摘要
目的利用血氧水平依赖性功能性磁共振成像（BOLD-fMRI）技术观察脑卒中失语症患者针刺联合语言康复训练治疗前和治疗后语言中枢激活脑区的变化，并比较单纯语言康复训练与联合治疗两种任务态下患者的言语功能恢复情况及激活脑区功能性磁共振成像（fMRI）差异。 方法选取20例脑卒中失语症患者，所有患者均为右利手，按随机数字表法将其分为单一治疗组和联合治疗组，每组10例。单一治疗组采用语言康复训练，联合治疗组在此基础上增加针刺治疗，分别于入院当日及治疗1个月后采用BOLD-fMRI技术对患者的中枢激活脑区进行评定，并于治疗1个月后应用汉语失语成套测验（ABC）评价患者的言语功能恢复情况。 结果治疗过程中，单一治疗组有1例患者再发脑卒中，未能复查fMRI。治疗后，单一治疗组和联合治疗组的有效率分别为55.56%和100.00%，联合治疗组言语功能恢复状况优于单一治疗组（P〈0.05）。单一治疗组和联合治疗组患者的激活体素和激活强度变化与组内治疗前比较，差异均有统计学意义（P〈0.05），其中联合治疗组右侧激活脑区明显多于左侧，且其激活脑区较单一治疗组更为显著、广泛（P〈0.05），主要包括双侧额叶、楔叶、后扣带回、舌回、枕叶、胼胝体压部、小脑半球，左侧中央前后回、中央旁小叶、颞叶、角回、楔前叶，右侧海马、海马旁回。 结论针刺联合语言康复训练可引起患者相应脑功能激活区产生变化，而这些特异性激活区可能与患者的言语功能恢复有关。
Objective To observe and compare the effects of acupuncture and acupuncture plus speech therapy on activation of the brain areas in aphasic patients by use of oxygenation level dependent-functional magnetic resonance imaging （BOLD-fMRI）. Methods Twenty patients with aphasia caused by stroke were randomized into two groups by use of random number table （ 10 cases in each group） ： an experimental group subject to acupuncture treatment combined with speech therapy, and a control group subject to speech therapy only. All the cases were dex- tromanuality. On admission and after 1 month of treatment, BOLD-fMRI was used to test signals of the activated brain areas of both group, and Aphasia Battery of the Chinese （ABC） was employed to evaluate the changes of speech abil- ity of the patients. Results During the study, 1 case from control group was unable to do the post-intervention e- valuation due to onset of the second stroke. The effective rates of the control and experimental group were 55.56% and 100.00% , respectively, and recovery of verbal ability in experimental group was significantly better than in con- trol group （P 〈 0.05）. The active volume and extent in brain were significantly increased in both groups （P 〈 0.05 ） , and a comparison between the two groups showed that the changes in activation volume and extent of the brain were significantly greater extensive in experimental group than in the control group, especially in bilateral frontal lobe, cuneus, posterior cingulate gyrus, lingual gyms, occipital lobe, splenium of corpus callosum, cerebellar hemisphere, and the left precentral gyrus, post-central gyrus, paracentral lobule, temporal lobes, angular gyrus, precuneus, and the right hippoeampus, parahippocampus gyrus. Conclusion Acupuncture combined with speech therapy could cause changes in activation patterns of the brain areas, which may contribute to the improvement of verbal abili- ty of the aphasic patients.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2013年第7期552-556,共5页
Chinese Journal of Physical Medicine and Rehabilitation
基金
湖北省教育厅科研项目（D20091604）
关键词
功能性磁共振成像
脑卒中
失语症
针刺
Functional magnetic resonance imaging
Stroke
Aphasia
Acupuncture
