Clinical Research On Plum-blossom Needle And Scalp Acupuncture Combined With Language Rehabilitation Training For Treatment Of Ischemic Aphasia From Apoplexy

Objective: Cerebrovascular disease, ischemic and hemorrhagic, with the characteristics of high morbidity, high mortality, and high recurrence, has risen to second place in the current death in China, according to the latest information. Ischemic cerebrovascular disease (mainly cerebral infarction) is an ischemic brain tissue damage caused by arterial insufficiency. The extent of brain dysfunction varies greatly due to different causes, pathogenesis, brain lesion sizes and different compensatory ability of collateral circulation, resulting in a variety of clinical manifestations of the syndrome, which belongs to "apoplexy" category in Chinese medicine, with syndromes of deficiency in origin and excess in superficiality, the former caused by deficiency of liver-yin and kidney-yin, deficiency of qi and blood, the latter by wind, fire, phlegm and stasis, both reinforcing each other, converting into each other. Aphasis caused by the disease, coma, hemiplegia, deviation of the eye and mouth, dysphagia, are known as the five main symptoms of apoplexy. It is reported that about 1/3 of patients with apoplexy have varying degrees of speech disturbance. Aphasia as the main form of speech disturbance is well known to Chinese and foreign physicians for being far more refractory in clinical practice. Whereas the normal verbal communication is one of the important healthy living conditions, and the loss of it will give great burden to the patient, their family and the society. Western medicine has studied aphasia for a long time, and classification varies.This research is to assess the language function in patients, in accordance with"Chinese Aphasia Test Battery"by Beijing Medical University, with two different approaches to treatment of ischemic aphasia from apoplexy (needling mid-line, anterior and posterior oblique line of vertex-temporal, with plum-blossom needle combined with language training, and simple language training), to explore the significance of the acupuncture methods in treating the disease, and to seeking a better way than the simple language training.Methods: According to the diagnostic criteria in"Points of Various Types of Cerebral Vascular Disease Diagnosis"revised at the 4th National Cerebrovascular Disease Academic Council by Chinese Medical Association in 1995,"Aphasia Battery of Chinese"by Beijing Medical University was used to evaluate the speech function of patients with Benson classification, namely: Broca aphasia, Wernicke aphasia, conduction aphasia, transcortical motor aphasia, transcortical sensory aphasia, transcortial mixed aphasia, complete aphasia, anomic aphasia, subcorticalaphasia syndrome, among which complete aphasia is commonly seen in clinical practice, accounting for about 17% of aphasia, but such patients were excluded since they have lost all or most of the speech function, cannot communicate with the outside world, and cannot fully carry our language training; and so did the patients with subcortical aphasia since it is rarely seen in clinic. In this research, 60 cases of ischemic apoplectic aphasia, aged 30– 70 and attacked within 6 months, were randomly divided into treatment group of acupuncture and tapping with language training and control group of the simple language training. Treatment group selected points on mid-line, anterior and posterior oblique line of vertex-temporal; Schuell Stimulation was used to give specific language training to patients, including oral pronunciation trainings, lip and voice training, oral expression training and practical communicative skill training with emphasis on training of expressing and understanding, usually in a special rehabilitation room away from distractions. Severe patients were taken training at the bedside. Motor aphasia attached importance to expressing and text-based reading; sensory aphasia to listening comprehension and repeating; conduction aphasia to reading and understanding; anomic aphasia began with learning to name and read aloud at the same time. Before and after treatment, the patients were evaluated on language function with"Aphasia Battery of Chinese"(ABC ).Results: After treatment, four language features of spontaneous conversation, understanding, restating and naming, including the amount of information, fluency, repeating, word naming, color naming, reaction naming, auditory discrimination, verbal instruction, all the above in treatment group were significantly improved compared to control group (p<0.05). There were significant differences between all the sub-item scores before and after treatment (p<0.05). Treatment group was superior to control group.Conclusion: 1. both methods were declared valid in treating ischemic apoplectic aphasia. 2. Acupuncture with language training is more effective than simple language training in treatment. 3. the combination of scalp acupuncture, plum-blossom needle, and language training is a positive and effective treatment for ischemic apoplectic aphasia, which can improve the patient's communicative skill and aphasia degree, with important clinical significance in treating ischemic apoplectic aphasia.