control group in improving the fluency, repetition and listening comprehension of the patients, but there was no significant difference in the total clinical effect. Conclusion: to sum up, both of the two treatments can improve the speech function of the patients. The therapeutic effects of regulating the spirit, regulating the qi and acupuncture of tongue on the functional language communication ability and speech fluency, repetition, listening comprehension, clinical effect of acupuncture are better than those of routine acupuncture. The information content, naming, reading and writing were all improved, but there was no significant difference between the two groups. Acupuncture and moxibustion are effective in the treatment of aphasia after apoplexy, but the research shows that acupuncture of regulating spirit and regulating qi and three acupuncture of tongue have certain clinical value for motor aphasia.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6
，
本文编号：2366360
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