ACUPUNCTURE COMBINED WITH LANGUAGE TRANING FOR TREATMENT OF MOTOR APHASIA CAUSED BY ISCHEMIC APPLEXY

With aging of people in the society and the tendency of the onset of erebrovascular disease(CVD)becoming earlier in age，the incidence of CVDis increasing year after year．In addition to sensory and motor dysfunction of extremities，speech disorder is one of the complications of CVDfrequently encountered．Domestic evidence has shown that 25 of the patients suffering fromCVDare complicated with speech disorder，including aphasia，dysarthria，apraxia of speech，among which motor aphasia is mostly encounteredone．Since it directly affects their communication with other people，which brings severe suffering and influences their life quality，it is of great significance to treataphasia withefficiency．The authors have treated motor aphasia induced by cerebral infarction by using acupuncture combined with language training and achieved good therapeutic effects．The seq ue1ae of apoplexy，suchasdrooping ofthe angle of the mouth，numbness andstiffnessof the tongue body，and ambiguous speaking are mostly related to the Heart，Liver，Spleenand Kidney Meridians．The heart stores mind，and it is in charge of blood and vessels，and it has its specific body openmg in the tongue．I．arge llaterals of the Heart Meridian ascend and connect with the tongue body'tor which the tongue is the key positi0n where circulation of qi and blood is regulated．The liver stores blood，and It is in charge of dominating tendons．Along the posterior part of the throat，the Liver Meridian converges with the Governor Meridian in the ertex．Insufficient storage of blood in the Liver will result In improper nourishment of tendons，leading to malfunction of the tongue．The spleen has its specific body openmg in the m0uth，and the Spleen Meridian connocts with the root of the tongue，and it is distributed sublingual 1v．As the external appearance of the spleen，the tongue body is closely related to transporting and trans-forming function of the spleen．The kidney stores essence and is in charge of water metabolism．Along thethroat，the Kidney Meridian reaches the root of the tongue．Insufficient kidney-yin will result in rigidity of the tongue and difficulty in its stretching out due to insufficient nourishment of the tongue root．Acupuncture at the tongue body not only can stimulate the meridians connecting with the tongue to dredge meridians，regulate qi and blood，and induce resuscitation，but also is beneficial to nourish the tongue body to strengthen functional activities of the tongue．The tongue body is innervated by nerve endings of the hypoglossal nerve，and stimulating peripheral nerves can also boost up the excitability of the central nervous systemand promote nervous reflex to make equilibrium(balance)between the specific conduction system and nonspecific conduction systemby way of regulating the circuit of cerebralcortex-thalamus ‘cerebral cortex．so as to reestablish the nervous circular loop for speech activities and accelerate functional rehabilitation．Clinical investigation has shown that stimulating the tongue body can remarkably increase blood perfusion in the brain tissue in the affected focus，minify the size of affected area，activate functional activities of neurons to improve linguistic function．Studies have shown that acupuncture directly applied at the tongue body can improve the inhibitory state of speech function of the cerebral cortex to link up circuits and reestablish conditioned reflex，adj ust degenerative cells in the linguistic center and promote functional making up and compensation in the unaffected areas，so as to improve speechfunction to obtain the effect on numbness and rigidity of the tongue and speech disorder．Alarge number of clinical observations have shown that language rehabilitation training is obviously effecrive on motor aphasia caused by cerebral infarction，and the earlier the treatment is given，the better the efficacy will be．Recent studies have emonstrated that the feature and type of sensory stimulation are related to growth of neurons and their functional development．Therefore，following stabilization of pathogenic tuation，early hearing and speaking training can accelerate compensative function to facilitate restoration of inj ured higher central functions due to brain lesion．At the same time，movement training of the muscles responsible to pronunciation can prevent muscular atrophy of the tongue，throat and laryngeal，and it is also beneficial to speaking rehabilitation in the patients with some muscular atrophy．Because oflack of normal dynamic muscular feedback monitoring in patients with motor aphasia，causing failure of voluntary dominating movement of the lips and tongue to make a sound，visual and hearing feedback produced by watching mouthshape and listening to fl sound can be compensative for re—learning control of muscular movement for making correct sound．In a word，language rehabilitation training can obviously promote restoration of speech function in patients with motor aphasia due to cerebral infarction．Event related potentials(ERPs)is an electrical physiological index for obj eetively reflecting high—grade mental activities，and its components，such as N2 and P3，are closely related to recognition and processing of certain stimulation message in the brain．As an important index for assisted diagnosis and for evaluating therapeutic effects and prognosis of functional recognition lesions in mental and neuropathic diseases，Pso0 has provided an obj ective，non—invasive，quantitative and valuable electrophysiological measure，which has become a reliable supplement to the past behavioral indices mostly depending on described phenomena ．In the present study，P300 was detected before and after treatment，and the results showed that,the lateneies of N2 and P3 waves in P300 were significantly shortened and the amplitude of P3 was significantly elevated in the treatment group