镜像疗法结合常规言语训练治疗急性脑梗死后运动性失语的疗效观察

关键词：镜像疗法  急性脑梗死  运动性失语  言语训练  言语功能

Keywords:mirror therapy  acute cerebral infarction  expressive aphasia  speech training  speech function

摘要：

      摘要 目的：观察镜像疗法结合常规言语训练治疗急性脑梗死后运动性失语的临床疗效。 方法：纳入脑梗死后运动性失语患者60例，随机分成治疗组和对照组，其中治疗组在常规言语治疗加用镜像治疗，对照组给予常规言语治疗，评估两组治疗前、病程第3周及病程第12周失语商（AQ）、美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表（mRS）。以3个月AQ提高≥30分分界为言语功能明显改善，改良mRS 0—2分为神经功能预后良好。 结果：经过2周治疗，校正基线影响后治疗组在病程第3周及病程第12周失语商、自发言语、听理解、复述、命名、NIHSS及mRS改善优于对照组（?P<0.05）；治疗组的言语功能明显改善率(70.0%)较对照组(33.3%)更为显著（P=0.006）。治疗组功能预后良好率（mRS 0—2）（86.7%）优于对照组（48.1%）（P=0.005）。校正混杂因素后，干预方式与言语功能明显改善独立相关（P＜0.05）。 结论：镜像疗法结合常规言语训练有助于急性脑梗死后运动性失语患者言语和神经功能的康复，同时促进患者3个月言语功能的明显改善及神经功能预后良好。

Abstract:

      Abstract Objective：To observe the effects of using mirror therapy and conventional speech training in the rehabilitation of expressive aphasia after acute cerebral infarction. Method：Sixty patients with expressive aphasia after cerebral infarction were divided into observation group and control group randomly.Treatment group received conventional speech therapy plus mirror therapy， and patients in the control group were given conventional speech therapy. The aphasia quotient (AQ) in the western aphasia test，National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (mRS) were assessed prior to and the 3th week of the disease， and the 12th week of the disease.AQ increased by ≥30 points in three months was regarded as a significant improvement of speech function， 0—2 scores of improved mRS were considered to have a good prognosis for neurological function. Result：After 2 weeks of treatment， the improvement of aphasia， spontaneous speech， listening comprehension， retelling， naming， NIHSS and mRS in the treatment group was better than that in the control group after adjusting for baseline effects(?P<0.05).The significant improvement rate of speech function was better in the treatment group (70.0%)than in the control group(33.3%)(P=0.006).The functional prognosis rate (mRS 0—2) (86.7%) was better in the treatment group than in the control group (48.1%)(P=0.005). After adjusting for confounding factors， intervention factor was independently correlated with aphasia function significant improvement(P<0.05). Conclusion：Mirror therapy combined with conventional speech therapy can facilitate speech and neurological function rehabilitation after acute cerebral infarction in patients with expressive aphasia，and can also promote the significant improvement of speech function and the good prognosis of neurological in 3 months.