"开窍利咽"针刺联合六字诀训练治疗脑卒中后构音障碍:随机对照试验OA

Objective To observe the clinical effect of Kaiqiao Liyan(opening orifices and benefiting the throat)acupuncture therapy combined with six-character exercise in treatment of post-stroke dysarthria.Methods Seventy-five patients with post-stroke dysarthria were randomly divided into a comprehensive therapy group(25 cases,1 case dropped out),an acupuncture group(25 cases),and a six-character exercise group(25 cases,1 case was eliminated).The patients of the three groups received basic treatment and conventional rehabilitation training.In the acupuncture group,Kaiqiao Liyan acupuncture therapy was used at Baihui(GV20),Sishencong(EX-HN1),Lianquan(CV23),three-tongue points(Extra),Fengfu(GV16),Yamen(GV15),and bilateral Fengchi(GB20)and Yifeng(TE17).Acupuncture intervention was given once daily,20 min each time.In the six-character exercise group,the patients practiced the six-character exercise for 20 min each intervention,once daily.In the comprehensive therapy group,both acupuncture therapy and the six-character exercise were delivered.Once after consecutive 6 days of treatment,the intervention was discontinued for 1 day,and 2 weeks of intervention were required in each group.The patients'vocal function(loudness,maximum phonation time[MPT],and maximum counting ability[MCA]),speech intelligibility,and the score of the modified Frenchay dysarthria evaluation table(FDET)were evaluated before and after treatment.The clinical effect was assessed in each group.Results After treatment,all three groups showed the improvements in vocal function(loudness,MPT and MCA),speech intelligibility,and the scores of each item and the total scores of the modified FDET compared with those before treatment(P＜0.05).The comprehensive group demonstrated the improvements in loudness,speech intelligibility,the scores for respiration,soft palate and speech and the total score of the modified FDET when compared with the acupuncture group and the six-character exercise group,respectively(P＜0.05).In the comprehensive therapy group and the six-character exercise group,the MPT,MCA and scores for laryngeal function of the modified FDET were better than those of the acupuncture group(P＜0.05).The speech intelligibility in the acupuncture group was superior to the six-character exercise group(P＜0.05).The scores for the tongue function in the modified FDET in the comprehensive therapy group and the acupuncture group were higher when compared with the six-character exercise group(P＜0.05).The total effective rate in the comprehensive therapy group was 88%(22/25),higher than that of the six-character exercise group(60%,15/25)and the acupuncture group(64%,16/25,P＜0.05),respectively.Conclusion The combination of Kaiqiao Liyan acupuncture therapy and six-character exercise improves speech and vocal function in patients with post-stroke dysarthria.