靳三针联合解语丹治疗卒中后失语症的临床疗效研究

来源期刊：广州医药 | 416-422 发布时间：2024-05-17 收稿时间：2025/11/13 18:49:26 阅读量：85

作者：: 叶海霞,

李世林,

关键词：: 卒中后失语症解语丹靳三针西方失语成套测验汉语失语检查量表副反应量表; post-stroke aphasia Jieyu Dan Jin's Three Needle;Western Aphasia Battery（WAB）Aphasia Battery of Chinese（ABC）Treatment Emergent Symptom Scale（TESS）

DOI：: 10.3969/j.issn.1000-8535.2024.04.015

收稿时间：: 2023-10-08
修订日期：
接收日期：
引用总数：: 2

目的探索以解语丹联合靳三针为基础的不同治疗方案对卒中后失语症（PSA）的治疗效果。方法收集广州市第一人民医院神经内科、中医科PSA患者120例,随机分为解语丹组、靳三针组、联合组和对照组,每组各30例。试验组除给予常规卒中治疗外,分别给予解语丹、靳三针及解语丹联合靳三针治疗,对照组仅给予常规卒中治疗,治疗周期共12周。分别利用西方失语成套测验（WAB）、汉语失语检查量表（ABC）、副反应量表（TESS）于试验前、试验2周及12周时对患者进行评估,并进行药物安全性评价,观察解语丹联合靳三针治疗卒中后失语症的临床治疗效果。结果经2周治疗后,试验组各组WAB中的失语指数（AQ）、操作指数（PQ）、大脑皮质指数（CQ）评分分别为68.14±7.23;67.26±7.23;69.73±6.97、15.47±3.91;15.92±6.35;18.06±7.83、66.84±7.85;65.78±6.75;70.35±6.73,均较治疗前及对照组有明显改善,比较差异有统计学意义（P<0.05）;试验组各组比较,联合组各项评分优于解语丹组和靳三针组,比较差异有统计学意义（P<0.05）;治疗12周后,试验组WAB的AQ、PQ、CQ评分分别为91.87±7.81;85.75±6.87;94.58±7.83、31.57±7.38;25.67±6.28;35.72±8.31、89.74±6.98;84.16±6.79;93.56±7.88,与治疗2周后比较,差异有统计学意义（P<0.05）。言语功能各亚项评分显示,联合组在口语表达、听理解、复述、命名等方面优于其他各组,两两比较差异有统计学（P<0.05）。试验各组在2周及12周时,TESS评分比较差异无统计学意义（P<0.05）。统计分析表明,解语丹联合靳三针治疗卒中后失语症,2周后起效12周后效果更为明显。结论解语丹联合靳三针早期治疗PSA患者能有效提升认知功能,改善患者的言语功能,提高患者的人际交往和生活自理能力,且具有较好的安全性,无严重不良反应,可为临床治疗PSA提供一种新的方法。

Objective To compare the therapeutic effects of different treatment plans based on Jieyu Dan combined with Jin's Three Needle on aphasia patients after stroke．Methods A total of 120 patients with aphasia after stroke in the neurology and traditional Chinese medicine departments of Guangzhou First People's Hospital were collected and randomly divided into Jieyu Dan group,Jin's Three Needle group,combined group and control group,with 30 cases in each group．The treatment groups were treated with Jieyu Dan,Jin's Three Needle and Jieyu Dan combined with Jin's Three Needle respectively,in addition to conventional stroke treatment．The control group was only treated with conventional stroke treatment,with a total treatment period of 12 weeks．The Western Aphasia Battery（WAB）,Aphasia Battery of Chinese（ABC）and Treatment Emergent Symptom Scale（TESS）were used to evaluate patients before,at 2 weeks and 12 weeks of the trial,and drug safety was evaluated to observe the clinical therapeutic effect of Jieyu Dan combined with Jin's Three Needle in treating post stroke aphasia．Results After 2 weeks of treatment,the aphasia quotient（AQ）,performance quotient（PQ）,cortical quotient（CQ）scores of WAB in each group of the experimental group were 68.14±7.23,67.26±7.23,69.73±6.97;15.47±3.91,15.92±6.35,18.06±7.83;66.84±7.85,65.78±6.75,70.35±6.73,respectively,and all significantly improved compared to before treatment and the control group,with significant differences（P<0.05）．Compared with the experimental group,the combined group had better scores than the Jieyu Dan group and Jin's Three Needle group,with a statistically significant difference（P<0.05）．After 12 weeks of treatment,the AQ,PQ,and CQ scores of the experimental group's WAB were 91.87±7.81,85.75±6.87,94.58±7.83;31.57±7.38,25.67±6.28,35.72±8.31;89.74±6.98,84.16±6.79,93.56±7.88,respectively．Compared with 2 weeks of treatment,the difference was statistically significant（P<0.05）．The scores of each sub item of speech function showed that the combined group was significantly better than the other groups in terms of oral expression,listening comprehension,retelling,naming,etc．,with statistical significance（P<0.05）．At 2 and 12 weeks,there were no significant statistical differences in TESS scores among the experimental groups（P<0.05）．Statistical analysis showed that the combination of Jieyu Dan and Jin's Three Needle in the treatment of post-stroke aphasia had a more significant effect after 2 weeks and 12 weeks．Conclusions The combination of Jieyu Dan and Jin's Three Needle can effectively improve cognitive function and enhance patients' self-care ability in the early treatment of aphasia after stroke．The clinical efficacy is significant and has good safety,making it an effective treatment plan for aphasia after stroke．

1、叶海霞,李世林.多奈哌齐治疗早期卒中后失语患者的随机对照研究[J].中华行为医学与脑科学杂志,2014,23(3):225-227.

2、刘兰兰,黄兵,宋曼萍.头针联合舌三针治疗脑卒中后运动性失语症分析[J].长春中医药大学学报,2020,36(5):944-947.

3、李世龙. 靳氏舌三针结合焦氏头皮针治疗中风后运动性失语的疗效观察[D].南京:南京中医药大学,2015.

4、 TENG Y Y.Clinical observation of scalp acupuncture plus speech rehabilitation for Broca's aphasia after cerebral stroke[J].J Acupunct Tuina Sci,2017,15(2):104-108.

5、张华洋. 舌三针颞三针联合言语训练对脑出血后失语症的疗效及神经功能缺损的影响[J].中国中医药现代远程教育,2022,20(5):126-128.

6、韩德雄,张莺.失语症及舌三针治疗机理浅析[J].浙江中医药大学学报,2014,38(4):470-472.

7、王玲姝,李静,顾雪彤,等.舌针、头针配合言语训练治疗缺血性卒中后运动性失语疗效观察[J].河北中医,2020,42(1):118-121.

8、林鸿. 益智四项头针疗法治疗阿尔茨海默病的临床研究[D].广州:广州中医药大学,2016.

9、邓颖. 基于fMRI针刺治疗脑卒中后失语的研究进展[J].中国疗养医学,2023,32(2):143-147.

10、李昭缘,张建忠,张思聪,等.针刺治疗脑卒中后失语症的研究进展[J].西部中医药,2023,36(6):149-152.

11、王树青,周义杰,韦华军,等.不同疗程解语丹药棒治疗脑卒中后运动性失语的临床研究[J].云南中医中药杂志,2018,39(2):36-38.

12、李华,王树青.解语丹冰药棒联合舌、颞三针治疗运动性失语临床观察[J].云南中医中药杂志,2022,43(3):63-66.

13、何玉琴,郑宏忠,陈锦泳.解语丹联合针刺治疗缺血性中风早期失语症疗效观察[J].中国现代药物应用,2015,9(12):242-245.

14、 POSTMAN-CAUCHETEUX W A,BIRN R M,PURSLEY R H,et al.Single-trial fMRI shows contralesional activity linked to overt naming errors in chronic aphasic patients[J].J Cogn Neurosci,2010,22( 6):1299-1318.

15、 KESER Z,SEBASTIAN R,HASAN KM,et al.Right hemispheric homologous language pathways negatively predicts poststroke naming recovery[J]. Stroke,2020,51(3):1002-1005.

16、 STEFANIAK J D,HALAI A D,LAMBON RALPH M A.The neural and neurocomputational bases of recovery from post-stroke aphasia[J].Nat Rev Neurol,2020,16(1):43-55.

17、 STOCKERT A,WAWRZYNIAK M,KLINGBEIL J,et al.Dynamics of language reorganization after left temporo-parietal and frontal stroke[J].Brain,2020,143(3):844-861.

18、 SINGH T,PHILLIP L,BEHROOZMANDR,et al.Pre-articulatory electrical activity associated with correct naming in individuals with aphasia[J]. Brain Lang,2018(177-178):1-6.

19、 HOPE T M H,LEFF A P,PREJAWA S,et al.Right hemisphere structural adaptation and changing language skills years after left hemisphere stroke[J].Brain,2017,140(6):1718-1728.

20、 ASHAIR S A,CHERNEY L R.Eye tracking as a tool to identify mood in aphasia:a feasibility study[J]. Neurorehabil Neural Repair,2020,34(5):463-471.

21、乔保俊,胡良晨,郝延磊.卒中危险因素的研究与预防[J].济宁医学院学报,2017,40(5):382-388.

22、 STIPANCIC K L,BORDERS J C,BRATES D,et al.Prospective investigation of incidence and co-occurrence of dysphagia,dysarthria,and aphasia following ischemic stroke[J].Am J Speech Lang Pathol,2019,28(1):188-194.

23、 LI G,YANG E S.An fMRI study of acupuncture-induced brain activation of aphasia stroke patients[J].Complementary Ther Med,2011,19(suppl 1):S49-S59.

24、 HAMILTON R H.Neuroplasticity in the language system:Reorganization in post-stroke aphasia and in neuromodulation interventions[J].Restor Neurol Neurosci,2016,34(4):467-471.

1、勾怡婷.基于数据挖掘针灸治疗中风后运动性失语的选穴规律与临床疗效观察[D].黑龙江省中医药科学院,2025.DOI:10.27126/d.cnki.ghlzy.2025.000025.

2、宁威,凡军,张治,等.靳三针联合脚本训练在颅脑损伤后非流畅性失语患者中的干预效果研究[J].河北中医,2025,47(10):1693-1697.