词联导航训练法与Schuell刺激疗法改善卒中后言语功能的对比研究

摘要 目的：比较词联导航训练法（WANT）和Schuell刺激疗法（SSM）对失语症患者言语功能改善的疗效。 方法：18例失语症患者随机分为WANT组（n=9）和SSM组（n=9）。从中文联想词汇库中选取122个词汇，WANT组由治疗师采用网络分析技术自动生成语义关联顺序的词汇进行训练。而SSM组由言语治疗师根据失语症类型和严重程度自主决定训练素材和刺激方法。两种方法训练疗程均为10d，每日2次。训练前后进行西方失语症成套测验（WAB）和日本标准失语症检查量表（SLTA）检查。 结果：WAB显示WANT组训练后自发言语项积分和AQ差值显著高于SSM组，WANT组训练后自发言语、听理解、复述、命名项积分显著高于训练前，SSM组训练前后各项积分无显著差异。SLTA显示WANT组命名项差值显著高于SSM组，WANT组训练后名词理解、口头指令、漫画说明、句子理解等项积分显著高于训练前，SSM组训练后读、写项积分显著高于训练前。 结论：WANT可以有效地改善失语症患者的自发言语、命名和计算能力。

A contrast research on word association navigation training with Schuell stimulus method in speech rehabilitation

Abstract Objective: To contrast the effects of word association navigation training (WANT) with Schuell stimulus method (SSM) on improvement of speech function. Method: Eighteen patients with aphasia were randomly divided into WANT group (n=9) and SSM group (n=9). A total of 122 words chosen from Chinese word association norms were used in WANT group by speech therapist. The presentation sequence of words was generated automatically with network analysis techniques. The select of training material and method were determined by speech therapist based on the aphasia types and severity of the subjects in SSM group. All the patients with aphasia received language training twice a day for ten consecutive days. The tests of western aphasia battery(WAB) and standard language test of aphasia(SLTA) before and after training were evaluated in all patients. Result: The sub-item of spontaneous speech and aphasia quotient (AQ) of WAB were significantly higher in WANT than in SSM. The AQ and all sub-items of spontaneous speech, comprehension, repeating and naming in WAB were significantly higher after training than before training in WANT. The differences after and before training in sub-items of naming and calculation of SLTA were significantly higher in WANT than in SSM. The sub-items of words and sentences comprehension, oral instruction and cartoon illustration in SLTA were significantly higher after training than before training in WANT. The sub-items of reading comprehension and writing in SLTA were significantly higher after training than before training in SSM. Conclusion: WANT may effectively improve spontaneous speech, naming and calculation in aphasia patients. Author's address Shangze Hospital, Suzhou, 215228