基于无创性功能磁共振量化分析透刺法治疗面神经麻痹临床研究  

Clinical Study of the Non-invasive Functional Magnetic Resonance Quantitative Analysis of the Muscle for Facial Paralysis

作　　者：赵钧[1] 刘川[1] 吴爽[1] 陈志安[2] 赵古月 孙冬梅[2] ZHAO Jun;LIU Chuan;WU Shuang;CHEN Zhian;ZHAO Guyne;SUN Dongmei(Shenyang Hospital of Traditional Chinese M edicine,Shenyang 110004,Liaoning,China;Shengjing Hospital of China Medical University,Shenyang 110004,Liaoning,China)

机构地区：[1]沈阳市中医院,辽宁沈阳110004 [2]中国医科大学附属盛京医院,辽宁沈阳110004

出　　处：《辽宁中医药大学学报》2020年第7期9-12,F0003,共5页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：沈阳市科技局科研课题(17-230-9-88)。

摘　　要：目的验证针灸透刺治疗面神经麻痹的临床疗效。方法将60例面神经麻痹患者随机分成观察组(透刺)和对照组(体针),每组30例,对两组患者治疗前后的中医主要症状和多伦多(Sunnybrook)面神经评定系统量表进行评分,并用无创性功能磁共振量化分析治疗前后口轮匝肌、咬肌的变化。结果观察组治疗总有效率显著高于对照组,组间比较有显著性差异(P<0.05)。两组治疗后口眼歪斜、面部板滞、畏风恶寒和舌苔薄白症状积分均显著少于治疗前(P<0.05),且观察组治疗后各症状积分均显著低于对照组(P<0.05)。两组治疗后的Sunnybrook评分均较治疗前显著升高(P<0.05),且观察组得分显著高于对照组(P<0.05)。两组口轮匝肌、咬肌无创性功能磁共振[磁共振弥散张量成像(DTI)和组织T2值的多回波GraSE序列(T2mapping)]治疗前后两组间比较无显著性差异(P>0.05)。结论穴位透刺疗法治疗面神经炎患者疗效确切,可有效改善面神经麻痹证候,提高面神经功能。无创性功能磁共振(DTI和T2mapping)未显示出口轮匝肌在治疗前后的显著改变。透刺对肌肉组织产生积极影响,并在无创性磁共振DTI和T2mapping观测针灸治疗面部疾病上进行初步探索。Objectivec To verify the clinical efficacy of acupuncture for facial paralysis.Methods Sixty patients with facial paralysis were randomly divided into a treatment group(penetration acupuncture)and a control group(body acupuncture),30 patients in each group.The main symptoms of TCM and the Sunnybrook facial nerve assessment system scale were scored before and after treatment.The non-invasive functional magnetic resonance was used to quantitatively analyze the changes of the orbicularis oculi muscle、masseter muscle before and after treatment.Results The total effective rate of the observation gr oup was significantly higher than that of the control group(P<0.05).The scores of TCM symptoms,such as facial paralysis,aversion to wind-cold,and thin white tongue,were significantly decreased after treatment than those before treatment(P<0.05),and the decrease was more obvious in the observation group than that in the control group(P<0.05).The Sunnybrook scores were significantly increased in both groups(P<0.05),and the increase in the observation group was more obvious than that in the control group(P<0.05).Non-invasive functional magnetic resonance imaging(MRI)(DTI and T2 mapping)of the orbicularis oculi muscle and masseter muscle.After treatment in both groups was not superior to that before treatment and was not superior to the control group.Conclusion Penetration acupuncture therapy for patients with facial paralysis effective,it can effectively improve the symptoms of facial paralysis and improve facial nerve function.which has a more positive effect on muscle tissue.The preliminary exploration was carried out on the use of non-invasive nuclear magnetic resonance DTI and T2 mapping to observe acupuncture treatment of facial diseases.

关 键 词：针刺 透刺 面神经麻痹 磁共振成像 

分 类 号：R745.12[医药卫生—神经病学与精神病学]