Department of Neurology, the Clinical Medicine School of Yangtze University, the First Affiliated Hospital of Yangtze University, Jingzhou 424023, Hubei Province, China; Department of Research and Training, Mirembe National Mental Health Hospital, P. O. Box 910, Dodoma, Tanzania.
Department of Neurology, the Clinical Medicine School of Yangtze University, the First Affiliated Hospital of Yangtze University, Jingzhou 424023, Hubei Province, China.
J Integr Med. 2022 May;20(3):244-251. doi: 10.1016/j.joim.2022.03.002. Epub 2022 Mar 12.
Emerging evidence shows the effectiveness of speech and language therapy (SLT); however, precise therapeutic parameters remain unclear. Evidence for the use of adjunctive transcranial direct current stimulation (tDCS) to treat post-stroke aphasia (PSA) is promising; however, the utility of combining tDCS and electroacupuncture (EA) has not yet been analyzed. This study assessed the therapeutic consequences of EA and tDCS coupled with SLT in subacute PSA patients who were also undergoing hyperbaric oxygen therapy (HBOT).
A retrospective analysis was conducted on subacute (< 6 months) PSA patients who were divided into three groups: patients who received EA plus tDCS (acupuncture group), patients who underwent tDCS (tDCS group), and patients who experienced conventional therapy (HBOT + SLT). All subjects underwent 21 days of treatment and also received conventional treatment. The aphasia battery of Chinese (ABC) was used to score pre- and post-intervention status.
The analysis comprised 238 patients. Cerebral infarction was the most frequent stroke type (137 [57.6%]), while motor (66 [27.7%]) and global aphasia (60 [25.2%]) were the most common types of aphasia. After 21 days of intervention, the ABC scores of all patients were improved. The acupuncture group had the highest ABC scores, but only repetition, naming, and spontaneous speech were statistically improved (P < 0.01). Post-hoc tests revealed significant improvement in word retrieval in the acupuncture and tDCS groups (P < 0.01, P = 0.037), while the acupuncture group had additional significant improvement in spontaneous conversation (P < 0.01).
Combining acupuncture and tDCS as an adjuvant therapy for subacute PSA led to significant spontaneous speech and word retrieval improvements. Future prospective, multi-ethnic, multi-center trials are warranted.
新出现的证据表明言语和语言治疗（SLT）是有效的；然而，确切的治疗参数仍不清楚。辅助经颅直流电刺激（tDCS）治疗中风后失语症（PSA）的证据很有前景；然而，尚未分析联合 tDCS 和电针（EA）的效用。本研究评估了在接受高压氧治疗（HBOT）的亚急性 PSA 患者中，将 EA 和 tDCS 与 SLT 联合治疗的治疗效果。
对亚急性（<6 个月）PSA 患者进行回顾性分析，将患者分为三组：接受 EA 加 tDCS（针刺组）、接受 tDCS（tDCS 组）和接受常规治疗（HBOT+SLT）的患者。所有患者均接受 21 天的治疗，并接受常规治疗。使用汉语失语症成套测验（ABC）对治疗前后的情况进行评分。
分析共纳入 238 例患者。脑梗死是最常见的中风类型（137 例[57.6%]），运动性（66 例[27.7%]）和完全性失语症（60 例[25.2%]）是最常见的失语症类型。干预 21 天后，所有患者的 ABC 评分均有所提高。针刺组的 ABC 评分最高，但只有重复、命名和自发言语有统计学意义的提高（P<0.01）。事后检验显示，针刺组和 tDCS 组在词语检索方面有显著改善（P<0.01，P=0.037），而针刺组在自发会话方面有进一步的显著改善（P<0.01）。
将针刺和 tDCS 联合作为亚急性 PSA 的辅助治疗方法可显著改善自发言语和词语检索能力。需要进行未来的前瞻性、多民族、多中心试验。
