太阳透地仓、颊车治疗周围性面瘫的临床研究及对面神经传导功能的影响  

Clinical Study of Puncturing Taiyang(EX-HN5)Towards Dicang(ST4)and Jiache(ST6)for Peripheral Facial Paralysis and Its Effect on Facial Nerve Conduction Function

作　　者：王波[1] 谭春凤 徐琼 黄建福 王天磊[1] WANG Bo;TAN Chun-feng;XU Qiong;HUANGJian-fu;WANG Tian-lei(Sanya Hospital of Traditional Chinese Medicine,Sanya 527000,China)

机构地区：[1]三亚市中医院,三亚527000

出　　处：《上海针灸杂志》2020年第11期1385-1390,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金项目(81560796)。

摘　　要：目的探讨太阳透地仓、颊车治疗周围性面瘫(PFP)临床疗效及对面神经传导功能影响。方法120例PFP患者随机分成针刺组和透刺组,每组60例。针刺组予常规针刺治疗,透刺组加用针刺太阳透地仓、颊车穴治疗。观察两组治疗前后在肌电图、微循环、相关积分、House-Brackmann量表(H-B量表)、血清学指标变化。结果两组治疗后额肌、口轮匝肌、上唇方肌、眼轮匝肌的M波波幅均较治疗前显著升高,而运动潜伏期较治疗前均显著下降(P<0.05);透刺组显著优于针刺组(P<0.05)。两组治疗后面神经功能缺损评分、面部残疾指数量表(FDI)、H-B量表评分较治疗前显著升高(P<0.05);透刺组面神经功能缺损评分、FDI、H-B量表评分显著优于针刺组(P<0.05)。两组治疗后输入支管径、输出支管径、管袢数较治疗前显著升高,而流态积分较治疗前均显著下降(P<0.05);透刺组流态积分显著低于针刺组,余显著高于针刺组(P<0.05)。两组治疗后H-B量表Ⅰ级、Ⅱ级比率较治疗前显著提高,而Ⅲ级、Ⅳ级、Ⅴ级比率较治疗前均显著降低(P<0.05);透刺组Ⅲ级、Ⅳ级、Ⅴ级比率显著低于针刺组,Ⅰ级、Ⅱ级比率显著高于针刺组(P<0.05)。两组治疗后P物质(SP)、血管活性肠肽(VIP)、降钙素基因相关肽(CGRP)较治疗前显著下降(P<0.05);透刺组SP、VIP、CGRP显著低于针刺组,差异有统计学意义(P<0.05)。结论太阳透地仓、颊车能促进PFP面神经传导功能和微循环,促进新陈代谢,从而恢复面神经功能,改善症状。Objective To discuss the clinical efficacy of puncturing Taiyang(EX-HN5)towards Dicang(ST4)and Jiache(ST6)in treating peripheral facial paralysis(PFP)and its effect on facial nerve conduction function.Method A total of 120 PFP patients were randomized into an acupuncture group and a penetrating needling group,with 60 cases in each group.The acupuncture group was given conventional acupuncture treatment,while the penetrating needling group was additionally treated with puncturing Taiyang towards Dicang and Jiache.The electromyogram(EMG),microcirculation,relevant scores,House-Brackmann(H-B)facial nerve grading,and serum indexes were observed before and after treatment in the two groups.Result The M-wave amplitudes of the frontal,orbicularis oris,quadratus labialis and orbicularis oculi muscles increased significantly and their motor latencies all decreased significantly after treatment in the two groups(P<0.05);the penetrating needling group was markedly better than the acupuncture group(P<0.05).After treatment,the facial nerve deficit score,Facial Disability Index(FDI)score and H-B facial nerve grading increased significantly in the two groups(P<0.05);the facial nerve deficit score,FDI score and H-B score were significantly better in the penetrating needling group than in the acupuncture group(P<0.05).After intervention,the input branch diameter,output branch diameter and the number of loops increased significantly in the two groups,and the flow integral decreased significantly(P<0.05);the flow integral was markedly lower in the penetrating needling group than in the acupuncture group,and the rest parameters were markedly higher in the penetrating needling group than in the acupuncture group(P<0.05).The ratios of H-B gradeⅠand gradeⅡincreased significantly after treatment in both groups,and the ratios of gradesⅢ,ⅣandⅤdecreased significantly(P<0.05);the ratios of gradesⅢ,ⅣandⅤwere markedly lower in the penetrating needling group than in the acupuncture group,and the ratios of gradesⅠandⅡwere mar

关 键 词：针刺疗法 面神经麻痹 面神经传导速度 House-Brackmann量表 P物质 血管活性肠肽 降钙素基因相关肽 透刺法 

分 类 号：R246.6[医药卫生—针灸推拿学]