电针联合面部表情控制肌群康复训练治疗重度特发性面瘫临床研究  

Clinical study of electroacupuncture assisted with facial expression muscle control rehabilitation training for the patients with severe idiopathic facial paralysis

作　　者：杨正明[1] 郭加磊 侍昊 宋斐[1] Yang Zhengming;Guo Jialei;Shi Hao;Song Fei(Department of Acupuncture and Moxibustion,Lianyungang Hospital of Traditional Chinese Medicine,Lianyungang 222004,China)

机构地区：[1]江苏省连云港市中医院针灸科,222004

出　　处：《国际中医中药杂志》2021年第9期868-872,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的评价电针联合面部表情控制肌群康复训练治疗重度特发性面瘫的疗效。方法将符合入选标准的2017年1月-2019年12月本院重度特发性面瘫患者130例,按随机数字表法分为2组,每组65例。2组均采用常规西医对症治疗,在此基础上对照组配合面部表情控制肌群康复训练,观察组在对照组基础上联合电针。2组均治疗8周,随访6个月。采用H-B量表和面神经Sunnybrook量表评价面神经功能;采用面部残疾指数躯体功能(Facial Disability Index Physical Function, FDIP)量表和面部残疾指数社会功能(Facial Disability Index Social Function, FDIS)量表评价日常生活质量;采用肌电诱发电位仪检测患侧眼轮匝肌、口轮匝肌运动诱发动作电位潜伏期/M波波幅;记录随访期间面肌痉挛发生情况;评价临床疗效。结果观察组总有效率为92.3% (60/65 )、对照组为76.9%(50/65) ,2组比较差异有统计学意义(χ^(2)=6.495,P=0.039)。治疗后,观察组H-B量表评分低于对照组(t=3.438,P<0.01),面神经Sunnybrook量表评分高于对照组(t=2.674,P=0.032);观察组FDIP评分低于对照组(t=3.986,P<0.01);FDIS评分高于对照组(t=4.621,P <0.01);观察组眼轮匝肌[(2.51±0.27)ms比(2.82±0.46)ms,t=4.258]与口轮匝肌[(2.97±0.22)ms比(3.35±0.40) ms,t=4.783]NCV潜伏期低于对照组(P <0.01);观察组眼轮匝肌[(1.83±0.45)mV比(1.30±0.39)mV,t=3.827]与口轮匝肌[(2.58±0.60)mV比(1.97±0.36)mV,t=4.017]M波波幅高于对照组(P <0.01)。随访期间观察组面肌痉挛发生率为4.62% (3/65)、对照组为15.38% (10/65),2组比较差异有统计学意义(χ^(2)=9.271,P=0.033)。结论电针联合面部表情控制肌群康复训练可有效提高重度特发性面瘫患者的面神经功能,改善日常生活质量,有效缓解临床症状,并有助于降低面肌痉挛发生风险。Objective To investigate the clinical effects of electroacupuncture assisted with facial expression muscle control rehabilitation training in the treatment of patients with severe idiopathic facial paralysis.Methods A total of 130 patients with severe idiopathic facial paralysis who met inclusion criterion were chosen and randomly divided into 2 groups,65 patients in each,from January 2017 to December 2019 in our hospital.The control group were treated with facial expression muscle control rehabilitation training and western medicine,and the experiment group with electroacupuncture on the basis of the control group.Both groups were treated for 8 weeks and followed up for 6 months.The facial nerve function was evaluated by H-B scale and facial nerve sunny brook scale the quality of daily life was evaluated by Facial Disability Index Physical Function(FDIP)scale and Facial Disability Index Social Function(FDIS)scale.The latency/M wave amplitude of motor evoked action on orbicularis oculi muscle and orbicularis ORIS muscle were measured by EMG evoked potential instrument.The occurrence of hemifacial spasm during follow-up was recorded.The clinical effective rates were evaluated.Results The total effective rate of experiment group was 92.31%(60/65),which was significantly higher than that of the control group 76.9%(50/65)(χ^(2)=6.495,P=0.039).The H-B scale scores of experiment group after treatment were significantly less than that of the control group(t=3.438,P<0.01).The facial nerve sunny brook scale scores of experiment group after treatment were significantly more than that of the control group(t=2.674,P=0.032).The FDIP scores of experiment group after treatment were significantly less than that of the control group(t=3.986,P<0.01).The FDIS scores of experiment group after treatment were significantly more than that of the control group(t=4.621,P<0.01).The NCV latency of orbicularis oculi muscle[(2.51±0.27)ms vs.(2.82±0.46)ms,t=4.258]and orbicularis oris muscle[(2.97±0.22)ms vs.(3.35±0.40)ms,t=4.783]of obser

关 键 词：面神经麻痹 针灸疗法 康复 诱发电位 治疗 临床研究性 

分 类 号：R246.6[医药卫生—针灸推拿学]