强制性诱导语言治疗联合低频重复经颅磁刺激对非流畅性失语的疗效

目的：观察强制性诱导语言治疗（CILT）联合低频重复经颅磁刺激（rTMS）对非流畅性失语的语言功能和交流能力的影响。方法：40例失语症患者随机分为4组各10例，分别采用常规治疗（常规组）、常规治疗＋CIL T （CILT组）、常规治疗＋1Hz rTMS（rTMS组）及常规治疗＋CILT＋1Hz rTMS（联合组）治疗10d ，治疗前后进行西方失语症成套测验（WAB）的自发言语、听理解、复述及命名前4项及日常生活交流活动检查（CADL ）评定语言功能和交流能力。结果：治疗10d后，联合组WAB各项功能评分及CADL评分均较治疗前、CILT 组及常规组明显提高（P＜0．05），联合组WAB评分自发言语、听理解和命名3项及CADL评分均较rTMS组明显提高（P＜0．05）， WAB评分复述项联合组与rTMS组组间比较差异无统计学意义；rTMS组WAB各项功能评分及CADL评分均较治疗前及常规组提高更明显（P＜0．05）；CILT组WAB评分自发言语、听理解和命名3项及CADL评分均较治疗前及常规组明显提高（P＜0．05）；常规组WAB评分仅自发言语较治疗前有提高（P＜0．05），CADL评分治疗前后比较差异无统计学意义。结论：强制性诱导疗法和低频重复性经颅磁刺激对非流畅型失语疗效优于常规治疗，两者联合运用疗效更优。

Effectiveness of constraint induced language therapy combined with low frequency repetitive transcranial magnetic stimulation for non-fluent aphasia

Objective：To observe the effects of constraint induced language therapy（CILT） combined with low fre-quency repetitive transcranial magnetic stimulation（rTMS） on language functions and communication skills of non-fluent aphasia patients .Methods：Forty patients were randomly assigned to four groups accepting conventional thera-py（conventional group） ,conventional therapy ＋ CILT （CILT group） ,conventional therapy ＋ 1 Hz rTMS （rTMS group） ,and conventional therapy＋CILT＋1 Hz rTMS（combined group） for 10 days ,respectively .Before and after therapy ,the language functions were evaluated with the first 4 items of Western Aphasia Battery （WAB） ,and the Communicative Abilities in Daily Living （CADL） test was adopted to assess the patients＆#39;communication skills .Re-sults：After treatment for 10 days ,WAB and CADL scores in combined group increased significantly（P〈 0 .05） , which is higher than that in pre-therapy ,CILT group and conventional group .More progress on WAB scores inclu-ding spontaneous speech ,listening comprehension and naming and CADL scores in combined group were observed comparing to rTMS group（P〈0 .05） .While ,no obviously statistical differences was found between combined group and rTMS group on WAB score of repetition .WAB scores and CADL scores obtained in rTMS group were increased more significantly than in conventional group .The progress was achieved only on WAB score in conventional group （P〈0 .05） .However ,no change was observed on CADL scores in conventional group .Conclusion：For non-fluent a-phasia ,CILT and low frequency rTMS were more effec-tive than conventional therapy ,and the combination of CILT and low frequency rTMS could obtain more satis-factory effectiveness .