音乐和语言治疗在卒中后非流畅性失语症患者中的疗效观察
음악화어언치료재졸중후비류창성실어증환자중적료효관찰
Therapeutic effect of music therapy and speech language therapy on post-stroke patients with non-fluent aphasia
  • 万方数据
    中华神经科杂志 중화신경과잡지
    Chinese Journal of Neurology
    2015年 4期 274-278 ,共5页

    张媛%姚永坤%卢香云

    장원%요영곤%로향운

    卒中%失语,Broca%音乐疗法%语言疗法%治疗结果 卒中%失語,Broca%音樂療法%語言療法%治療結果
    졸중%실어,Broca%음악요법%어언요법%치료결과
    Stroke%Aphasia,Broca%Music therapy%Language therapy%Treatment outcome
    目的 评估音乐和语言治疗在卒中后非流畅性失语症患者中的疗效.方法 收集2012年6月至2014年5月在石河子大学第一附属医院诊断为卒中后非流畅性失语的患者84例,按照随机数字表法随机分为音乐治疗组和语言治疗组(均包括慢性组和急性组)各42例[每组患者按照发病至治疗时间分为急性组(38例)和慢性组(46例)].在神经内科常规用药的基础上,分别给予1个月的音乐治疗和语言治疗.治疗前后用中文版西部失语症成套测试的部分指标评估两组患者的失语情况.结果 慢性组和急性组在音乐治疗和语言治疗前后自发言语、听理解、复述、命名和失语商分值的变化差异无统计学意义.慢性组在音乐治疗和语言治疗前后复述[32.00(15.00,53.75)分与48.50(24.50,72.00)分,Z=2.147,P=0.032;33.00(14.50,49.25)分与48.50(18.50,63.75)分,Z =2.018,P=0.038]、命名[20.00(8.50,34.75)分与37.50(12.50,64.75)分,Z=2.298,P=0.022;19.50(7.00,31.25)分与34.50(15.00,52.75)分,Z=2.039,P=0.041]和失语商[24.50(10.50,37.50)分与43.00(18.00,64.75)分,Z=2.432,P=0.015;22.50(10.00,34.50)分与36.00(14.00,54.00)分,Z=2.027,P=0.043]分值差异有统计学意义,并且音乐治疗前后听理解[62.00(30.50,88.75)分与89.50(46.50,112.00)分,Z=1.998,P=0.046]分值差异有统计学意义.急性组在音乐治疗和语言治疗前后复述[24.50(11.00,38.75)分与46.50(24.50,67.75)分,Z=2.038,P=0.043;26.50(9.50,36.25)分与42.50(19.00,64.25)分,Z=1.972,P=0.048]分值差异有统计学意义,并且音乐治疗前后自发言语[2.00 (1.00,3.75)分与8.00(4.00,12.75)分,Z=2.012,P=0.036]、听理解[51.00(17.50,73.75)分与85.00(48.00,101.00)分,Z=2.298,P=0.022]、命名[17.50(6.00,29.00)分与37.50(16.00,58.75)分,Z=2.161,P=0.031]和失语商[18.00 (7.50,31.25)分与42.50(20.50,63.75)分,Z=2.256,P=0.024]分值差异有统计学意义,而语言治疗前后自发言语、听理解、命名和失语商分值差异均无统计学意义.结论 音乐治疗和语言治疗两种治疗方式在慢性卒中后非流畅性失语患者中均具有一定疗效,音乐治疗在急性卒中后非流畅性失语患者中同样具有疗效.
    목적 평고음악화어언치료재졸중후비류창성실어증환자중적료효.방법 수집2012년6월지2014년5월재석하자대학제일부속의원진단위졸중후비류창성실어적환자84례,안조수궤수자표법수궤분위음악치료조화어언치료조(균포괄만성조화급성조)각42례[매조환자안조발병지치료시간분위급성조(38례)화만성조(46례)].재신경내과상규용약적기출상,분별급여1개월적음악치료화어언치료.치료전후용중문판서부실어증성투측시적부분지표평고량조환자적실어정황.결과 만성조화급성조재음악치료화어언치료전후자발언어、은리해、복술、명명화실어상분치적변화차이무통계학의의.만성조재음악치료화어언치료전후복술[32.00(15.00,53.75)분여48.50(24.50,72.00)분,Z=2.147,P=0.032;33.00(14.50,49.25)분여48.50(18.50,63.75)분,Z =2.018,P=0.038]、명명[20.00(8.50,34.75)분여37.50(12.50,64.75)분,Z=2.298,P=0.022;19.50(7.00,31.25)분여34.50(15.00,52.75)분,Z=2.039,P=0.041]화실어상[24.50(10.50,37.50)분여43.00(18.00,64.75)분,Z=2.432,P=0.015;22.50(10.00,34.50)분여36.00(14.00,54.00)분,Z=2.027,P=0.043]분치차이유통계학의의,병차음악치료전후은리해[62.00(30.50,88.75)분여89.50(46.50,112.00)분,Z=1.998,P=0.046]분치차이유통계학의의.급성조재음악치료화어언치료전후복술[24.50(11.00,38.75)분여46.50(24.50,67.75)분,Z=2.038,P=0.043;26.50(9.50,36.25)분여42.50(19.00,64.25)분,Z=1.972,P=0.048]분치차이유통계학의의,병차음악치료전후자발언어[2.00 (1.00,3.75)분여8.00(4.00,12.75)분,Z=2.012,P=0.036]、은리해[51.00(17.50,73.75)분여85.00(48.00,101.00)분,Z=2.298,P=0.022]、명명[17.50(6.00,29.00)분여37.50(16.00,58.75)분,Z=2.161,P=0.031]화실어상[18.00 (7.50,31.25)분여42.50(20.50,63.75)분,Z=2.256,P=0.024]분치차이유통계학의의,이어언치료전후자발언어、은리해、명명화실어상분치차이균무통계학의의.결론 음악치료화어언치료량충치료방식재만성졸중후비류창성실어환자중균구유일정료효,음악치료재급성졸중후비류창성실어환자중동양구유료효.
    Objective Estimating the therapeutic effect of music therapy and speech language therapy on post-stroke patients with non-fluent aphasia.Methods Eighty-four post-stroke patients diagnosed with non-fluent aphasia who came from the First Affiliated Hospital of Medical College of Shihezi University were collected between June 2012 and May 2014,then they were randomly divided into music therapy group (n =42) and speech language therapy group (n =42;including chronic (n =46) and acute groups (n =38)) based on table of random numbers.On the basis of conventionally using neurological drugs,music therapy and speech language therapy were given to the patients for one month,respectively.And language function was assessed by partial items of Chinese Version-Western Aphasia Battery before and after therapy.Results No significant changes were found in spontaneous speech,comprehension,repetition,naming and aphasia quotient in chronic and acute group patients through the music therapy and speech language therapy.Significant improvements were revealed in repetition (32.00 (15.00,53.75) vs 48.50(24.50,72.00),Z =2.147,P =0.032;33.00(14.50,49.25) vs 48.50(18.50,63.75),Z =2.018,P=0.038),naming (20.00 (8.50,34.75) vs 37.5(12.50,64.75),Z =2.298,P =0.022;19.50 (7.00,31.25) vs 34.50 (15.00,52.75),Z =2.039,P =0.041) and aphasia quotient (24.50 (10.50,37.50) vs 43.00 (18.00,64.75),Z =2.432,P =0.015;22.50 (10.00,34.50) vs 36.00 (14.00,54.00),Z =2.027,P =0.043) through music therapy and speech language therapy in chronic group patients.Comprehension was significantly improved through music therapy in chronic group patients.Repetition (24.50 (11.00,38.75) vs 46.50 (24.50,67.75),Z =2.038,P =0.043;26.50 (9.50,36.25) vs 42.50(19.00,64.25),Z =1.972,P =0.048) was significantly improved through music therapy and speech language therapy in acute group patients.And spontaneous speech (2.00 (1.00,3.75) vs 8.00 (4.00,12.75),Z =2.012,P =0.036),comprehension (51.00 (17.50,73.75) vs 85.00 (48.00,101.00),Z =2.298,P =0.022),naming (17.50(6.00,29.00) vs 37.50(16.00,58.75),Z =2.161,P =0.031) and aphasia quotient (18.00 (7.50,31.25) vs 42.50 (20.50,63.75),Z =2.256,P =0.024) were significantly improved through music therapy in acute group patients.However,no significant improvements were found in the speech language therapy group of acute patients.Conclusion The two therapies are effective in the chronic patients with non-fluent aphasia,and music therapy is also effective in acute patients with non-fluent aphasia.
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