低频电脉冲刺激结合针刺治疗对急性脑梗死后痉挛型构音障碍的临床观察

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目的探讨低频电脉冲刺激结合针刺治疗对急性脑梗死后痉挛型构音障碍的临床疗效。方法选择2011年1月至2014年10月廊坊市第四人民医院神经内科住院治疗的160例急性脑梗死后痉挛型构音障碍患者为研究对象,按入院顺序随机分为对照组和观察组,每组80例,对照组在灯盏细辛活血祛瘀、阿司匹林抗血小板聚集等一般治疗的基础上进行言语训练康复治疗,观察组在对照组基础上实施针刺治疗和功能性低频电脉冲刺激治疗。采用神经功能评分(NIHSS)评定神经功能,采用修订的Barthel指数(MBI)评价日常生活能力,采用Frenchay构音障碍评定法评价构音障碍等级。结果治疗前两组患者NIHSS评分、MBI指数比较,差异无统计学意义(P>0.05);治疗后两组NIHSS评分及MBI指数均较同组治疗前明显改善(P<0.05);治疗后观察组NIHSS评分低于对照组、MBI指数高于对照组,差异均有统计学意义(t=2.687,P<0.05;t=7.013,P<0.05)。治疗后两组患者Frenchay评分较同组治疗前明显改善(P<0.05),观察组改善程度明显好于对照组,差异均有统计学意义(Z=-2.308,P<0.05)。结论低频电脉冲刺激结合针刺治疗急性脑梗死后痉挛型构音障碍,可有效降低NIHSS评分和提高MBI评分,改善患者的构音能力。 Objective To investigate the clinical effect of low-frequency electrical pulse combined with acupuncture on spastic dysarthria after acute cerebral infarction. METHODS: From January 2011 to October 2014, 160 patients with spastic dysarthria after acute cerebral infarction hospitalized in the Fourth People’s Hospital of Langfang City were enrolled in this study. The patients were randomly divided into control group and observation group according to admission sequence, 80 cases in each group. The control group received verbal training and rehabilitation therapy on the basis of the general treatment of Erigeron Breviscapus, blood stasis and aspirin anti-platelet aggregation. The observation group received acupuncture therapy and functional low-frequency electrical pulse stimulation on the basis of the control group . Nerves function was assessed by neurological function score (NIHSS), daily living ability was assessed by modified Barthel index (MBI), and dysarthria rating was evaluated by Frenchay dysarthria assessment. Results There was no significant difference in NIHSS score and MBI index between the two groups before treatment (P> 0.05). NIHSS score and MBI index of both groups were significantly improved after treatment (P <0.05) The NIHSS score of the group was lower than that of the control group, MBI index was higher than that of the control group (t = 2.687, P <0.05; t = 7.013, P <0.05). After treatment, Frenchay score was significantly improved in both groups (P <0.05), and the improvement in the observation group was significantly better than that in the control group (Z = -2.308, P <0.05). Conclusion Low-frequency electrical stimulation combined with acupuncture treatment of spastic dysarthria after acute cerebral infarction can effectively reduce the NIHSS score and improve the MBI score to improve patients’ ability to make the sound.
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