言语训练联合美金刚治疗脑卒中后失语的有效性和安全性评价

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摘要目的：评价言语训练联合美金刚治疗脑卒中后失语（PSA）的有效性和安全性。方法：选取2015年1月至2018年6月在温州市中医院治疗的120例PSA的患者，其中对照组60例，观察组60例，2组均给予言语训练，观察组加用美金刚治疗。2组患者在治疗前和治疗后1、3个月分别进行简易精神状态检查（MMSE）及中国康复研究中心汉语标准失语检查（CRRCAE）的测评，并比较2组的评分结果，同时观察不良反应。结果：治疗后3个月，观察组MMSE评分较治疗前明显提高（P＜0.05）。治疗后1个月，组内比较，观察组、对照组听理解及复述的评分较治疗前均显著提高（P＜0.05）；组间比较，观察组与对照组CRRCAE各项评分差异均无统计学意义（P＞0.05）。治疗后3个月，组内比较，观察组、对照组CRRCAE各项评分均较治疗前显著提高（P＜0.05）；组间比较，观察组的名词听理解及句子听理解改善显著优于对照组（P＜0.05）。2组均未发现明显的不良反应。结论：言语训练可改善PSA患者的语言功能，联合应用美金刚疗效更佳，尤其在名词听理解、句子听理解方面，并有较高的安全性。

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关键词 ：脑卒中后失语, 美金刚, 言语训练, 简易精神状态检查

Abstract：Objective: To evaluate the efficacy and safety of speech training combined with memantine in the treatment of post-stroke aphasia (PSA). Methods: A total of 120 patients with PSA, including 60 cases in the control group, 60 cases in the observation group. Both groups were given speech training. The observation group was treated with memantine additionally. The patients in the two groups were evaluated by MMSE and CRRCAE before treatment and 1 and 3 months after treatment. The scores of the two groups were compared and the adverse reactions were observed at the same time. Results: After 3 months of treatment, the MMSE score in the observation group was significantly higher than before (P<0.05). After 1 month of treatment, the scores of listening comprehension and retelling in the observation group and the control group were significantly higher than those before treatment (P<0.05). There was no significant difference in the CRRCAE score between the observation group and the control group (P>0.05). After 3 months of treatment, the CRRCAE score in the observation group and the control group were significantly higher than those before treatment (P<0.05). The improvement of listening comprehension of nouns and sentences in the observation group was significantly better than that in the control group (P<0.05). No obvious adverse reactions were found in both groups. Conclusion: Speech training is effective in improving the language function of PSA patients, and maybe more effective when combined with memantine, especially in noun listening comprehension, sentence listening, and has a higher security.

Key words： post-stroke aphasia memantine speech training minimental state examination

收稿日期: 2018-07-10

基金资助:温州市科技计划项目（Y20160288）。

作者简介: 潘蓉蓉（1986-），女，浙江温州人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I11/842

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