| 摘要: |
| ［摘要］ 目的 分析重复经颅磁刺激（rTMS）联合常规语音康复训练治疗脑卒中后构音障碍患者的疗效。方法 招募2022年6月至2024年3月上海交通大学医学院附属瑞金医院收治的126例脑卒中后构音障碍患者。采用随机数字表法将患者分为观察组和对照组，每组63例。对照组给予常规语音康复训练，观察组给予rTMS联合常规语音康复训练，连续治疗4周。比较两组总有效率及治疗前后构音功能、声学指标、日常生活能力变化情况，记录治疗期间不良反应发生情况。结果 观察组总有效率显著高于对照组（P<0.05）。治疗后，两组改良版Frenchay构音障碍评定表中反射、呼吸、唇运动、舌运动、颌运动、软腭运动、喉控制、言语理解等维度评分及总分高于治疗前，且观察组高于对照组，差异有统计学意义（P<0.05）。治疗后，两组声音响度、构音清晰度、改良Barthel指数量表评分高于治疗前，且观察组高于对照组，最长声时长于治疗前，且观察组长于对照组，差异均有统计学意义（P<0.05）。治疗期间，两组均未发生不良反应。结论 rTMS联合常规语音康复训练治疗脑卒中后构音障碍患者疗效显著，可有效改善构音障碍，延长最长声时，提高声音响度、构音清晰度及日常生活能力。 |
| 关键词: 脑卒中 构音障碍 重复经颅磁刺激 语音康复训练 声学指标 日常生活能力 |
| DOI：10.3969/j.issn.1674-3806.2025.07.18 |
| 分类号:R 743 |
| 基金项目:上海市黄浦区科研项目（编号：HLM202220） |
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| Analysis on therapeutic effect of repetitive transcranial magnetic stimulation combined with conventional speech rehabilitation training on post-stroke dysarthria patients |
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FANG Chenjun1, WANG Zhenni2, ZHANG Weiming1, XIAO Zihao2, GAO Yi2, SHEN Qin2, ZHAO Na2
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1.Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2.Department of Rehabilitation Therapy, Shanghai Ruijin Rehabilitation Hospital, Shanghai 200023, China
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| Abstract: |
| ［Abstract］ Objective To analyze the therapeutic effect of repetitive transcranial magnetic stimulation(rTMS) combined with conventional speech rehabilitation training on post-stroke dysarthria patients. Methods A total of 126 patients with post-stroke dysarthria who were admitted to Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from June 2022 to March 2024 were recruited. The patients were divided into observation group and control group by using random number table method, with 63 patients in each group. The control group was given conventional speech rehabilitation training, while the observation group was given rTMS combined with conventional speech rehabilitation training. Both groups were treated continuously for 4 weeks.The total effective rates were compared between the two groups and the changes in articulating function, acoustic indicators and daily living ability were compared between the two groups before and after treatment. The occurrence of adverse reactions during the treatment period was recorded in both groups. Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05). After treatment, the scores of the dimensions of reflex, breathing, lip movement, tongue movement, jaw movement, soft palate movement, laryngeal control and speech comprehension, and the total scores in the modified Frenchay Dysarthria Assessment Scale in both groups were higher than those before treatment, and the scores in the observation group were higher than those in the control group after treatment, and the differences were statistically significant(P<0.05). After treatment, the voice loudness, clarity of articulations and modified Barthel Index scores in the two groups were higher than those before treatment, and these indicators in the observation group were higher than those in the control group after treatment, and the longest sound duration in the two groups was longer than that before treatment, and the longest sound duration in the observation group was longer than that in the control group after treatment, with statistically significant differences(P<0.05). During the treatment period, neither group experienced any adverse reactions. Conclusion The combination of rTMS and conventional speech rehabilitation training is significantly effective in treatment of patients with post-stroke dysarthria. The combined treatment can effectively improve dysarthria, prolong the longest sound duration, and improve voice loudness, clarity of articulations and daily living ability. |
| Key words: Stroke Dysarthria Repetitive transcranial magnetic stimulation(rTMS) Speech rehabilitation training Acoustic indicators Daily living ability |
