针刺结合肌肉能量技术治疗周围性面瘫的临床研究

Clinical Study on Acupuncture Combined with Muscle Energy Technique for Treatment of Peripheral Facial Paralysis

【目的】观察针刺结合肌肉能量技术治疗周围性面瘫的临床疗效及其对表面肌电图的影响。【方法】将60例周围性面瘫患者随机分为观察组和对照组,每组各30例。对照组给予西医常规疗法联合针刺治疗,观察组在对照组治疗的基础上,联合肌肉能量技术,每周连续治疗6 d,休息1 d,共治疗4周。治疗4周后,评价2组患者的临床疗效,观察2组患者治疗前及治疗2、4周后House-Brackmann(H-B)面神经功能评分、Portmann面瘫简易评分及表面肌电图的变化情况,并比较2组患者的痊愈时间。【结果】(1)观察组总有效率为96.67%(29/30),对照组为83.33%(25/30)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗2、4周后,2组患者的H-B面神经功能评分均明显改善(P<0.05),且观察组在改善H-B面神经功能评分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗2、4周后,2组患者的Portmann面瘫简易评分均明显改善(P<0.05),且观察组在改善Portmann面瘫简易评分方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗2、4周后,2组患者的面肌表面肌电均方根值(包括额肌、眼轮匝肌、口轮匝肌、颧小肌、颧大肌)均明显改善(P<0.05),且观察组在改善面肌表面肌电均方根值方面明显优于对照组,差异有统计学意义(P<0.05)。(5)观察组痊愈时间为(20.98±3.76)d,对照组为(24.36±4.37)d。观察组痊愈时间明显少于对照组,差异有统计学意义(P<0.05)。【结论】针刺结合肌肉能量技术治疗周围性面瘫,可明显改善患者面神经功能,提高疗效,缩短疗程。

Objective To observe the clinical effect of acupuncture combined with muscle energy technology for the treatment of peripheral facial paralysis and its effect on surface electromyogram.Methods Sixty patients with peripheral facial paralysis were randomly divided into observation group and control group,30 cases in each group.Both groups received conventional western medical therapies combined with acupuncture treatment,additionally,the observation group received muscle energy technology for 6 continuous days every week,one day off,the treatment lasting 4 weeks.After 4 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in House-Brackmann(H-B)facial nerve function grading score,Portmann facial paralysis simple scale score and surface electromyography parameters in the two groups were compared before and after treatment for 2,4 weeks,and the recovery time for the two groups of patients were compared.Results(1)The total effective rate was 96.67%(29/30)in the observation group,and was 83.33%(25/30)in the control group.The curative efficacy of the observation group was superior to that of the control group(P<0.05).(2)After 2,4 weeks of treatment,the H-B facial nerve grading score in the two groups was improved(P<0.05),and the improvement in H-B facial nerve grading score in the observation group was superior to that of the control group(P<0.05).(3)After 2,4 weeks of treatment,the Portmann facial paralysis simple score in the two groups was improved(P<0.05),and the improvement in Portmann facial paralysis simple score in the observation group was superior to that of the control group(P<0.05).(4)After 2,4 weeks of treatment,the surface electromyography root-meansquare value(RMS)of musculus facialis(including frontalis,orbicularis oculi,orbicularis oculi,zygomaticus,zygomaticus)in the two groups was improved(P<0.05),and the improvement in surface electromyogram rootmean-square value in the observation group was superior to that of the control group(P<0.05).(5)The recovery time was(20.98±3.76)days in the observation group,and was(24.36±4.37)days in the control group.The recovery time for the observation group was superior to that of the control group(P<0.05).Conclusion Acupuncture combined with muscle energy technology for peripheral facial paralysis is effective for significantly improving the patient’s facial nerve function,promoting clinical efficacy,and shortening the course of treatment.