注意训练联合重复经颅磁刺激治疗卒中后非流畅性失语症的疗效

郑怡;顾莹;员玲玲;张伟明;石春丽;汤继芹;

1:潍坊医学院康复医学院

2:山东省立第三医院康复医学科

3:山东中医药大学康复医学院

摘要
目的 观察常规言语训练基础上结合注意训练及重复经颅磁刺激(repetitive transcranial magnetic stimulation, rTMS)对卒中后非流畅性失语症患者的认知、言语及日常生活能力的影响。方法 脑卒中患者45例按随机数字表分为3组,语训+注意训练组(A组)、语训+rTMS组(B组)和语训+注意训练+rTMS组(C组),每组15例。所有患者均接受常规言语训练,A组在此基础上增加注意训练;B组在常规言语训练基础上对右侧大脑额下回三角区进行低频重复经颅磁刺激;C组接受上述3种疗法的联合治疗。常规言语训练时间为30 min,注意训练及rTMS治疗时间均为20 min,上述3种治疗每天1次,每周5次,疗程4周。治疗前后对患者进行简易智能状态检查(mini-mental state examination, MMSE)、改良Barthel指数量表(modified barthel index, MBI)以及汉语失语症成套量表(aphasia battery of Chinese, ABC)评估。结果 治疗前,3组间MMSE、MBI、ABC各项(命名、听理解、阅读、书写)评分差异均无统计学意义;治疗后3组各项评分均较治疗前提高,差异有统计学意义(P<0.05)。C组MMSE、ABC的命名及书写的评分改善程度显著优于A组和B组,差异有统计学意义(P<0.05)。C组ABC的阅读得分仅优于B组(P<0.05);C组的MBI和ABC的听理解得分与其余两组无统计学差异(P>0.05)。结论 在常规言语训练的基础上,注意训练联合重复经颅磁刺激能有效改善失语症患者的认知、命名及书写能力,且其临床疗效优于单独使用注意训练或者重复经颅磁刺激治疗。
关键词
脑卒中;失语症;重复经颅磁刺激;注意训练;言语治疗
基金项目(Foundation):
山东省中医药科技发展计划项目(2017-011)
作者
郑怡;顾莹;员玲玲;张伟明;石春丽;汤继芹;
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