三线针法联合祛风愈瘫丸治疗周围性面瘫的临床研究

Clinical Effect of Sanxian Facial Acupuncture Combined with Qufengyutan Pills on Peripheral Facial Paralysis

目的:观察三线针法联合口服祛风愈瘫丸与单纯三线针法治疗周围性面瘫的临床疗效。方法:选取2020年8月至2021年8月海南省三亚市中医院针灸科收治诊断为周围性面瘫的患者70例作为研究对象,采用简单随机化法将患者随机分为对照组和观察组,每组35例。对照组采用单纯三线针法治疗,观察组采用三线针法联合口服祛风愈瘫丸治疗。1周为1个疗程,连续治疗4个疗程;分别观察2组患者的治疗效果、治疗前后的House-Brackmann(H-B)分级、Sunnybrook(S-B)评分、复合肌肉动作电位(CMAP)潜伏期和波幅变化、面部残疾指数(FDI)评分的身体功能指数(FDIp)和社会功能指数(FDIs)比较及血清内皮素(ET)、血清一氧化氮(NO)水平变化。结果:观察组的疗效优于对照组疗效(P<0.05)。治疗后2组患者H-B(P<0.05)、S-B(P<0.001)及FDIp(P<0.001)评分较治疗前提高,且观察组患者显著高于对照组,FDIs评分较治疗前降低,且观察组显著低于对照组(P<0.05);治疗后2组患者CMAP潜伏期均较治疗前明显缩短、波幅明显延长,且观察组较对照组比较潜伏期明显缩短(P<0.01)、波幅明显延长(P<0.001)。治疗后2组患者血清ET水平显著低于治疗,血清NO水平明显高于治疗前,(P<0.001);且观察组血清ET水平明显低于对照,血清NO水平显著高于对照组,(P<0.001)。结论:三线针法联合祛风愈瘫丸对周围性面瘫疗效显著,可以显著改善患者的面神经功能、肌电图指标及血清ET、NO水平,有临床推广应用价值。

Objective:To compare the clinical effects of Sanxian facial acupuncture combined with and without Qufengyutan Pills on peripheral facial paralysis.Methods:Seventy patients with peripheral facial paralysis treated in the Department of Acupuncture and Moxibustion,Sanya Hospital of Traditional Chinese Medicine from August 2020 to August 2021 were randomized into an observation group and a control group,with 35 patients in each group.The control group was treated with Sanxian facial acupuncture alone,and the observation group was treated with Sanxian facial acupuncture combined with Qufengyutan Pills.Each treatment course lasted for 1 week,and both groups were treated for 4 consecutive courses.The therapeutic efficacy was compared between the two groups.The House-Brackmann(H-B)grade,Sunnybrook(S-B)score,facial disability index physical(FDIp)and social(FDIs)scores,compound muscle action potential(CMAP)and serum levels of endothelin(ET)and nitric oxide(NO)were determined before and after treatment.Results:The therapeutic effect in the observation group was higher than that in the control group(P<0.05).The treatment in both groups increased the H-B grade(P<0.05),S-B score(P<0.001),and FDIp score(P<0.001)and decreased the FDIs score,and the changes were higher in the observation group than in the control group(P<0.05).The treatment shortened the incubation period and extended the amplitude of CMAP,and the observation group had shorter incubation period(P<0.01)and higher amplitude(P<0.001)than the control group after treatment.In addition,the treatment lowered the ET level and elevated the NO level(P<0.001),and the observation group had lower ET level and higher NO level than the control group after treatment(P<0.001).Conclusion:Sanxian facial acupuncture combined with Qufengyutan Pills cloud regulate the facial neural function,electromyographic indicators,and serum levels of ET and NO in the patients with peripheral facial paralysis.