背景重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)是一项脑卒中后失语治疗的新技术,但存在定位不准确的问题。神经影像导航下重复经颅磁刺激已应用于临床,但对脑卒中后失语的临床疗效尚未见研究报道。目的分析...背景重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)是一项脑卒中后失语治疗的新技术,但存在定位不准确的问题。神经影像导航下重复经颅磁刺激已应用于临床,但对脑卒中后失语的临床疗效尚未见研究报道。目的分析评价神经影像导航定位引导重复经颅磁刺激治疗亚急性脑卒中非流利性失语患者的安全性和有效性。方法本研究为随机、双盲、前瞻性临床试验。选择2020年10月-2022年4月于解放军总医院第一医学中心康复医学科住院的脑卒中后非流利性失语患者,随机数字法分为导航rTMS组(neuronavigational rTMS,nTMS)和传统的国际10-20脑电系统定位组(conventional TMS,cTMS),两组均行右半球额下回三角部(pars triangularis,PTr)低频rTMS治疗。在治疗前、治疗10 d后,通过不良事件评分量表评价治疗的安全性,以中文语失语症评分(aphasia battery of Chinese,ABC)评价和比较组内和组间的言语功能。结果nTMS组15例,rTMS组14例,两组性别、年龄、病程等一般资料差异无统计学意义(P>0.05)。治疗过程中,无不良事件发生。治疗前,两组复述、命名、听理解、阅读等言语评分无统计学差异(P>0.05);治疗后,nTMS组自发言语、听理解、复述、命名、阅读、空间与结构、运用均较治疗前显著改善,差异有统计学意义(P<0.05),cTMS组听理解、命名、阅读均较治疗前显著改善,差异有统计学意义(P<0.05);组间比较,导航rTMS组复述、命名功能较传统定位组改善更显著,差异有统计学意义(P<0.05)。结论导航下右侧额下回三角部低频rTMS治疗相比传统定位组可更显著改善亚急性脑卒中后非流利性失语患者的命名、复述功能。展开更多
OBJECTIVE:Acupuncture has often been used for aphasia rehabilitation in China.The purpose of this paper was to:1) provide a historic overview of acupuncture for aphasia due to stroke;2) summarize the commonly used acu...OBJECTIVE:Acupuncture has often been used for aphasia rehabilitation in China.The purpose of this paper was to:1) provide a historic overview of acupuncture for aphasia due to stroke;2) summarize the commonly used acupuncture approaches;and 3) objectively comment on the effectiveness of acupuncture for the rehabilitation of this type of disorder.METHODS:The Elsevier database and a Chinese database(CNKI) were searched through December,2010 with the key words "aphasia,acupuncture" in English and Chinese,respectively.Case reports,uncontrolled clinical observations and controlled clinical trials were all included if acupuncture was the sole treatment or the main component of complex intervention for the rehabilitation of aphasia caused by cerebrovascular disease.RESULTS:More than 100 relevant articles were found.After analyzing these articles,we found that acupuncture for apoplectic aphasia most often included tongue,scalp,body and combination acupuncture.Tongue bleeding,deep insertion and strong stimulation were adopted by many practitioners.The ten most frequently used acupoints(or areas) were Lianquan(RN 23),Jinjin(EX-HN 12),Yuye(EX-HN 13),Tongli(HT 5),Fengchi(GB 20),Neiguan(PC 6),Baihui(DU 20),No.1,2 and 3 language sections,Sanyinjiao(SP 6) and Yamen(DU 15).CONCLUSIONS:Controlled clinical studies and a systematic literature review demonstrate that acupuncture has therapeutic effects on aphasia after stroke.展开更多
文摘OBJECTIVE:Acupuncture has often been used for aphasia rehabilitation in China.The purpose of this paper was to:1) provide a historic overview of acupuncture for aphasia due to stroke;2) summarize the commonly used acupuncture approaches;and 3) objectively comment on the effectiveness of acupuncture for the rehabilitation of this type of disorder.METHODS:The Elsevier database and a Chinese database(CNKI) were searched through December,2010 with the key words "aphasia,acupuncture" in English and Chinese,respectively.Case reports,uncontrolled clinical observations and controlled clinical trials were all included if acupuncture was the sole treatment or the main component of complex intervention for the rehabilitation of aphasia caused by cerebrovascular disease.RESULTS:More than 100 relevant articles were found.After analyzing these articles,we found that acupuncture for apoplectic aphasia most often included tongue,scalp,body and combination acupuncture.Tongue bleeding,deep insertion and strong stimulation were adopted by many practitioners.The ten most frequently used acupoints(or areas) were Lianquan(RN 23),Jinjin(EX-HN 12),Yuye(EX-HN 13),Tongli(HT 5),Fengchi(GB 20),Neiguan(PC 6),Baihui(DU 20),No.1,2 and 3 language sections,Sanyinjiao(SP 6) and Yamen(DU 15).CONCLUSIONS:Controlled clinical studies and a systematic literature review demonstrate that acupuncture has therapeutic effects on aphasia after stroke.
