祛风活络汤联合针灸对腮腺术后面神经麻痹临床疗效研究

Clinical Study of Qufeng Huoluo Decoction Combined with Acupuncture on Facial Paralysis After Parotidectomy

目的研究祛风活络汤联合针灸对腮腺术后面神经麻痹临床疗效的影响。方法选取2017年2月—2019年2月接受治疗的腮腺术后面神经麻痹患者96例,采用随机数字表法分为联合组和针疗组各48例,针疗组接受针灸治疗,联合组在此基础上予以祛风活络汤治疗,观察比较两组患者临床疗效、中医证候积分、神经功能缺损改良Portmann简易评分、HouseBrackmann(H-B)分级、社会功能评分(FDIS)、躯体功能评分(FDIP)、运动传导诱发电位的潜伏期与波幅。结果治疗后,联合组总有效率(89.58%)明显高于针疗组(70.83%)(P<0.05);治疗前,两组中医证候积分、Portmann简易评分、H-B分级、波幅、潜伏期、FDIS及FDIP值比较差异无统计学意义(P>0.05);治疗后,两组中医证候积分与治疗前比较显著下降(P<0.05),针疗组中医证候积分明显高于联合组(P<0.05),两组Portmann简易评分与治疗前比较显著增大(P<0.05),联合组Portmann简易评分明显高于针疗组(P<0.05),两组患者H-B分级比较差异有统计学意义(P<0.05),两组波幅与治疗前比较显著增大,潜伏期与治疗前比较显著减小(P<0.05),联合组波幅明显大于针疗组,潜伏期明显小于针疗组(P<0.05),两组FDIS、FDIP值与治疗前比较显著增大(P<0.05),联合组FDIS、FDIP值明显大于针疗组(P<0.05)。结论祛风活络汤联合针灸对腮腺术后神经麻痹疗效显著,能有效改善患者面神经功能缺损,缓解神经功能障碍,提高患者躯体及社会功能,值得推广应用。

Objective To investigate the effect of Qufeng Huoluo Decoction combined with acupuncture on facial paralysis after parotidectomy. Methods 96 patients with facial paralysis after parotidectomy in our hospital from February 2017 to February 2019 were selected and randomly divided into two groups,each with 48 cases. The acupuncture group was treated with acupuncture,based on this,the combined group was treated with Qufeng Huoluo Decoction. Clinical efficacy,TCM syndrome score,modified Portmann score,House-Brackmann(H-B)facial grading system,Facial Disability Index-Social(FDIS),Facial Disability Index-Physical(FDIP),latency and amplitude of motor evoked potential were observed and compared between the two groups. Results After treatment,the total effective rate of the combined group was significantly higher than that of the acupuncture group(89.58% vs 70.83%,P<0.05);TCM syndrome scores,Portmann score,H-B grades,amplitude,latency,FDIS and FDIP had no difference between groups before treatment(P>0.05). After treatment,TCM syndrome scores were decreased in both groups(P<0.05),and were lower in the combined group than in the acupuncture group(P<0.05). Portmann score,FDIS and FDIP were increased in both groups after treatment(P<0.05),and were higher in the combined group than in the acupuncture group(P<0.05). The H-B grades after treatment had significant difference between groups(P<0.05). After treatment,the amplitude was increased in both groups(P<0.05),the latency was decreased in both groups(P<0.05),and the combined group had longer amplitude and shorter latency than those of acupuncture group(P<0.05). Conclusion Qufeng Huoluo Decoction combined with acupuncture can effectively ameliorate the facial nerve dysfunction,alleviate neurological dysfunction,improve patients’ physical and social functions for patients after parotidectomy,which is worthy of promotion.