针刺配合中频分期治疗贝尔面瘫疗效观察及对表面肌电信号的影响

Curative Effect Observation on Acupuncture Combined with Intermediate Frequency Therapy by Stages for Bell Palsy and its Effect on Surface Electromyography

目的:观察针刺配合中频分期治疗贝尔面瘫的临床疗效及对表面肌电信号的影响。方法:将60例贝尔面瘫患者随机分为治疗组与对照组各30例;2组患者在急性期内(发病1周内)均采用单纯针刺治疗;恢复期(1周后)对照组配合电针仪治疗;治疗组在对照组基础上加用中频治疗;2组均以7天为1疗程,共治4疗程。观察比较2组临床疗效,并于治疗前后比较2组House-Brackmann(H-B)面神经功能评价系统分级情况及表面肌电信号(_sEMG)变化情况。结果:总有效率治疗组为93.3%,对照组为80.0%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组H-B面神经功能分级均较治疗前改善,经秩和检验,差异有统计学意义(P<0.05);组间比较,差异无统计学意义(P>0.05)。治疗后2组额肌群、颊肌群、轮匝肌群_sEMG疗效均较治疗前改善,经秩和检验,差异有统计学意义(P<0.05);组间比较,差异无统计学意义(P>0.05)。治疗后2组患健侧额肌群、颊肌群、口轮匝肌群均方根值(RMS)比值均较治疗前明显升高,差异有统计学意义(P<0.05);组间比较,治疗组上述指标改善优于对照组(P<0.05)。结论:应用针刺配合中频疗法分期治疗贝尔面瘫,对患者面神经功能的恢复效果确切,可改善患者额肌群、颊肌群、轮匝肌群s EMG,提高临床疗效。

Objective： To observe the clinical effect of acupuncture combined with intermediate frequency therapy by stages for bell palsy and its effect on surface electromyography（s EMG）. Methods：Divided 60 cases of patients with bell palsy into the treatment group and the control group randomly, 30 cases in each group. In acute stage（i.e. onset within 1 week）, patients in the two groups were treated with simple acupuncture. In recovery stage（i.e. after one week）, the control group was added with electroacupuncture,while the treatment group was additionally treated with intermediate frequency therapy based on the treatment of the control group. The two groups received treatment for four courses, seven days being one course. Observed and compared the clinical effect in the two groups, and compared the changes in the grading conditions of House-Brackmann（H-B） facial nerve function evaluation system and s EMG in the two groups before and after treatment. Results：The total effective rate was 93.3% in the treatment group and was 80.0%in the control group, the difference being significant（P〈0.05）. After treatment, the grading condition of facial nerve function in the two groups was improved when compared with that before treatment respectively, the difference being significant（P〈0.05）. No significant difference was found in the comparison of the grading conditions between the two groups（P〉0.05）. After treatment, the s EMG evaluation of frontal muscles,buccinator muscles and orbicularis oris muscles were improved when compared with those before treatment respectively, the difference being significant（P〈0.05）. No significant difference was found in the comparison of the above s EMG evaluation between the two groups（P〉0.05）. After treatment, the RMS ratio of the frontal muscles, buccinator muscles and orbicularis oris muscles of the affected side in the two groups was significantly increased when compared with that before treatment respectively,the difference being significant（P〈0.05）. In the comparison of the two groups,the improvement of the above indexes in the treatment group was better than that in the control group（P〈0.05）. Conclusion： The therapy of acupuncture combined with intermediate frequency therapy by stages for bell palsy has a clear effect on the recovery of facial nerve function in patients,which can improve the s EMG of frontal muscles, buccinator muscles and orbicularis oris muscles of patients, and enhance the clinical curative effect.