针药结合治疗面神经炎早期多项主客观指标与痊愈时间相关性探讨

Exploration of correlation between multiple subjective and objective evaluation indicators in early stage with recovery time in combination of acupuncture and medication for treating facial neuritis

目的分析针药结合分期治疗面神经炎患者早期多项评估指标与痊愈时间(治疗至痊愈所需时间)的相关性,优选出能早期预测面神经炎痊愈时间的主客观指标。方法针药结合分期治疗所有患者,研究对象为来自该院针灸科门诊的64例面神经炎患者,对其发病第7天时面神经瘫痪分级、表面肌电图相关数据、自拟症状评分量表评分、Sunnybrook面神经评定系统(SFGS)评分、面部残疾指数躯体功能(FDIP)评分、面部残疾指数社会生活功能(FDIS)评分与患者痊愈时间进行相关性分析。结果痊愈时间与发病第7天的面神经瘫痪分级、FDIS评分呈正相关(P<0.01),与自拟症状评分量表评分、FDIP评分、SFGS评分、面神经颊支及颞支混合肌肉动作电位(CMAP)振幅患健侧比值呈负相关(P<0.01或P<0.05);痊愈时间与面神经颧支CMAP振幅患健侧比值,面神经颞支、颊支、颧支CMAP潜伏期患健侧比值,F波出波率无明显相关性(P>0.05)。结论在针药结合治疗面神经炎患者的早期主观指标中面神经瘫痪分级、自拟症状评分量表评分、FDIP、FDIS评分及客观指标中表面肌电图面神经颊支、颞支CMAP振幅患健侧比值可用来预判痊愈时间,能更好地指导治疗及与患者更有效精准沟通。

Objective To analyze the correlation between the multiple evaluation indicators in the early stage and the cure time(needed time from treatment to cure)of the patients with facial neuritis treated by acupuncture combined with medication,and to optimize the subjective and objective indicators enable predicting the cure time of facial neuritis in early stage.Methods All patients were treated by acupuncture and medication combination.The research subjects were 64 patients with facial neuritis from the outpatient of cupuncture and moxibustion department of this hospital.The correlation between the grade of facial nerve paralysis,surface electromyography related data,scores of self-made symptom scoring scale,Sunnybrook Facial Grading System(SFGS)score,Facial Disability Index-Physical(FDIP)score,Facial Disability Index-Social(FDIS)score on 7 d of onset with the cure time was analyzed.Results The cure time was positively correlated with the grade of facial nerve paralysis and FDIS score on 7 d of onset(P<0.01),amd negatively correlated with the scores of self-made symptom scoring scale,FDIP score,SFGS score and the affected side to healthy ratio of CMAP amplitude of buccal temporal branch of facial nerve(P<0.01 or P<0.05);the cure time had no significant correlation with the ratio of affected side and healthy side of CMAP amplitude in zygomatic branch of facial nerve,the ratio of affected side and healthy side of CMAP latent period of temporal branch,buccal branch and zygomatic branch of facial nerve and F wave output rate(P>0.05).Conclusion In the early stage subjective indicators of the acupuncture combined with medication for treating facial neuritis,grade of facial nerve paralysis,self-made symptom scoring scale,scores of self-made symptom scoring scale,FDIP and FDIS scores and the ratio of affected side to healthy side of CMAP amplitude of the buccal branch,temporal branch of the facial nerve in sEMG in the objective indicators could be used to predict the cure time,better guide the treatment and have more effective and accurate comunication with the patients.