扎跳针刺阳性筋结点靶向治疗顽固性面瘫的临床研究

Clinical Study on Targeted Treatment of Refractory Facial Paralysis with Zhatiao Needling Positive Sinew Nodes

目的:用扎跳针刺手法对顽固性面瘫阳性筋结点进行靶向治疗,并与常规针刺治疗相比较,验证扎跳针刺阳性筋结点是否为治疗本病的更优疗法。方法:依据随机等量原则,将64例病患分为治疗组与对照组,每组各32例,对照组采用常规的针刺手法,治疗组在对照组的基础上实施扎跳针刺阳性筋结点的手法。针刺治疗5次/周,每次留针时间持续30 min,5次作为1个疗程,共进行6个疗程。治疗前后,分别对两组患者进行H-B系统评级、Sunnybrook面神经评分、FDIS评分和面神经肌电图评价。结果:经治疗后,两组患者治疗后的H-B评级、Sunnybrook面神经评分、FDIS评分和面神经肌电图最大波幅变化均明显高于治疗前;治疗组临床疗效明显高于对照组,对照组总有效率71.88%(23/32),治疗组总有效率为93.75%(30/32),差异具有统计学意义(P<0.05)。此外,治疗组治疗后的H-B分级明显较对照组降低,Sunnybrook面神经评分、FDIS评分和面神经肌电图最大波幅变化较对照组有显著提高,两组比较差异具有统计学意义(P<0.05)。结论:扎跳针刺阳性筋结点靶向治疗顽固性面瘫采用“以结为腧”的治疗原则,直达病所,加快面部经筋功能的恢复,减轻面神经缺血、水肿的病理状态,缓解其所受到的卡压,缩短病程,有利于疾病恢复。

Objective:To verify whether Zhatiao needling positive sinew nodes is a better therapy for the treatment of refractory facial paralysis compared with conventional needling.Methods:64 patients were randomly divided into the treatment group and the control group,with 32 cases in each group.The control group was treated with conventional needling;on which basis,the treatment group was also treated with Zhatiao needling positive sinew nodes.The interventions were 5 times per week for 6 weeks,with the needle retention time lasting for 30 minutes each time.H-B rating,Sunnybrook facial nerve score,FDIS score and facial nerve electromyography were assessed before and after the treatment in the two groups.Results:The H-B rating,Sunnybrook facial nerve score,FDIS score,and maximum amplitude change of facial nerve electromyography were significantly higher after the treatment than those before the treatment in the two groups,and the therapeutic effect of the treatment group was significantly higher than that of the control group in the two groups(P<0.05).The total effective rate of the treatment group was 93.75%(30/32),which was significantly higher than 71.88%(23/32) of the control group(P<0.05).The H-B rating of the treatment group was significantly lower than that of the control group(P<0.05).The Sunnybrook facial nerve score,FDIS score,and maximum amplitude change of facial nerve electromyography were significantly improved in the treatment group than those in the control group after the treatment(P<0.05).Conclusion:The targeted treatment of refractory facial paralysis by Zhatiao needling positive sinew nodes adopts the treatment principle of 'using nodes as acupoints' and goes directly to the lesions,it can speed up the recovery of facial functions,the ischemia and edema of facial nerve,improve the compression and shorten the course of the disease.