电针结合点刺放血、拔罐辅助治疗特发性面神经麻痹急性期40例随机对照临床观察  

Electroacupuncture Combined with Point Bloodletting and Cupping for Idiopathic Facial Palsy in Acute Stage of 40 Cases:A Randomized Controlled Trial

作　　者：秦懿囡 杨丽红 白杨 徐天宇 赵娜娜 李之湄 杜元灏 QIN Yi'nan;YANG Lihong;BAI Yang;XU Tianyu;ZHAO Nana;LI Zhimei;DU Yuanhao(School of Acupuncture,Moxibustion and Tuina,Shanxi University of Chinese Medicine,Xianyang,712046;First Teaching Hospital of Tianjin University of Traditional Chinese Medicine;Qingyang Hospital of Traditional Chinese Medicine,Gansu Province)

机构地区：[1]陕西中医药大学针灸推拿学院,陕西省咸阳市712046 [2]天津中医药大学第一附属医院 [3]甘肃省庆阳市中医医院

出　　处：《中医杂志》2024年第14期1458-1463,共6页Journal of Traditional Chinese Medicine

基　　金：陕西省自然科学基础研究计划(2023-JC-QN-1002)。

摘　　要：目的 观察电针结合点刺放血及拔罐辅助治疗特发性面神经麻痹(IFP)急性期对面神经功能恢复的影响。方法 将80例IFP急性期患者随机分为治疗组和对照组各40例。对照组在病程≤10天的急性期予以口服醋酸泼尼松片;病程>10天的恢复期予以电针及闪罐治疗,每周5次。治疗组急性期在对照组治疗的基础上予以针刺患侧的星状神经节、耳甲腔迷走神经刺激点、翳风、听会,翳风、听会连接电针仪,每日1次;翳风点刺放血后拔罐,每周2次;恢复期治法同对照组。两组均治疗至发病45天。主要结局指标为多伦多面部评分系统(SFGS)评分,次要结局指标包括House-Brackmann (H-B)分级、面部残疾指数(FDI)评分、H-B分级Ⅰ级病例数,并记录两组的不良事件。结果 与治疗前比较,两组患者发病后第10天、第30天、第45天SFGS评分升高(P<0.05),发病后第30天、第45天H-B分级降低(P<0.05),发病后第30天、第45天面部残疾指数-躯体功能(FDIP)评分及面部残疾指数-社会心理(FDIS)评分升高(P<0.05)。治疗组患者SFGS评分在发病后第30天、第45天均显著高于对照组(P<0.05);H-B分级在发病后第30天、第45天显著低于对照组(P<0.05);发病后45天FDIP评分,发病后第30天、第45天FDIS评分均显著高于对照组(P<0.05)。在治疗结束时治疗组H-B分级Ⅰ级者77.50%(31例)显著高于对照组的55.00%(22例)(P<0.05)。两组均未发生不良事件。结论 IFP急性期采用电针结合点刺放血拔罐疗法能改善面神经功能恢复程度、提高疗效,且安全性较高。Objective To explore the influence of electroacupuncture combined with point bloodletting and cupping for facial nerve function recovery in acute stage of idiopathic facial palsy(IFP).Methods Eighty patients with IFP in the acute stage were randomly divided into 40 cases each in the treatment group and the control group.In the control group,oral prednisone acetate tablets were administered during the acute stage when the disease duration was less than 10 days;and electroacupuncture and flash cupping were provided during the recovery stage when the disease duration was more than 10 days,five times a week.For treatment group in acute stage,the stellate ganglion,vagus nerve stimulation point in the auricular cavity,Yifeng(TE 17)and Tinghui(GB 2)were needled on the affected side on the basis of the treatment of control group,with Yifeng and Tinghui connecting to electroacupuncture apparatus,once a day;point bloodletting and then cupping in Yifeng 2 times a week;in recovery stage,the treatment was the same as that of the control group.Both groups were treated until the 45th day from onset.The primary outcome was the Toronto facial grading system(SFGS),and the secondary outcomes included house-brackmann(H-B)grade,facial disability index(FDI)score,and number of H-B grade-Ⅰcases.Adverse events were recorded in both groups.Results The SFGS scores of the patients in both groups were higher on the 10th,30th and 45th days after onset of disease compared with those before the treatment(P<0.05);the H-B grade was lower on the 30th and 45th days after the onset of the disease compared with those before the treatment(P<0.05);and the facial disability index physical function(FDIP)and facial disability index social function(FDIS)scores were higher on the 30th and 45th days after onset of disease(P<0.05).SFGS scores of patients in the treatment group were significantly higher than those of the control group on the 30th and 45th days after onset(P<0.05);H-B grade was significantly lower than that of the control group on the 30th an

关 键 词：特发性面神经麻痹 急性期 面神经功能 电针 刺络放血 拔罐 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]