郭华平,姚春雨,葛云龙,等.低频重复经颅磁刺激联合旋律音调疗法治疗脑卒中后早期失语症的疗效观察[J].中华物理医学与康复杂志,2025,47(11):973-977
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| 低频重复经颅磁刺激联合旋律音调疗法治疗脑卒中后早期失语症的疗效观察 |
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| DOI：10.3760/cma.j.cn421666-20250512-00409 |
| 中文关键词: 重复经颅磁刺激 旋律音调疗法 失语症 |
| 英文关键词: Transcranial magnetic stimulation Melodic intonation therapy Aphasia |
| 基金项目:河北省医学科学研究课题计划资助（20240836) |
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| 中文摘要: |
| 目的 探讨低频重复经颅磁刺激（rTMS)联合旋律音调疗法（MIT)治疗脑卒中后早期失语症患者的临床疗效。 方法 采用随机数字表法将60例脑卒后早期失语症患者分为对照组（20例）、MIT组（20例）及观察组（20例）。对照组给予常规康复干预，MIT组在此基础上辅以MIT治疗，观察组则在常规康复干预基础上辅以低频rTMS及MIT治疗，rTMS刺激靶点为右侧大脑半球额下回（IFG）及颞上回后部(pSTG)，刺激频率为1 Hz。于治疗前、治疗4周后分别采用中文版西方失语症成套检验(WAB)、日常生活交流能力量表（CADL）对3组患者语言功能及交流能力进行评定。 结果 治疗4周后发现MIT组及观察组WAB量表自发言语、理解、复述、命名评分、失语商(AQ)及CADL评分均较治疗前明显提高，并且观察组上述指标评分亦显著优于MIT组及对照组水平(P＜0.05)，同时MIT组上述指标评分亦显著优于对照组水平(P＜0.05)。 结论 健侧低频rTMS联合MIT治疗可有效改善脑卒中后早期失语症患者的言语功能，减轻失语严重程度，并有效提升患者的交流能力，该联合疗法值得临床推广、应用。 |
| 英文摘要: |
| Objective To observe the effect of combining low-frequency transcranial magnetic stimulation (rTMS) with melodic intonation therapy (MIT) in the treatment of aphasia soon after a stroke. Methods Sixty survivors of a recent stroke with aphasia were randomly divided into a control group, an MIT group and an observation group, each of 20. All received conventional rehabilitation therapy, but for 4 weeks the MIT group was additionally given MIT while the observation group received MIT plus 1Hz rTMS applied over the right inferior frontal gyrus and the posterior superior temporal gyrus. The intensity was 80% of the resting motor threshold. Before and after the treatment, language function and communication ability were evaluated using the Chinese version of the Western Aphasia Battery (WAB) and Communicative Activities of Daily Living (CADL) scale. Results Significant improvements in the WAB and CADL scores and aphasia quotient (AQ) were observed in both the MIT group and the observation group after the treatment compared to their pre-treatment levels, but the observation group demonstrated significantly higher scores than the other two groups on all three assessments. The MIT group′s average scores were superior to those of the control group. Conclusions Applying rTMS and MIT in combination significantly improves the speech and the daily communication abilities of aphasics early post-stroke, reducing the severity of their aphasia. The therapy exhibits considerable promise for clinical implementation. |
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