| Objective: Objective to investigate the effect of scalp acupuncture combined with transcranial direct current stimulation(tDCS)and comparison of scalp acupuncture and transcranial direct current stimulation on the clinical efficacy and language function recovery of patients with motor aphasia after ischemic stroke,so as to provide more effective and optimized scheme for patients and provide basis for clinical promotion.Methods:80 patients with motor aphasia after ischemic stroke who met the inclusion criteria were randomly divided into four groups,20 cases in each group,according to the principle of random allocation.74 patients were treated with ordinary acupuncture+scalp acupuncture+tDCS therapy(18 cases),ordinary acupuncture+tDCS therapy(18 cases),ordinary acupuncture+scalp acupuncture therapy(19 cases),and ordinary acupuncture therapy(19 cases),The basic treatment plan of the four groups was the same.The course of treatment was once a day,6 times a week,with an interval of 1 day for 4 weeks.The scores of Chinese Rehabilitation Research Center aphasia examination(CRRCAE)and Chinese functional communication profile(CFCP)were collected as observation indexes at baseline(before treatment),at the end of 2 weeks and at the end of 4 weeks,the improvement of speech function was evaluated.Results:1.Comparison within CRRCAE group: in terms of listening comprehension,speaking,reading,writing(copying,description,dictation),and calculation,the score of the four groups,namely,general acupuncture+scalp acupuncture+tDCS group,general acupun-cture+tDCS group,general acupuncture+scalp acupuncture group and general acupuncture group increased with the treatment time,and the score of the group as a whole showed an upward trend.In terms of repetition and voice reading,the scores of the four groups showed an overall upward trend with the increase of treatment time.The improvement degree of the ordinary acupuncture group was not obvious after 2 weeks of treatment,but the improvement effect was significant after 4 weeks of treatment and between 2 weeks of treatment and 4 weeks of treatment.Comparison between CRRCAE groups: curative effect comparison:(1)The scores of listening comprehension,retelling,speaking,voice reading and calculation of CRRCAE in the general acupuncture+scalp acupuncture+tDCS group were better than those in the other three groups,and the scores of voice reading and reading in the general acupuncture group were better than those in the general acupuncture group.(2)The scores of CRRCAE listening comprehension,retelling,speaking and calculation in the conventional acupuncture+tDCS group were better than those in the ordinary acupuncture group.Under the combined effect of scalp acupuncture and tDCS,the therapeutic effect of TDCS was higher than that of scalp acupuncture in the scores of listening comprehension,retelling,speaking,reading and calculation of CRRCAE.(3)The general acupuncture plus scalp acupuncture group was superior to the general acupuncture group in the scores of CRRCAE listening comprehension,retelling,speaking and calculation.(4)There was no difference in writing improvement among the four groups.Comparison of improvement degree: after 2 weeks of treatment,(1)The improvement degree of general acupuncture+scalp acupuncture+tDCS group was better than that of ordinary acupuncture group except writing items;In terms of calculation,the improvement degree of general acupuncture+scalp acupuncture+tDCS group was better than that of general acupuncture+scalp acupuncture group and general acupuncture+tDCS group.(2)The general acupuncture+tDCS group was better than the ordinary acupuncture group in the improvement of speech.(3)The degree of improvement in speech of the general acupuncture+scalp acupuncture group was better than that of the ordinary acupuncture group.(4)There was no difference in writing improvement among the four groups.After 4 weeks of treatment,(1)The improvement degree of general acupuncture+scalp acupuncture+tDCS group was better than that of ordinary acupuncture group except writing items;The improvement degree of listening comprehension and calculation was better than that of conventional acupuncture+tDCS group;The improvement in listening comprehension,retelling,speaking and calculation was better than that in the conventional acupuncture +scalp acupuncture group.(2)The improvement of listening comprehension and retelling in the general acupuncture+tDCS group was better than that in the ordinary acupuncture group.(3)There was no difference in the improvement of CRRCAE scores between the general acupuncture+scalp acupuncture group and the ordinary acupuncture group.(4)There was no difference in writing improvement among the four groups.2.Comparison within the CFCP group: with the increase of treatment time,the scores of the four groups showed an upward trend.Comparison between CFCP groups: curative effect comparison: the general acupuncture+scalp acupuncture+tDCS group was better than the other three groups,the general acupuncture+tDCS group was better than the ordinary acupuncture group,there was no difference between the general acupuncture+tDCS group and the general acupuncture+scalp acupuncture group,and there was no difference between the general acupuncture+scalp acupuncture group and the ordinary acupuncture group.Under the combined action of scalp acupuncture and tDCS,the therapeutic effect of TDCS was higher than that of scalp acupuncture.Comparison of improvement degree: after 2 weeks of treatment,the improvement degree of CFCP in the general acupuncture+scalp acupuncture+tDCS group was better than that in the general acupuncture+scalp acupuncture group and the ordinary acupuncture group,and the improvement degree in the general acupuncture+tDCS group,the general acupuncture+scalp acupuncture group and the ordinary acupuncture group was similar.After 4 weeks of treatment,the improvement of CFCP in the general acupuncture+scalp acupuncture+tDCS group was better than that in the other three groups.The improvement of CFCP in the general acupuncture+tDCS group,the general acupuncture+scalp acupuncture group and the ordinary acupuncture group was similar.3.Comprehensive efficacy: the total effective rate was 83.33% in the general acupuncture+scalp acupuncture+tDCS group,50% in the general acupuncture+tDCS group,42.11% in the general acupuncture +scalp acupuncture group and 31.58% in the ordinary acupuncture group.There was significant difference in the overall clinical efficacy between the general acupuncture+scalp acupuncture+tDCS group and the general acupuncture+scalp acupuncture group(P<0.05,P<0.01).The overall clinical efficacy of general acupuncture+scalp acupuncture+tDCS group was better than that of general acupuncture+scalp acupuncture group and common acupuncture group.Conclusion:1.After treatment,the speech function of the four groups were improved in varying degrees.2.On the whole,for CRRCAE and CFCP scores,the longer the treatment time is,the more obvious the combined effect of scalp acupuncture and tDCS is.The combined effect of scalp acupuncture and tDCS has a sustained effect.Scalp acupuncture combined with tDCS has the best effect on improving speech function.3.Under the combined action of scalp acupuncture and tDCS,the therapeutic effect of TDCS is higher than that of scalp acupuncture in the listening comprehension,retelling,speaking,reading,calculation and CFCP score of CRRCAE.4.The combination of scalp acupuncture and tDCS is safe and effective,and it is worth popularizing. |
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