Abstract:

Objective To explore the therapeutic effect of speech training combined with scalp acupuncture in improving speech, cognitive function and activities of daily living in stroke patients with aphasia. 

Methods A retrospective analysis was made on 90 patients with apoplectic aphasia admitted to rehabilitation department and neurology department of our hospital from January 2016 to January 2017. They were divided into speech training combined with scalp needle group, speech training group and control group. Speech training combined with scalp needle group and speech training group served as observation groups, and compared before and after treatment. The functional recovery after treatment for 1 month and 3 months, and the long-term therapeutic effect at 9 months after discontinuation of treatment were evaluated by Barthel index (BI), Montreal cognitive assessment (MoCA) and aphasia quotient. 

Results (1) The BI, MoCA score and aphasia quotient of each group were all improved after 1 month and 3 months of treatment and at 9 months after ceasing treatment. (2) MoCA scores and aphasia quotient of the two observation groups both showed continuous improvement after treatment (P <0.001). (3) MoCA score and aphasia quotient of speech training combined with scalp needle group were better than that of speech training group and control group (P <0.05); the BI of speech training combined with scalp needle group was better than that of speech training group after 3 months of treatment (P <0.05).

Conclusions Speech training combined with scalp needle rehabilitation therapy can obviously improve speech and cognitive impairment, and improve activities of daily living more better in a short term.

Key words: Speech training; Scalp acupuncture; Stroke; Aphasia; Cognitive function

摘要：

目的 探讨分析言语训练结合头皮针灸在卒中失语症患者中改善言语功能、认知功能和日常生活 活动能力的临床疗效。 

方法 回顾性分析上海健康医学院附属嘉定区中心医院康复科和神经内科自2016年1月-2017年1月 收治的卒中失语症患者90例，分成言语训练+头皮针灸组、言语训练组、对照组，使用改良Barthel指 数、失语商（采用西部失语成套测验量表）、蒙特利尔认知评估（Montreal cognitive assessment，MoCA） 三方面数据，评定治疗前、治疗1个月和3个月的功能恢复情况，以及停止治疗9个月的远期治疗效果。 

结果 ①治疗1个月、3个月及停止治疗9个月的三组改良Barthel指数、MoCA指数、失语商均得到改善。②言语训练+头皮针灸组和言语训练组的MoCA指数和失语商在治疗后均呈现出持续改善的现象 （均P＜0.001）。③言语训练+头皮针灸组的MoCA指数和失语商改善程度优于言语训练组和对照组（P ＜0.05），言语训练+头皮针灸组的改良Barthel指数在治疗3个月内优于言语训练组（P＜0.05）。 

结论 言语训练结合头皮针灸的康复治疗方法改善言语障碍和认知障碍的效果明显，且短期内提 高日常生活活动能力的效果较佳。

关键词: 言语训练; 头皮针灸; 卒中; 失语症; 认知功能