巨刺法联合常规针刺辨证治疗急性期周围性面瘫患者的临床研究  

Clinical Efficacy of Contralateral Channel Needling Combined with Conventional Acupuncture in Treating Patients with Acute Peripheral Facial Paralysis Based on Syndrome Differentiation

作　　者：杨淑宏[1] 吴玉敏[1] 张晨迪 石欢 YANG Shu-hong;WU Yu-min;ZHANG Chen-di;SHI Huan(Department of Acupuncture and Moxibustion,South Zone of Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 102600)

机构地区：[1]中国中医科学院广安门医院南区针灸科,北京102600

出　　处：《世界中西医结合杂志》2023年第10期2033-2037,2043,共6页World Journal of Integrated Traditional and Western Medicine

摘　　要：目的观察巨刺法联合常规针刺辨证治疗急性期周围性面瘫患者的临床疗效及对体液免疫功能、面神经表面肌电信号、面部血流动力学的影响。方法选取2020年7月—2021年10月期间中国中医科学院广安门医院南区针灸科门诊及住院急性期周围性面瘫患者94例作为研究对象,采用随机数字表法分为对照组和治疗组,每组各47例。两组患者均给予抗病毒、营养神经等常规基础治疗。对照组同时给予常规针刺辨证治疗,治疗组同时给予巨刺法联合常规针刺辨证治疗。治疗4周后,观察比较两组患者临床疗效、体液免疫功能[免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白M(Immunoglobulin M,IgM)]含量、面神经表面肌电信号、面部血流动力学参数[收缩期峰值流速(Systolic peak velocity,Vs)、舒张末期流速(End-diastolic velocity,Vd)、阻力指数(Resistance index,RI)]。结果治疗后治疗组总有效率95.65%(44/46)明显高于对照组81.82%(36/44),差异有统计学意义(χ2=4.358,P=0.037<0.05)。治疗后两组患者体液免疫功能血清IgA、IgG、IgM水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者面额肌、眼轮匝肌、口轮匝肌潜伏期均治疗前降低,波幅均较治疗前升高,差异有统计学意义(P<0.05);且治疗组潜伏期低于对照组,波幅高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者患侧面动脉Vs、Vd指数较治疗前升高,RI指数较治疗前降低,差异有统计学意义(P<0.05);且治疗组患侧面动脉Vs、Vd指数高于对照组,RI指数低于对照组,差异有统计学意义(P<0.05)。结论巨刺法联合常规针刺辨证治疗能够提高急性期周围性面瘫患者临床疗效,可能与调节体液免疫功能、改善面神经肌电信号与血流动力学等因素有关。Objective To observe the clinical efficacy of contralateral channel needling combined with conven⁃tional acupuncture in treating the patients with acute peripheral facial paralysis based on syndrome differentiation and the effects of this therapy on humoral immune function,facial nerve surface electromyography(SEMG),and facial hemodynam⁃ics.Methods A total of 94 patients with acute peripheral facial paralysis treated in the Department of Acupuncture and Moxibustion,South Zone of Guang′anmen Hospital,China Academy of Chinese Medical Sciences from June 2020 to October 2021 were randomized into a treatment group(n=47)and a control group(n=47)according to the random number table method.All the patients received antiviral and neurotrophic treatment.In addition,the control group was treated with con⁃ventional acupuncture based on syndrome differentiation,and the treatment group with contralateral channel needling com⁃bined with conventional acupuncture based on syndrome differentiation.After treatment for 4 weeks,the two groups were compared in terms of clinical efficacy,humoral immune function[immunoglobulin A(IgA),immunoglobulin G(IgG),and immunoglobulin M(IgM)],facial nerve SEMG,and facial hemodynamic parameters[systolic peak velocity(Vs),end-di⁃astolic velocity(Vd),and resistance index(RI)].Results The treatment group had higher total response rate than the control group[95.65%(44/46)vs 81.82%(36/44);χ2=4.358,P=0.037<0.05].The treatment in both groups low⁃ered the serum levels of IgA,IgG,and IgM,and the treatment group had lower levels than the control group after treatment(P<0.05).The treatment in both groups shortened the latency of frontal muscle,orbicularis oculi,and orbicularis oris re⁃sponses to stimulation and increased the amplitude,and the changes were more obvious in the treatment group(P<0.05).The treatment in both groups elevated Vs and Vd and decreased RI,and the treatment group had higher Vs and Vd and lower RI than the control group(P<0.05).Conclusion Contralateral channel needling c

关 键 词：周围性面瘫 巨刺法 体液免疫功能 面神经肌电信号 血流动力学 

分 类 号：R245.31[医药卫生—针灸推拿学] R745.1[医药卫生—中医临床基础]