CAJ | 학술논문

目的：评价多奈哌齐联合针刺及语言康复措施治疗脑梗死后失语的疗效，探索脑梗死后失语治疗的有效措施。方法序贯入组120例脑梗死后失语患者，随机分配至单纯语言康复组（A组，29例）、多奈哌齐联合语言康复组（B 组，28例）、针刺治疗联合语言康复组（C 组，28例）、多奈哌齐联合针刺及语言康复组（D组，30例），所有患者接受为期4周的治疗，分别于治疗前、治疗12周及治疗24周末采用西方失语症成套测验（WAB）评定疗效，比较4组疗效。结果4组患者基线失语指数及各亚项（自发语言、听力理解、复述及命名）评分比较差异无统计学意义（P＞0.05）。经重复测量资料方差分析及单因素方差分析，治疗后D组失语指数及各亚项（自发语言、听力理解、复述及命名）评分均高于其他3组，4组患者比较差异有统计学意义（P均＜0.05）。治疗24周后，A、B、C、D组临床改善者分别占28％、50％、46％、77％，D组达临床改善者比例明显高于其他3组（P均＜0.05）。结论针刺、语言康复训练及药物三种康复方式联合有助于脑梗死后失语恢复。
목적：평개다내고제연합침자급어언강복조시치료뇌경사후실어적료효，탐색뇌경사후실어치료적유효조시。방법서관입조120례뇌경사후실어환자，수궤분배지단순어언강복조（A조，29례）、다내고제연합어언강복조（B 조，28례）、침자치료연합어언강복조（C 조，28례）、다내고제연합침자급어언강복조（D조，30례），소유환자접수위기4주적치료，분별우치료전、치료12주급치료24주말채용서방실어증성투측험（WAB）평정료효，비교4조료효。결과4조환자기선실어지수급각아항（자발어언、은력리해、복술급명명）평분비교차이무통계학의의（P＞0.05）。경중복측량자료방차분석급단인소방차분석，치료후D조실어지수급각아항（자발어언、은력리해、복술급명명）평분균고우기타3조，4조환자비교차이유통계학의의（P균＜0.05）。치료24주후，A、B、C、D조림상개선자분별점28％、50％、46％、77％，D조체림상개선자비례명현고우기타3조（P균＜0.05）。결론침자、어언강복훈련급약물삼충강복방식연합유조우뇌경사후실어회복。
Objective To evaluate the effectiveness of combining acupuncture and donepezfil in pa-tients with post-Infarction aphasia. Methods One hundred and twenty patients with acute aphasic infarct were randomly assigned into 4 groups:standard speech-language therapy group (group A),donepezil (5 mg/d)as an adjunctive treatment to standard speech-language therapy group (group B),acupuncture as an adjunctive treatment to standard speech-language therapy group (group C)and a combination of donepezil (5 mg/d), acupuncture and standard speech-language therapy group (group D). All patients underwent clinical assess-ment (western aphasia battery)three times over a 24-week period (the 1 st,1 2th,and 24th weeks)and clinical scores were analyzed. Results Compared with the baseline in each group,all items of WAB scores and Aphasia Quotien (AQ) were statistically significant (all P<0.05 ). The difference in all items of WAB scores and AQ between different groups in the 1 2th and 24th week became statistically significant. The signifi-cant improvement rate in the combination of donepezil,acupuncture and standard speech-language therapy group was 77% which was significantly greater than that of other groups (group A 27.6%,group B 50%and group C 46%,all P<0.05 ). Conclusion Acupuncture combined with donepezil has been shown to improve the poststroke aphasia.