基于无创性功能磁共振量化分析口轮匝肌四针八穴透刺法治疗面神经麻痹的临床研究

Clinical Study of Non-invasive Functional Magnetic Resonance Quantitative Analysis of Orbicularis Oculi Muscle for Facial Paralysis

目的观察四针八穴透刺法法治疗面神经麻痹的临床疗效疗效。方法将60例面神经麻痹患者患者按就诊顺序随机分为观察组和对照组各30例。对照组34例传统针刺法。观察组四针八穴透刺法。连续治疗3个疗程。观测临床疗效、中医症状积分、面神经系统评分、影像学结果。结果治疗后,观察组总有效率高于对照组(P<0.05);治疗前,两组中医症状积分比较,差异无统计学意义(P>0.05),具有可比性,治疗后,两组中医症状积分均有降低,观察组低于对照组(P<0.05);治疗前,两组面神经系统评分比较,差异无统计学意义(P>0.05),具有可比性,治疗后,两组面神经系统评分均有降低,观察组低于对照组(P<0.05);治疗前,两组口轮匝肌影像学DTI比较,差异无统计学意义(P>0.05),具有可比性,治疗后,两组口轮匝肌影像学DTI均有降低,但组内、组间比较均无统计学意义(P>0.05);治疗前,两组口轮匝肌T2mapping值比较,差异无统计学意义(P>0.05),具有可比性,治疗后,两组口轮匝肌T2mapping值均有降低,但组内、组间比较均无统计学意义(P>0.05)。结论四针八穴透刺法治疗面神经炎疗效确切,可有效改善面神经麻痹症候,提高面神经功能,无创性功能磁共振(DTI和T2mapping)可显示出口轮匝肌在治疗前后改变。

Objective To verify the clinical efficacy of acupuncture for facial paralysis.Methods Sixty patients with facial paralysis were randomly divided into a treatment group(penetration acupuncture)and a control group(body acupuncture),30 patients in each group.The main symptoms of TCM(traditional Chinese medicine)and the Sunnybrook facial nerve assessment system scale were scoredbefore and after treatment.The non-invasive functional magnetic resonance was used to quantitatively analyze the changes of the orbicularis oculi muscle before and after treatment.Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The scores of TCM symptoms,such as facial paralysis,aversion to wind-cold,and thin white tongue,were significantly decreased after treatment than those before treatment(P<0.05),and the decrease was more obvious in the observation group than that in the control group(P<0.05).The Sunnybrook scores were significantly increased in both groups(P<0.05),and the increase in the observation group was more obvious than that in the control group(P<0.05).Non-invasive functional MRI(DTI and T2mapping)of the orbicularis oculi muscle after treatment in both groups was not superior to that before treatment or that of the control group.Conclusion Penetration acupuncture therapyfor patients with facial paralysis is effective and can effectively improve the symptoms and facial nerve function.The non-invasive functional MRI(DTI and T2mapping)of the orbicularis oculi muscle does not reflect changes in efficacy.