孙氏滞提法配合常规针刺治疗顽固性周围性面瘫眼睑闭合不全的临床观察

Clinical Study on Sun's Method of Stagnating Lifting in Treating Intractable Peripheral Facial Paralysis with Insufficiency of Eyelid Closure

目的观察孙氏滞提法治疗顽固性周围性面瘫眼睑闭合不全的临床疗效。方法70例顽固性周围性面瘫伴眼睑闭合不全的患者按照随机数字表法分为常规组与滞提组各35例。常规组给予常规针刺治疗,穴取阳白、四白、攒竹、颧髎等,滞提组在常规组基础上配合孙氏滞提法治疗。两组均治疗4周。比较两组治疗后的临床疗效,观察两组面部瘫痪指数[躯体功能指数(FDIP)、社会功能指数(FDIS)评分]、House-Brackmann面神经功能分级(H-B)评分、上下眼睑距离及面神经颧支电生理(波幅、潜伏期)变化。结果滞提组总有效率为91.43%,明显高于常规组的80.00%(P<0.05);治疗后,两组FDIS、H-B评分、上下眼睑距离、面神经颧支传导潜伏期均降低(P<0.05),且滞提组明显低于常规组(P<0.05);治疗后,两组FDIP评分、面神经颧支传导波幅均明显增加(P<0.05),且滞提组显著高于常规组(P<0.05)。结论孙氏滞提法能有效改善顽固性周围性面瘫眼睑闭合不全患者临床症状,提高面神经传导功能,促进面肌功能恢复,疗效显著。

Objective:To observe the clinical effect of Sun's stagnating lfting method in the treatment of intrac-table peripheral facial paralysis with eyelid insufficiency.Methods:A total of 70 patients with intractable periph-eral facial paralysis with eyelid insufficiency were randomly divided into a routine group and a zhi-ti group,35 cases in each group.The routine group was given routine acupuncture,and the selected points included Yangbai(GB14),Sibai(ST02),cuanzhu(BL2),quanliao(SI18),etc.On the basis of the routine group,the stagnation lifting group was treated with Sun's stagnation lifting method.Both groups were treated for 8 weeks.The Facial Disability Index scale[Somatic function(FDIP),Social function(FDIS)],House-Brackmann grading system(H-BGS)score,upper and lower eyelid distance,and electromyographic changes were observed before and after treatment in the two groups,and the difference in clinical efficacy between the two groups after treatment was compared.Result:The total effective rate was 91.43%in the stagnation lifting group,which was significantly higher than 80.00%in routine group(P<0.05);after treatment,the FDIS,H-B scores,upper and lower eyelid distance,and zygomatic branch conduction latency of facial nerve decreased in both groups(P<0.05),and the stagnation lifting group was lower than those of the routine group(P<0.05);after treatment,the FDI score and zygomatic branch conduction amplitude of the facial nerve increased significantly in both groups(P<0.05),and the stagnation lifting group was significantly higher than those of the routine group(P<0.05).Conclusion:Sun's stagnating lifing method can effectively improve the clinical symptoms,improve the facial nerve conduction function,and promote the recovery of facial muscles function in patients with intractable facial paralysis with eyelid insufficiency,and has significant efficacy.