经筋刺法治疗周围性面瘫的疗效观察

Efficacy observation of muscle region acupuncture in treating peripheral facial paralysis

目的观察经筋刺法治疗周围性面瘫的临床疗效及其对瞬目反射、面部肌电图、动脉分支血流动力学的影响。方法将120例周围性面瘫患者随机分为观察组和对照组,每组60例。观察组采用经筋刺法治疗,对照组采用常规针刺治疗。观察两组治疗前后瞬目反射、面部肌电图指标(R1、R2波及对侧R2’波潜伏期,口轮匝肌、眼轮匝肌、鼻肌潜伏期及患健侧波幅比值)、动脉分支血流动力学指标[患侧面动脉、下唇动脉、内眦动脉、上唇动脉收缩期峰值血流速度(peak systolic velocity,PSV)和血管阻力指数(resistance index,RI)]、面神经功能[House-Brackmann(H-B)]分级及面部残疾指数(facial disability index,FDI)各项评分(躯体功能及社会/行为功能评分)的变化情况,比较两组临床疗效。结果两组治疗后R1、R2波及对侧R2’波潜伏期和口轮匝肌、眼轮匝肌、鼻肌潜伏期均较同组治疗前显著缩短,口轮匝肌、眼轮匝肌、鼻肌患健侧波幅比值及患侧面动脉、下唇动脉、内眦动脉、上唇动脉PSV均显著升高,RI和FDI各项评分均显著下降,差异均具有统计学意义(P<0.05)。观察组治疗后R1、R2波及对侧R2’波潜伏期和口轮匝肌、眼轮匝肌、鼻肌潜伏期均明显短于对照组,口轮匝肌、眼轮匝肌、鼻肌患健侧波幅比值及患侧面动脉、下唇动脉、内眦动脉、上唇动脉PSV均高于对照组,RI和FDI各项评分均低于对照组,差异均具有统计学意义(P<0.05)。两组治疗后H-B分级与同组治疗前比较,差异均具有统计学意义(P<0.05)。观察组治疗后H-B分级与对照组比较,差异具有统计学意义(P<0.05)。观察组总有效率为96.7%,明显高于对照组的83.3%(P<0.05)。结论经筋刺法治疗周围性面瘫疗效确切,可改善瞬目反射、面部肌电图及动脉分支血流动力学相关指标,提升患者面神经功能和日常生活水平。

Objective To observe the clinical efficacy of muscle region acupuncture in treating peripheral facial paralysis and its effects on blink reflex,facial electromyography(EMG),and arterial branch hemodynamics.Method A total of 120 patients with peripheral facial paralysis were randomly divided into an observation group and a control group,with 60 cases in each group.The observation group was treated with muscle region acupuncture,and the control group received ordinary acupuncture.The blink reflex,facial EMG indicators(the latencies of R1,R2,and the contralateral R2’waves,the latencies of orbicularis oris,orbicularis oculi,and nasal muscles and their amplitude ratio of the affected side to the healthy side),the arterial branch hemodynamic parameters[the vascular resistance index(RI)and peak systolic velocity(PSV)of the facial artery,inferior labial artery,inner canthus artery,and superior labial artery on the affected side],House-Brackmann(H-B)grading,and facial disability index(FDI)scores(physical function and social/behavioral function)were observed before and after the treatment.The clinical efficacy was also compared between the two groups.Result After the treatment,the latencies of R1,R2,and R2’waves,orbicularis oris,orbicularis oculi,and nasal muscles were shortened,the amplitude ratio of the affected side to the healthy side of the above muscles,the PSV of facial artery,inferior labial artery,inner canthus artery,and superior labial artery increased notably,and the RI and FDI scores decreased significantly in both groups(P<0.05).After the intervention,the latencies of R1,R2,and R2’waves,orbicularis oris,orbicularis oculi,and nasal muscles were shorter,the amplitude ratio of the affected side to the healthy side of the above muscles,the PSV of facial artery,inferior labial artery,inner canthus artery,and superior labial artery were higher,and the RI and FDI scores were lower in the observation group than in the control group,all showing statistical significance(P<0.05).The H-B grading changed significantly after the intervention in both groups(P<0.05),and the between-group difference also showed statistical significance(P<0.05).The total effective rate was 96.7%in the observation group,which was markedly higher than 83.3%in the control group(P<0.05).Conclusion Muscle region acupuncture is effective in treating peripheral facial paralysis.This method can improve blink reflex,facial EMG,and arterial branch hemodynamic parameters and enhance the patient’s facial nerve function and daily living level.