基于真实世界的急性期针灸治疗特发性面神经麻痹:队列研究  

Effect of acupuncture-moxibustion on idiopathic facial palsy at acute phase in the real world: a cohort study

作　　者：胡林雁 孙建华 裴丽霞 陈璐 HU Linyan;SUN Jianhua;PEI Lixia;CHEN Lu(Department of Acupuncture and Rehabilitation,Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Provincial Hospital of TCM,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院/江苏省中医院针灸康复科,南京210029

出　　处：《中国针灸》2025年第2期133-138,共6页Chinese Acupuncture & Moxibustion

基　　金：江苏省中医药科技发展计划项目:ZD202223;江苏省中医院高峰学术人才培养资金资助项目:y2021rc04。

摘　　要：目的:比较急性期和恢复期介入针灸对特发性面神经麻痹(IFP)的影响。方法:根据是否在急性期内接受针灸干预将198例IFP患者分为早期针灸组(118例)和非早期针灸组(80例),经倾向性评分匹配(PSM),最终早期针灸组与非早期针灸组各纳入70例。在西医常规治疗基础上,两组均接受针灸治疗,早期针灸组于急性期(病程≤7 d)介入针灸,非早期针灸组于恢复期(病程>7 d)介入针灸。急性期予温针灸治疗,穴取患侧翳风、下关、合谷、足三里;恢复期予电针治疗,穴取患侧攒竹、丝竹空、阳白等,予疏密波,频率2 Hz/100 Hz。均每次30 min,隔日1次,每周3次,共治疗4周。比较两组患者治疗前、治疗1周和治疗4周后House-Brackmann(H-B)面神经功能分级、Sunnybrook面神经功能评分和面部残疾指数(FDI)评分。并于治疗1、4周后评定两组临床疗效和安全性。结果:治疗1、4周后,两组患者H-B面神经功能分级均较治疗前改善(P<0.05);治疗4周后,早期针灸组H-B面神经功能分级优于非早期针灸组(P<0.05)。治疗1、4周后,两组患者Sunnybrook面神经功能评分、躯体功能评定(FDIP)评分较治疗前升高(P<0.05);治疗4周后,早期针灸组Sunnybrook面神经功能评分、FDIP评分升高幅度大于非早期针灸组(P<0.05)。治疗4周后,两组社会生活功能评定(FDIS)评分较治疗前降低(P<0.05)。治疗4周后,早期针灸组总有效率(97.1%,68/70)高于非早期针灸组(87.1%,61/70,P<0.05)。两组不良事件发生率比较差异无统计学意义(P>0.05)。结论:在急性期介入针灸较恢复期介入针灸更有利于IFP患者受损面神经功能康复。Objective To compare the effect of acupuncture-moxibustion on idiopathic facial palsy(IFP)at acute phase and recovery phase.Methods According to whether received acupuncture-moxibustion at acute phase or not,198 IFP patients were divided into an early-phase intervention group(118 cases)and a non-early-phase intervention group(80 cases).With the propensity score matching employed,70 cases were included in each group.On the basis of the conventional treatment of western medicine,acupuncture-moxibustion was supplemented in the two groups.In the early-phase intervention group,acupuncture-moxibustion was delivered at the acute phase(duration of illness≤7 days);in the non-early-phase intervention group,acupuncture-moxibustion was operated at the recovery phase(duration of illness>7 days).At the acute phase,warm needling was performed at Yifeng(TE17),Xiaguan(ST7),Hegu(LI4)and Zusanli(ST36)on the affected side;and at the recovery phase,electroacupuncture was delivered at Cuanzhu(BL2),Sizhukong(TE23)and Yangbai(GB14),etc.on the affected side,with the disperse-dense wave and 2 Hz/100 Hz of frequency.The intervention was operated for 30 min each time,once every two days,three treatments weekly and for 4 weeks.Before treatment,1 week and 4 weeks of treatment,the House-Brackmann(H-B)facial nerve function grade,the score of Sunnybrook facial nerve function,and the score of facial disability index(FDI)were compared between the two groups.The clinical effect in 1 and 4 weeks of treatment and safety were evaluated.Results In 1 and 4 weeks of treatment,the H-B grade was improved when compared with that before treatment in each group(P<0.05),and in 4 weeks of treatment,H-B grade in the early-phase intervention group was superior to that of the non-early-phase intervention group(P<0.05).In 1 and 4 weeks of treatment,Sunnybrook scores and the scores of physical function of FDI were elevated in comparison with those before treatment in the two groups(P<0.05);and in 4 weeks of treatment,the elevation of these two indexes in the early

关 键 词：特发性面神经麻痹 急性期 针灸 真实世界研究 介入时机 倾向性评分匹配 

分 类 号：R246.6[医药卫生—针灸推拿学]