电针联合功能性电刺激早期干预对脑梗死后痉挛型构音障碍的疗效研究

摘要

目的:探讨早期电针(EA)联合功能性电刺激(FES)对脑梗死痉挛型构音障碍的临床疗效.方法:将180例脑梗死痉挛型构音障碍患者随机分为对照组、治疗组和联合组,对照组予常规药物治疗加灯盏细辛注射液静滴,治疗组在对照组基础上加电针,针刺风池、百会、大椎、翳明、廉泉、外金津玉液,联合组在治疗组基础上加FES治疗,治疗前及治疗2周后采用修改的Barthel指数(MBI)、NIHSS评分和Frenchay构音障碍评价法评定其疗效.结果:经治疗后,对照组、治疗组、联合组的MBI、NIHSS评分均较同组治疗前明显改善(P＜0.001),经治疗后联合组的MBI高于对照组和治疗组(P＜0.05),NIHSS评分则低于对照组和治疗组,三组间的MBI、NIHSS评分比较差异具有显著性意义(P＜0.05)；治疗后治疗组和联合组的Frenchay构音障碍评定级别均较治疗前明显改善(P＜0.05,P＜0.001),差异具有显著性.结论:EA联合FES能有效地改善脑梗死患者构音障碍及日常生活能力.%Objective: To observe the curative effect of electro-acupuncture(EA) combined with functional electric stimulation (FES) on the treatment of spastic dysarthria in acute cerebral infarction (ACI) patients at the early stage. Method:A total of 180 cases of ACI patients with spastic dysarthria were randomly divided into control group, treatment group and combined treatment group. Conventional drug therapy and fleabane injection were used in control group. Additionally, EA at acupoints of Fengchi(GB20), Baihui(DU20), Dazhui(BU14), Yiming(EX-HN14), Lianquan(RN23) and lateral Jinjinyuye was performed in treatment group and FES and EA combined treatment were applied in combined treatment group. Neurology grade and recovery of lower limb function were evaluated by using modified Barthel index (MBI), National Health Institate stroke scale (N1HSS) and dysarthria Frenchay score before treatment and after 2 weeks treatment.rnResult: MBI and NIHSS scores increased significantly after treatment in all three groups (P<0.01). Compared with control group and treatment group, MBI increased significantly after treatment in combined treatment group (P< 0.05), but NIHSS score was lower than that in other two groups. There were significant differences regarding MBI and NIHSS score among three groups (P<0.05). Additionally, dysarthria Frenchay score increased significantly after　treatment in treatment group and combined treatment group (P<0.05, P<0.01); compared with treatment group, it rnincreased markedly in combined treatment group with significant difference (P<0.001).rnConclusion:The combined treatment of FES with EA applied in ACI patients with dysarthria at the early stage rncan efficiently improve the speech function and activities of daily living (ADL).