杨玲 郭耀光 李德华

摘要 目的：探討言語训练配合“颞三针”治疗中风后构音障碍疗效观察。方法：选取2015年6月至2017年成都中医药大学附属医院收治的中风后构音障碍患者120例，按随机数字法分为3组，各40例。联合组采用言语训练配合“颞三针”；颞三针组采用“颞三针”；言语训练组采用言语训练。观察比较3组治疗后言语功能、Frenchay构音评定、临床疗效、生命质量及不良反应情况。结果：治疗后，联合组患者言语功能均较颞三针组、言语训练组显著改善，差异有统计学意义（Hc=11.763，P=0.002）；治疗后联合组Frenchay构音障碍程度明显较颞三针组、言语训练组减轻，差异有统计学意义（Hc=11.635，P=0.002）；治疗后，联合组显效率为47.50%优于颞三针组、言语训练组（20.00%，22.50%），差异有统计学意义（χ2=6.76，χ2=5.49，P<0.05）；联合组治疗临床总有效率为95.00%优于颞三针组、言语训练组（65.00%，62.50%），差异有统计学意义（χ2=11.25，χ2=12.62，P<0.01）；治疗后，3组患者在生理领域、心理领域、环境领域和社会关系等的评分均较治疗前升高，且联合组四个领域评分升高的幅度较颞三针组、言语训练组大，差异有统计学意义（P<0.001）。结论：言语训练配合“颞三针”治疗中风后构音障碍患者有助于促进患者构音障碍的恢复，提高患者生命质量。

关键词 言语训练；颞三针；中风；构音障碍；临床疗效；生命质量

Abstract Objective：To investigate the efficacy of speech training combined with “Niesanzhen” in dysarthria after stroke. Methods：From June 2015 to 2017， 120 cases of stroke patients with dysarthria were divided into two groups according to the random number method， each of which was divided into three groups （n=40）. The joint group was provided with speech training and “Niesanzhen”，“Niesanzhen” group “Niesanzhen” and speech training group speech training. Speech function， Frenchay sound evaluation， clinical efficacy， quality of life and adverse reactions of the three groups after treatment were observed and compared. Results：After the treatment， the patients in the joint group had greater improvement in were speech function than the others， and the difference was statistically significant （Hc=11.763，P=0.002）； combined treatment group had less Frenchay dysarthria， and the difference was statistically significant （Hc=11.635，P=0.002）； after the treatment. The efficiency rate of the joint group was 47.50%， better than that of the temporal group and the speech training group （20%， 22.50%）， and the difference was statistically significant （χ2=6.76， χ2=5.49， P<0.05）； the clinical total effective rate of the joint group was 95%， higher than that of the temporal group and the speech training group （65%， 62.50%）， and the difference was statistically significant （χ2=11.25， χ2=12.62， P<0.01）； after treatment， three groups of patients had better score in the fields of physical and psychological， environmental and social relations， and the combined group had largest improvement， and the difference was statistically significant （P<0.001）. Conclusion：Speech training combined with “Niesanzhen” helps stroke patients with dysarthria recovery， improves the quality of life of patients.

Key Words Speech training； Niesanzhen； Stroke； Articulation disorder； Clinical efficacy； Quality of life

中图分类号：R255.2；R246.8文献标识码：Adoi：10.3969/j.issn.1673-7202.2017.06.053

构音障碍是指因发音器官神经肌肉的器质性病变诱发发音器官肌肉无力、肌张力异常以及不协调运动导致患者出现发声、发音、共鸣及韵律等言语运动控制障碍[1]，是中风后出现的一种主要后遗症症状。因患者发音模糊不清，有较重鼻音，语调语速异常，严重影响患者的日常交流，从而影响患者的生命质量。言语训练、发音肌电刺激治疗、手法治疗及针刺治疗等方式是目前构音障碍的主要治疗手段。本院选用言语训练联合颞三针针刺治疗中风后构音障碍患者，取得理想的疗效，现将结果报道如下。

1 资料与方法

1.1 一般资料 选取2015年6月至2017年我院康复科收治的中风后构音障碍患者120例，所有入选患者经头颅CT或MRI检查确诊为脑卒中患者。……