周围性面瘫患者针灸治疗前后面部表情肌弹性与面神经功能评分的相关性  

Correlation between facial expression muscle elasticity and facial nerve function score in patients with peripheral facial paralysis before and after acupuncture treatment

作　　者：伍晓鸣 董桂芳[1] 牟霜[1] 潘瑜[2] 蒋瑶[1] WU Xiaoming;DONG Guifang;MU Shuang;PAN Yu;JIANG Yao(Department of Ultrasound,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)

机构地区：[1]重庆市中医院超声科,400021 [2]重庆市中医院针灸科,400021

出　　处：《临床超声医学杂志》2022年第5期363-367,共5页Journal of Clinical Ultrasound in Medicine

基　　金：重庆市科卫联合中医药科研项目(2019ZY023149)。

摘　　要：目的应用剪切波弹性成像动态评估周围性面瘫患者针灸治疗前后面部表情肌弹性变化,探讨其与面神经功能评分的相关性。方法选取在我院接受针灸治疗的50例周围性单侧面瘫患者,应用剪切波弹性成像评估针灸治疗前及治疗1、3、7、14、28 d面部双侧表情肌(额肌、降口角肌、降下唇肌)的弹性模量值;同时应用面神经功能评分评估周围性面瘫程度。比较针灸治疗前、后弹性模量值和面神经功能评分的变化;分析患侧额肌、降口角肌、降下唇肌不同时间点弹性模量值与面神经功能评分的相关性。结果周围性面瘫患者患侧额肌、降口角肌、降下唇肌治疗前及治疗各时间点的弹性模量值均低于健侧,差异均有统计学意义(均P<0.05);随着针灸治疗次数增加,患侧额肌、降口角肌、降下唇肌的弹性模量值逐渐增加,其中患侧额肌治疗3、7、14、28 d的弹性模量值均明显高于治疗前,患侧降口角肌治疗7、14、28 d的弹性模量值均明显高于治疗前,患侧降下唇肌治疗14、28 d的弹性模量值均明显高于治疗前,差异均有统计学意义(均P<0.05)。而健侧表情肌随着针灸治疗时间延长,其弹性模量值无明显变化。随着针灸治疗时间延长,患侧面神经功能评分逐渐升高,其中治疗3、7、14、28 d面神经功能评分与治疗前比较差异均有统计学意义(均P<0.01);且治疗7 d时评分上升速率最快。相关性分析显示,患侧额肌、降口角肌、降下唇肌不同时间点的弹性模量值与其面神经功能评分均呈正相关(r=0.704、0.739、0.815,均P<0.001)。结论剪切波弹性成像可动态评估周围性面瘫患者针灸治疗前后面部表情肌的弹性变化,且其与面神经功能评分相关,为临床周围性面瘫治疗效果提供了重要影像学依据。Objective treatment in patients with peripheral unilateral facial paralysis,and to explore the correlation between facial expression muscle elasticity and facial nerve function score.Methods acupuncture treatment in our hospital were selected.The modulus of facial expression muscles elasticity(frontalis muscle,depressor anguli oris and depressor labii inferioris)before acupuncture treatment and 1,3,7,14,28 d after treatment were evaluated by shear wave elastography.The degree of peripheral facial paralysis was evaluated by facial nerve function score,and the changes of elastic modulus and facial nerve function score before and after acupuncture treatment were compared.The correlation between the elastic modulus of the affected side(frontalis muscle,depressor anguli oris and depressor labii inferioris)and the facial nerve function score at different treatment time points were analyzed.Results muscle,depressor anguli oris and depressor labii inferioris of the affected side in patients with peripheral facial paralysis were lower than those of the healthy side before and after treatment,and the difference were statistically significant(all P<0.05).With the increase of the number of acupuncture treatment,the elastic modulus of frontalis muscle,depressor anguli oris and depressor labii inferioris gradually increased.The elastic modulus of the affected side frontal muscle at 3,7,14,28 d after treatment were significantly higher than that before treatment,the elastic modulus of the affected side descending angular muscle at 7,14,28 d after treatment were significantly higher than that before treatment,and the elastic modulus of the affected side descending labial muscle at 14,28 d after treatment were significantly higher than that before treatment,the differences were statistically significant(all P<0.05).With the extension of acupuncture treatment time,there was no significant changes in the elastic modulus of facial muscles of the healthy side,the facial nerve function score of the affected side increased gradually.Th

关 键 词：弹性成像 剪切波 弹性模量值 周围性面瘫 面部表情肌 

分 类 号：R445.1[医药卫生—影像医学与核医学] R745.1[医药卫生—诊断学]