揿针联合针刺及穴位注射治疗周围性面瘫急性期临床疗效观察  

Clinical Effect of Press Needle Combined with Acupuncture and Acupoint Injection in Treatment of Peripheral Facial Paralysis in Acute Stage

作　　者：张振丰 鲍亮 李春宁 杨骏[2] 田鑫 邱帅辉 李飞[3,4] ZHANG Zhenfeng;BAO Liang;LI Chunning;YANG Jun;TIAN Xin;QIU Shuaihui;LI Fei(Graduate School of Anhui University of Chinese Medicine,Anhui Hefei 230012,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei230031,China;The Second Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230061,China;Intelligent Research Institute,Hefei University of Technology,Anhui Hefei 230041,China)

机构地区：[1]安徽中医药大学研究生院,安徽合肥230012 [2]安徽中医药大学第一附属医院,安徽合肥230031 [3]安徽中医药大学第二附属医院,安徽合肥230061 [4]合肥工业大学智能研究院,安徽合肥230041

出　　处：《安徽中医药大学学报》2024年第6期38-43,共6页Journal of Anhui University of Chinese Medicine

基　　金：青年岐黄学者培养项目(国中医药人教函[2022]256号);安徽省自然科学基金项目(2308085MH297);安徽省高等学校自然科学研究重大项目(2023AH040099)。

摘　　要：目的观察揿针联合针刺及穴位注射治疗周围性面瘫急性期的疗效。方法将60例周围性面瘫急性期患者随机分为治疗组和对照组,每组30例。对照组采用穴位注射配合针刺治疗,选取患侧阳白、攒竹、翳风、完骨、下关、牵正、太阳、颧髎、鱼腰、地仓、颊车、承浆、迎香及双侧足三里、合谷;治疗组在对照组治疗基础上联用揿针治疗,取穴同上。两组均每日治疗1次,治疗6 d后休息1 d,1周为1个疗程,共治疗3个疗程。比较两组患者治疗前后House-Brackmann(H-B)量表评分,面部残疾指数(facial disability index,FDI)评分,血清超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、降钙素原(procalcitonin,PCT)、白蛋白(albumin,Alb)水平,额肌群、颊肌群、口轮匝肌群的表面肌电图均方根(root mean square,RMS)平均值比值变化,以及临床疗效。结果与治疗前比较,两组患者治疗后H-B量表评分、FDI社会生活功能评分均显著减少(P<0.05),FDI躯体功能评分均显著增加(P<0.05),且治疗组H-B量表评分、FDI社会生活功能评分减少程度,FDI躯体功能评分增加程度较对照组更显著(P<0.05);血清hs-CRP、PCT水平均显著降低(P<0.05),Alb水平均显著升高(P<0.05),且治疗组hs-CRP、PCT水平降低程度,Alb水平升高程度较对照组更显著(P<0.05);两组患者治疗后额肌群、颊肌群、口轮匝肌群的表面肌电图RMS平均值比值均显著增加(P<0.05),且治疗组各肌群的表面肌电图RMS平均值比值增加程度显著大于对照组(P<0.05)。治疗组疗效优于对照组(P<0.05)。结论揿针联合针刺及穴位注射疗法可促进周围性面瘫急性期患者面神经功能恢复,改善其预后。Objective To investigate the clinical effect of press needle combined with acupuncture and acupoint injection in the treatment of peripheral facial paralysis in acute stage.Methods A total of 60 patients in the acute stage of peripheral facial paralysis were randomly divided into treatment group and control group,with 30 patients in each group.The patients in the control group received acupoint injection combined with acupuncture at ipsilateral Yangbai,Zanzhu,Yifeng,Wangu,Xiaguan,Qianzheng,Taiyang,Quanliao,Yuyao,Dicang,Jiache,Chengjiang,and Yingxiang points and bilateral Zusanli and Hegu points once a day,and those in the treatment group received press needle therapy at the same acupoints in addition to the treatment in the control group.Each course of treatment was 1 week(6 days of treatment and 1 day of rest),and both groups were treated for 3 courses.After treatment,the two groups were compared in terms of the changes in House-Brackmann(H-B)score,facial disability index(FDI),the serum levels of hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT),and albumin(Alb),and the ratio of average root mean square(RMS)values of surface electromyography for frontal,buccinator,and orbicularis oris muscle groups before and after treatment,as well as the clinical outcome.Results After treatment,both groups had significant reductions in H-B score and FDIS score(P<0.05)and a significant increase in FDIP score(P<0.05),and compared with the control group,the treatment group showed significantly greater reductions in H-B score and FDIS score and a significantly greater increase in FDIP score(P<0.05);both groups had significant reductions in the serum levels of hs-CRP and PCT and a significant increase in the serum level of Alb(P<0.05),and compared with the control group,the treatment group showed significantly greater reductions in hs-CRP and PCT and a significantly greater increase in Alb(P<0.05);both groups had significant increases in the ratio of average RMS values of surface electromyography for frontal,buccinator,a

关 键 词：周围性面瘫 揿针 针刺 穴位注射 急性期 

分 类 号：R246[医药卫生—针灸推拿学]