蔡礼松　何松彬

[摘要] 目的 探討加味补阳还五汤联合康复训练治疗卒中后失语症患者的疗效。 方法 收集2013年9月～2015年9月卒中后失语患者92例，按照随机数字表法随机分为四组：联合治疗组、康复治疗组、中药治疗组及对照组，每组各23例。四组均给予神经内科常规用药，其中治疗组分别给予1个月的加味补阳还五汤和/或康复训练治疗：联合治疗组（加味补阳还五汤+康复训练）、康复治疗组（康复训练）、中药治疗组（加味补阳还五汤治疗）。治疗前后用西部失语症成套测试的部分指标评估四组患者的失语情况，并对各组治疗前后分值差进行比较。 结果 卒中后失语症在联合治疗组、康复治疗组、中药治疗组及对照组治疗前后听理解、复述、命名分值的变化有明显统计学意义，其中联合治疗组分值变化较其余三组更明显。进一步亚组分析表明，在出血性卒中与缺血性卒中患者中联合治疗组分值变化仍较其余三组高。 结论 加味补阳还五汤和康复训练两种治疗方式在卒中后失语患者中均具有一定疗效，二者结合较单纯康复训练或中药治疗更有效。

[关键词] 卒中；失语；加味补阳还五汤；康复治疗

[中图分类号] R743.3；R289.5 [文献标识码] B [文章编号] 1673-9701（2017）16-0121-04

[Abstract] Objective To evaluate the efficacy of modified Buyang Huanwu decoction combined with rehabilitation training in the treatment of poststroke aphasia patients. Methods A total of 92 patients with poststroke aphasia from September 2013 to September 2015 were collected and randomly divided into four groups including the combination therapy group， the rehabilitation group， the traditional Chinese medicine treatment group and the control group， with 23 cases in each group. All the four groups were given conventional neurological drugs， of which the treatment groups were given modified Buyang Huanwu decoction and/or rehabilitation training treatment for 1 month： The combination therapy group（modified Buyang Huanwu decoction+rehabilitation training），the rehabilitation group（rehabilitation training）， the traditional Chinese medicine treatment group（modified Buyang Huanwu decoction treatment）. Aphasia was assessed in four groups of patients before and after treatment with partial indicators of Western aphasia test.And the difference in the changes of scores before and after treatment was compared among the four groups. Results There were statistically significant differences in the changes of listening comprehension， repetition， naming scores before and after treatment among the combination therapy group， the rehabilitation group， the traditional Chinese medicine treatment group and the control group. And the change of the scores in the combination therapy was more obvious than that in the other three groups.Further subgroup analysis showed that the change of scores of the the combination therapy group was significantly higher than that of the other three groups in patients with hemorrhagic stroke and ischemic stroke. Conclusion Modified Buyang Huanwu decoction and rehabilitation training in the treatment of poststroke aphasia patients both have a certain effect， and the combination of the two treatments is more effective than the simple rehabilitation training or the traditional Chinese medicine treatment.

[Key words] Stroke； Aphasia； Modified Buyang Huanwu decoction； Rehabilitation treatment

失语是脑卒中患者的最常见并发症之一，系器质性病变致大脑语言区域及相关区域（语言中枢）受损所致语言障碍，在急性卒中患者中发病率约为30%～40%[1]，为影响患者生活质量主要因素。常伴发的焦虑、抑郁等不良情绪，不利于患者康复。……