耳针疗法辅助治疗急性期周围性面瘫疗效观察  

Curative effect of auricular acupuncture in auxiliary treatment of acute peripheral facial paralysis

作　　者：李文杰[1] 李洋 LI Wenjie;LI Yang(Department of Acupuncture&Moxibustion,Baoji Hospital of Traditional Chinese Medicine,Baoji,Shaanxi 721001)

机构地区：[1]陕西省宝鸡市中医医院针灸科,陕西宝鸡721001

出　　处：《河北中医》2024年第5期809-814,共6页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察耳针疗法辅助治疗急性期周围性面瘫的临床疗效。方法将94例急性期周围性面瘫患者按照随机数字表法分为2组,对照组47例采取常规西医治疗,治疗组47例在对照组基础上联合耳针疗法治疗。2组均治疗4周。比较2组治疗效果,比较2组治疗前后面部神经传导速度、红外热成像(前额区、耳周区、口角区、颧区及患侧全区温度)、面瘫改良Portmann评分、面部残疾指数躯体(FDIP)评分、免疫炎性指标[免疫球蛋白(IgA)、IgM、IgG、白细胞介素6(IL-6)、IL-21]水平及世界卫生组织生活质量测定量表简表(WHOQOL-BRFF)评分变化情况,治疗后随访1年,统计对比2组复发率。结果治疗组总有效率95.74%(45/47),对照组总有效率80.85%(38/47),治疗组临床疗效优于对照组(P<0.05)。2组治疗1、2、3、4周面部神经传导速度均较本组治疗前升高(P<0.05),且治疗组治疗1、2、3、4周均高于对照组同期(P<0.05)。2组治疗1、2、3、4周前额区、耳周区、口角区及患侧全区温度均较本组治疗前升高(P<0.05),且治疗组治疗1、2、3、4周均高于对照组同期(P<0.05);2组治疗1、2、3、4周颧区温度均较本组治疗前升高(P<0.05),但2组组间同期比较差异无统计学意义(P>0.05)。2组治疗1、2、3、4周改良Portmann、FDIP评分均较本组治疗前升高,且治疗组治疗1、2、3、4周均高于对照组同期(P<0.05)。2组治疗后血清IgA、IgM、IgG、IL-6、IL-21水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后WHOQOL-BRFF各维度评分均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组复发率比较差异无统计学意义(P>0.05)。结论采用耳针疗法辅助治疗急性期周围性面瘫患者,能显著提高治疗效果,进一步改善患者面部肌群恢复情况,有效改善患者面部温度、神经功能及面部神经传导速度,且能有效抑制免疫炎性损伤,降低复Objective To explore the effect of auricular acupuncture in the auxiliary treatment of acute peripheral facial paralysis(PFP).Methods A total of 94 patients with acute PFP were randomzied 1∶1 to receive conventional Western medicine(CWM,the control group)or auricular acupuncture plus CWM(the treatment group).A 4-week treatment was performed in the both groups,aiming to compare treatment effects,the conduction velocity of facial nerves,and infrared thermal imaging(the temperature of the forehead area,the ear area,the corner of the mouth,the zygomatic area and the affected side),and the modified Portmann scale(MPS)for facial paralysis,Facial Disability Index(FDIP)score,the level of immuno-inflammatory indexes(immunoglobulin[IgA],IgM,IgG,interleukin-6[IL-6],IL-21),and the World Health Organization Quality of Life Brief(WHOQOL-BREF)score before and after treatment.After 1-year followed up,the recurrence rates of the two groups were statistically compared.Results The total effective rate of the treatment group was higher than that of the control group(95.74%[45/47]vs 80.85%[38/47],P<0.05).On weeks 1,2,3,and 4,the conduction velocity of facial nerve in the both groups was significantly elevated than that before treatment(P<0.05),especially in the treatment group(P<0.05).On weeks 1,2,3,and 4,the temperature of the forehead area,the ear area,the angle of mouth area and the affected area in the both groups were significantly higher than those before treatment,and the increase was more common in the treatment group relative to the control group(P<0.05).On weeks 1,2,3,and 4,the temperature of the zygomatic zone in the both groups was significantly higher than before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).On weeks 1,2,3,and 4,the scores of MPS and FDIP in the both groups were significantly higher than those before treatment(P<0.05),and the improvments were more pronounced in the treatment group compared to the control group(P<0.05).After treatment,the serum levels of IgA,Ig

关 键 词：面神经麻痹 耳针疗法 

分 类 号：R745.12[医药卫生—神经病学与精神病学] R245.323[医药卫生—临床医学]