Treatment of peripheral facial paralysis with acupuncture at Rényíng (人迎 ST 9) combined with stellate ganglion block:a randomized controlled trial

针刺人迎穴为主配合星状神经节阻滞术治疗周围性面瘫:随机对照研究(英文)

Objective To explore the best therapeutic method in the treatment of peripheral facial paralysis. Methods One hundred and twenty cases were randomized into a conventional acupuncture group [Yangbai （阳白 GB 24）, Sibai （四白 ST 2）, Yingxiang （迎香 LI 20）, etc.], a Renying （人迎ST 9） acupuncture group and an operation ＋ acupuncture group [acupuncture at ST 9 as the main acupoint and the stellate ganglion block （SGB）], 40 cases in each one. The treatment was given once a day, 7 treatments made one session. After 3 sessions of treatment, the latency and the amplitude of the direct stimulation evoked potential of the facial nerve （ENoG） were compared before and after treatment in three groups, as well as R2 and R2 values of blink reflex （BR）. The total clinical efficacy was assessed. Results The latency of ENoG was shortened and the amplitude was increased significantly in three groups. After treatment, ENoG latency was lower significantly in the operation ＋ acupuncture group as compared with that in the conventional acupuncture group （P〈0.05）. In the Renying （人迎 ST 9） acupuncture group, the amplitude of ENoG was increased as compared with P〈0.05）. After treatment in three groups, those in the other two groups （all R2 and R2 values were decreased significantly. The differences in R1 and R2 values in the Renying （人迎 ST 9） acupuncture group and the operation ＋ acupuncture group before and after treatment were bigger than those in the conventional acupuncture group （all P〈0.05）, and the difference in R2 value in the operation ＋ acupuncture group was bigger than that in the Renying （人迎 ST 9） acupuncture group （P〈O.05）. The clinical markedly effective and curative rate was 87.5% （35/40） in the operation ＋ acupuncture group, which was superior to 77.5% （32/40） in the Renying （）人迎 ST 9）acupuncture group and higher significantly than 65.0% （26/40） in the conventional acupuncture group （P〈0.05）. Conclusion Compared with the conventional acupuncture, the efficacy on peripheral facial paralysis is much better in the Renying （人迎 ST 9） acupuncture group and the operation ＋ acupuncture group. Moreover, the early reflex function of the damaged facial nerve is much better recovered in the operation ＋ acupuncture group as compared with that in the Renying （人迎 ST 9） acupuncture group.

目的:探寻治疗周围性面瘫的较佳疗法。方法:120例患者随机分为常规针刺组(穴取阳白、四白、迎香为主)、人迎针刺组(人迎穴为主)以及术针组(人迎穴为主针刺配合星状神经节阻滞术),每组40例。每天治疗1次,7次为一疗程,3个疗程后,比较3组治疗前后的面神经直接刺激诱发电位(ENoG)潜伏期和波幅,以及瞬目反射(BR)的R1值、R2值,并评定临床总疗效。结果:3组治疗均能显著缩短ENoG潜伏期,且诱发电位波幅显著升高;治疗后术针组ENoG潜伏期较常规针刺组显著降低(P<0.05),人迎针刺组诱发电位波幅较其他两组升高(均P<0.05);各组治疗后R1、R2值显著缩短,人迎针刺组和术针组治疗前后R1差值、R2差值均显著大于常规针刺组(均P<0.05),且术针组R1差值显著大于人迎针刺组(P<0.05);术针组临床愈显率为87.5%(35/40),优于人迎针刺组的77.5%(31/40),且显著高于常规针刺组的65.0%(26/40,P<0.05)。结论:与常规针刺比较,人迎针刺组和术针组治疗周围性面瘫疗效更优,且术针组较人迎针刺组能更好地恢复受损面神经的早发反射功能。