【作者】 王雪；

【导师】 东贵荣；

【作者基本信息】 黑龙江中医药大学 ， 针灸推拿学， 2007， 硕士

【摘要】 目的：通过音乐电针结合语言训练对中风早期运动性失语症的治疗，探讨穴位透刺对中风后运动性失语症的临床疗效及作用机理，阐明针刺结合语言训练是治疗中风后运动性失语症的有效方法，而音乐电针则更具有优越性。方法：利用音乐电针的频率和振幅随乐音的变化而不断变化，可以增强针刺效应，克服电针耐受的特点，运用穴位透刺和语言训练的方法，临床对比观察音乐电针组、脉冲电针组和语言训练组对中风早期运动性失语症的疗效。在治疗两个月后，分别采用《汉语失语症检查法》、功能性语言沟通能力检查法、失语严重程度分级标准，临床神经功能缺损程度评分标准评定患者的语言功能和神经功能。同时在疗程前采用经颅多普勒(TCD)对针灸患者进行针刺前后(即刻)脑血流检测，观察脑血流变化。结果：采用穴位透刺结合语言训练治疗中风早期运动性失语症，在语言功能和神经功能的改善方面，均取得明显的疗效，，音乐电针组和脉冲电针组明显优于语言训练组(P＜0.01)，而音乐电针组更具优势(P＜0.01)。针刺前后(即刻)脑血流检测，左侧大脑前动脉、中动脉、后动脉的平均血流速度显著改善(P＜0.01)，音乐电针组与脉冲电针组比较改善明显(P＜0.05)。结论：利用音乐电针的优越性，采用穴位透刺结合语言康复训练，是一种治疗中风早期运动性失语症的积极有效方法，能明显的促进语言功能的改善，其对患者日常生活语言沟通能力的提高和失语程度的降低均有较好的作用，是中风早期失语症治疗的重要方法之一，同时还能有效的促进神经功能的恢复。临床实验表明，穴位透刺有一定的改善脑血流的作用，而音乐电针的改善更具优势，可作为临床评价和预测疗效的指标之一，也是临床治疗机理之一。更多还原

【Abstract】 Objective Making use of music electroacupuncture integrate with language training to treat the earlier period aphemia from apoplexy; approaching clinical curative effect and mechanism of action of the acupoint penetration needling ; elucidating acupuncture integrate with language training effective method. Music electroacupuncture possess better superiority.Methods Using the clinical contrasted research to observe music electricity needle group, the pulse electricity needle group and the language training group to the stroke early time aphemia curative effect. After two months of treatment, separately uses《Chinese Aphasia Inspection Method》; the Chinese functional communication, Boston diagnostic aphasia examination, the nervous functional deficiency grades standard to evaluate patient’s language function and nerve function. Meanwhile the treatment of acupuncture group were given cerebral blood flow examination before and after acupuncture treatment instantly by Transcranial Doppler (TCD).Results Using the acupoint penetration needling Integrate with Language training to treat the earlier period aphemia from apoplexy , in the language function and the nerve function improvement aspect, obtained obvious curative effect, the music electric needle group and the pulse electric needle group obviously surpasses the language training group(P<0.01), But the music electric needle group has the superiority(P<0.01). After acupuncture, the treatment of acupuncture group had instantly remarkable improvement in the mean blood velocity(Vm) of anterior cerebral artery(ACA)、middle cerebral artery(MCA) and posterior cerebral artery(PCA) in the left hemisphere(P<0.01), compare the music electric needle group to the pulse electric needle group improve obviously(P<0.05).Conclusion Using the music electric needle superiority, integrate with language rehabilitation training is one positive effective method to treat the aphemia from apoplexy, can obviously promote language function improvement, as to the patient daily life language communication ability index enhancement and aphasia degree reduce has better function, is one important treatment method of the earlier period after stroke aphasia, Simultaneously also can effectively promote nerve function to restore. The clinical experiment indicated that the acupoint penetration needling has certain function on improving cerebral blood flow, but the music electric needle improvement has superiority, may take it as one of the clinical appraisal and forecast curative effect index, also is one of clinical therapeutic mechanism更多还原