标题：解语汤联合神经肌肉电刺激治疗缺血性脑卒中后运动性失语的疗效研究

      作者：刘爱珍 1，陈常周 1，方爱娟 2    1.濮阳市濮阳县中医医院综合病区，河南 濮阳 457100；2.濮阳市中医医院脑病科，河南 濮阳 457003

      卷次： 2024年35卷9期

      【摘要】 目的 观察解语汤联合神经肌肉电刺激治疗缺血性脑卒中后运动性失语的疗效，并探讨其作用机制。方法 选择2021年1月至2023年2月濮阳县中医医院收治的80例缺血性脑卒中后运动性失语症患者作为研究对象，按随机数表法分为观察组和对照组各40例。对照组患者在常规治疗基础上行神经肌肉电刺激，观察组患者对照组治疗的基础上联合解语汤内服，两组均连续治疗20 d。比较两组患者的治疗效果，治疗前后语言功能[采用汉语标失语成套检测(ABC)]、神经功能[采用美国国立卫生研究院卒中量表(NIHSS)]、脑血流动力学指标[(基底动脉平均血流速度(MFV)、阻力指数(RI)及搏动指数(PI)]、血清指标[(降钙素基因相关肽(CGRP)、内皮素-1 (ET-1)及神经胶质纤维酸性蛋白(GFAP)]，同时比较两组患者的不良反应发生情况。结果 观察组患者的治疗总有效率为92.50%，明显高于对照组的75.00%，差异有统计学意义(P<0.05)；治疗后，观察组患者的ABC得分为(70.82±16.07)分，明显高于对照组的(63.31±14.91)分，NIHSS得分为(6.53±1.14)分，明显低于对照组的(8.11±1.37)分，差异均有统计学意义(P<0.05)；治疗后，观察组患者的MFV及 PI分别为(49.79±6.88) cm/s、1.47±0.40，明显高于对照组的(44.21±6.13) cm/s、1.28±0.37，RI为1.27±0.16，低于对照组的1.41±0.22，差异均有统计学意义(P<0.05)；治疗后，观察组患者的平均CGRP为(133.41±32.03) ng/L，明显高于对照组的(118.27±29.18) ng/L，ET-1、GFAP分别为(62.29±9.83) ng/L、(3.73±1.16) ng/L，明显低于对照组的(77.31±10.16) ng/L、(4.48±1.20) ng/L，差异均具有统计学意义(P<0.05)；两组患者治疗前后的血、尿、便三大常规及肝肾功能指标均未出现明显异常，治疗期间均未发现明显的药物不良反应。结论 解语汤联合神经肌肉电刺激可提高缺血性脑卒中后运动性失语患者疗效，改善患者语言功能及神经功能，其机制可能与改善脑血流动力学指标及血清指标有关。
      【关键词】 缺血性脑卒中；运动性失语；解语汤；神经肌肉电刺激；疗效
      【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1003—6350（2024）09—1233—05

Efficacy of Jieyu soup combined with neuromuscular electrical stimulation on motor aphasia after ischaemicstroke and its mechanism analysis.
LIU Ai-zhen 1, CHEN Chang-zhou 1, FANG Ai-juan 2. 1. Integrated Ward, PuyangCounty Hospital of Traditional Chinese Medicine, Puyang 457100, Henan, CHINA; 2. Department of Encephalopathy,Puyang Hospital of Traditional Chinese Medicine, Puyang 457003, Henan, CHINA
【Abstract】 Objective To observe the therapeutic efficacy of Jieyu soup combined with neuromuscularelectrical stimulation in the treatment of motor aphasia after ischaemic stroke and to explore its mechanism of action.Methods Eighty patients with motor aphasia after ischaemic stroke admitted to Puyang County Hospital of TraditionalChinese Medicine from January 2021 to February 2023 were selected and divided into two groups (40 cases each) by ran-dom number table method. The patients in the control group were treated with neuromuscular electrical stimulation onthe basis of conventional treatment, and the patients in the observation group were treated on the basis of the controlgroup plus the combination of Jieyu soup for internal use, both continuously for 20 d. The treatment effect, languagefunction [Aphasia Battery of Chinese (ABC) score], neurological function [National Institutes of Health Stroke Scale(NIHSS) score], cerebral haemodynamic indexes [basilar artery mean flow velocity (MFV), resistance index (RI), andpulsatility index (PI)], and serum indexes [calcitonin gene-related peptide (CGRP), endothelin-1 (ET-1), and neuroglialfibrillary acidic protein (GFAP)] before and after the treatment were compared between the two groups. The incidence ofadverse events was also compared between the two groups. Results The total effective rate of treatment of patients inthe observation group was 92.50%, which was significantly higher than 75.00% in the control group (P<0.05). After treat-ment, the ABC score of the observation group was (70.82±16.07) points, significantly higher than (63.31±14.91) points ofthe control group; the NIHSS score was (6.53±1.14) points, significantly lower than (8.11±1.37) points of the controlgroup; the differences were statistically significant (P<0.05). After treatment, the MFV and PI of the observation groupwere (49.79±6.88) cm/s, 1.47±0.40, significantly higher than (44.21±6.13) cm/s, 1.28±0.37 of the control group; theRI was 1.27±0.16, significantly lower than 1.41±0.22 of the control group; the differences were statistically significant(P<0.05). After treatment, the mean CGRP of the observation group was (133.41±32.03) ng/L, significantly higherthan (118.27±29.18) ng/L of the control group; the ET-1 and GFAP of the observation group were (62.29±9.83) ng/L,(3.73±1.16) ng/L, significantly lower than (77.31±10.16) ng/L, (4.48±1.20) ng/L of the control group; the differenceswere statistically significant (P<0.05). There were no obvious abnormalities in blood, urine, stool routine and liver andkidney function indexes before and after treatment between the two groups, and no obvious adverse drug reactions werefound in the two groups during the treatment period. Conclusion Jieyu soup combined with neuromuscular electricalstimulation can improve the efficacy of patients with motor aphasia after ischemic stroke, and improve the patients' lan-guage function and neurological function. Its mechanism may be related to the improvement of cerebral hemodynamicindexes and serum indexes such as CGRP, ET-1, and GFAP.
      【Key words】 Ischaemic stroke; Motor aphasia; Jieyu soup; Neuromuscular electrical stimulation; Efficacy