针药结合治疗面神经炎的神经电生理变化

Change of Nerve Electrophysiological Examination in Facial Paralysis Pa-tients with Treatment by Acupuncture and Medicine.

目的探讨针灸结合西药治疗面神经炎的效果及其神经电生理变化。方法方便选取该院2012年11月—2014年2月门诊及住院的50例面神经炎患者,经针灸结合西药治疗前后的面神经各分支行运动神经传导(CMAP)及针电极肌电图(EMG)检测,记录指标包括患侧的潜伏期、波幅及自发电位、运动单位形态,并与健侧对比。结果 50例患者就诊时有35例面神经各分支CMAP潜伏期较健侧延长,50例患侧面神经各分支波幅均较健侧减低;经治疗后3个月复查各分支潜伏期均缩短,与健侧对比无差异,额支、颧支波幅均较就诊时升高,且与健侧差异无统计学意义,颊支波幅稍有升高,与健侧相比仍差异有统计学意义。结论针灸结合西药治疗面神经炎有肯定效果,神经电生理检测可以对面神经炎损伤及治疗效果进行定量分析,对预后有很好的指示作用。

Objective To investigate the effect of acupuncture combined with medicine in the treatment of facial paralysis and the change of nerve electrophysiological. Methods 50 patients with facial paralysis from outpatient and inpatient de-partment between November 2012 and February 2014 were included. Before and after treatment,Compound muscle action potentials （CMAP） and electromyography of each branch of facial nerve were detected.Record index include latency、ampli-tude and spontaneous activity、motor unit form of affected side,all compared with healthy side. Results Before treatment,the CMAP latency of each branch of facial nerve were delayed compare with healthy side in 35 of 50 patients; the CMAP am-plitude of each branch of facial nerve were reduced compared with healthy side in all 50 patients. 3 months After treatment, latency of each branch were shortened , amplitude of frontal branch and zygomatic branch of facial nerve were raised ,and there were no statistical difference compared with healthy side.The amplitude of buccal branch was little raised,and still has statistical difference compared with healthy side. Conclusion Acupuncture combined with medicine can significantly im-prove the symptoms of facial paralysis. Nerve electrophysiological examination can quantitiative analysis the degree of injury and treatment effect of facial paralysis,and can give a clear instruction for prognosis.