排刺胸锁乳突肌对周围性面瘫恢复期疗效的影响

Effect of row-like puncture at sternocleidomastoid on peripheral facial palsy at recovery stage

目的:观察常规针刺联合排刺胸锁乳突肌治疗周围性面瘫恢复期的临床疗效。方法:将60例周围性面瘫恢复期患者随机分为观察组和对照组,每组30例。对照组针刺患侧攒竹、阳白、四白、颧髎、颊车、地仓,合谷、太冲、足三里;观察组在对照组基础上排刺胸锁乳突肌(肌肉的起点、止点各刺1针,起止点的连线上排刺3~4针)。两组均每日治疗1次,5次为一疗程,疗程间隔2 d,共治疗4个疗程。观察两组患者治疗前后H-B面神经功能分级、面神经功能评分系统动态观评分、面部残疾指数(FDI)量表评分[包括躯体功能评分(FDIp)和社会功能评分(FDIs)],并比较两组的临床疗效。结果:治疗后,两组患者H-B面神经功能分级较治疗前改善(P<0.05),且观察组优于对照组。治疗后两组患者动态观评分、FDIp评分较治疗前增加(P<0.05),FDIs评分降低(P<0.05);与对照组比较,观察组动态观评分、FDIp评分增加(P<0.05),FDIs评分降低(P<0.05)。观察组总有效率为93.3%(28/30),高于对照组的73.3%(22/30,P<0.05)。结论:与常规针刺相比,联合排刺胸锁乳突肌治疗周围性面瘫恢复期能提高疗效。

Objective To observe the effect of conventional acupuncture combined with row-like puncture at sternocleidomastoid on peripheral facial palsy at recovery stage.Methods A total of 60 patients with peripheral facial palsy at recovery stage were randomized into an observation group and a control group,30 cases in each one.Acupuncture was applied at affected Cuanzhu(BL 2),Yangbai(GB 14),Sibai(ST 2),Quanliao(SI 18),Jiache(ST 6),Dicang(ST 4),Hegu(LI 4),Taichong(LR 3)and Zusanli(ST 36)in the control group.On the basis of the treatment in the control group,row-like puncture was applied at sternocleidomastoid(1 needle was punctured at muscle origin and insertion respectively,3 to 4 needles were row-like punctured at the connection line of muscle origin and insertion).The treatment was given once a day,5 times were as one course,with 2-day interval,totally 4 courses were required in the both groups.The house-brackmann(H-B)facial nerve function grade,facial nerve function rating system-dynamic view rating scale score and facial disability index(FDI)scale score[including scores of FDI physical function(FDIp)and FDI social life function(FDIs)]before and after treatment were observed,and the clinical efficacy was evaluated in the two groups.Results After treatment,the H-B facial nerve function grades were improved compared before treatment in the both groups(P<0.05),and that in the observation group was superior to the control group(P<0.05).After treatment,the scores of dynamic view rating scale and FDIp were increased(P<0.05),FDIs scores were decreased compared before treatment in the both groups(P<0.05);compared with the control group,the scores of dynamic view rating scale and FDIp were increased(P<0.05),FDIs score was decreased in the observation group(P<0.05).The total effective rate was 93.3%(28/30)in the observation group,which was superior to 73.3%(22/30)in the control group(P<0.05).Conclusion Compared with conventional acupuncture,combination therapy with row-like puncture at sternocleidomastoid can improve the therapeutic effect of peripheral facial palsy at recovery stage.