针刺联合隔姜灸对周围性面瘫SFGS评分及血清GDNF水平影响

Effect of Acupuncture plus Ginger-partitioned Moxibustion on SFGS score and serum GDNF levels in peripheral facial paralysis

目的观察针刺联合隔姜灸治疗周围性面瘫的临床疗效及对Sunnybrook面瘫分级系统(SFGS)评分及血清胶质细胞源性神经营养因子(GDNF)水平的影响。方法选取周围性面瘫患者129例,采用随机数字表法分为对照1组、对照2组与治疗组,每组43例。对照1组采用针刺治疗,对照2组采用隔姜灸治疗,治疗组采用针刺联合隔姜灸治疗。于治疗前、治疗后分别采用SFGS评分对3组面神经功能进行评定,检测血清GDNF和神经生长因子(NGF)水平。比较3组临床疗效和不良反应发生情况。结果治疗组总有效率高于对照1组和对照2组(P<0.05)。治疗后,3组SFGS中静态对称性评分均较治疗前降低(P<0.05),且治疗组低于对照1组和对照2组(P<0.05);3组SFGS中动态对称性评分及血清GDNF、NGF水平均较治疗前升高(P<0.05),且治疗组均高于对照1组和对照2组(P<0.05)。3组治疗期间均未见不良事件发生。结论针刺联合隔姜灸治疗周围性面瘫可有效上调患者血清GDNF、NGF水平,改善面瘫症状及面神经功能,疗效优于单纯针刺和单纯隔姜灸。

Objective To observe the effect of acupuncture plus ginger-partitioned moxibustion on the clinical efficacy, the Sunnybrook facial grading system(SFGS) score and serum glial cell-derived neurotrophic factor(GDNF)levels in peripheral facial paralysis. Method One hundred and twenty-nine patients with peripheral facial paralysis were allocated, using a random number table, to a control 1 group, a control 2 group and a treatment group, with 43 cases in each group. Control 1 group received acupuncture;control 2 group received ginger-partitioned moxibustion;the treatment group, acupuncture plus ginger moxibustion. Facial nerve function was assessed using the SFGS score and serum GDNF and nerve growth factor(NGF) levels were measured in the three groups before and after treatment.The clinical efficacies and adverse reactions were compared between the three groups. Result The total efficacy rate was higher in the treatment group than in control 1 and control 2 groups(P<0.05). After treatment, the SFGS static symmetry score decreased in the three groups compared with before(P<0.05) and was lower in the treatment group than in control 1 and control 2 groups(P<0.05);the SFGS dynamic symmetry score and serum GDNF and NGF levels increased in the three groups compared with before(P<0.05) and were higher in the treatment group than in control 1 and control 2 groups(P<0.05). No adverse reactions occurred in the three groups during treatment. Conclusion Acupuncture plus ginger-partitioned moxibustion can effectively up-regulate serum GDNF and NGF levels, relieve the symptoms of facial paralysis and improve facial nerve function in treating patients with peripheral facial paralysis. Its therapeutic effect is better than that of acupuncture or ginger-partitioned moxibustion alone.