从生物力学角度谈刃针治疗面瘫后遗联带运动  

A Biomechanical Perspective on Bladed Needle Treatment of Facial Synkinesis

作　　者：刘付嘉 李德华[2] Liu Fujia;Li Dehua(Chengdu University of Traditional Chinese Medicine,Chengdu,610075,China;Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,610072,China)

机构地区：[1]成都中医药大学,四川成都610075 [2]成都中医药大学附属医院,四川成都610072

出　　处：《成都中医药大学学报》2025年第2期28-32,共5页Journal of Chengdu University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82374602);四川省中医药管理局项目(2023MS459,210061)。

摘　　要：面部联带运动(facial synkinesis,FS)是面瘫后常见且严重的后遗症,其病理机制主要由于面神经轴突受损后在再生过程中出现异位支配,导致面部表情肌群的张力失衡。本文基于Hill-Zajac模型,深入探讨了FS中面部肌肉协调失衡的生物力学机制。Hill-Zajac模型通过描述主动收缩单元、被动弹性单元和串联弹性单元的力学特性,解释了在去神经支配状态下,激动肌与拮抗肌之间的协调失调、肌肉弹性支持的减弱以及肌腱的过度拉伸或扭曲等变化如何导致FS的发生。基于这一理论,本研究提出刃针作为一种潜在有效的治疗手段,通过松解紧张的肌腱纤维和筋膜,减轻局部组织的牵拉和高张力,从而在生物力学层面上重新调整面部肌肉的张力平衡。通过单个病例的初步观察,证实了刃针在FS治疗中的应用前景,并为未来进一步研究其治疗机制提供了理论基础。Facial synkinesis(FS)is a prevalent and severe sequela of facial paralysis,primarily arising from the aberrant reinnervation of facial nerve axons during regeneration,which leads to an imbalance in the tension of facial expression muscles.This paper delves into the biomechanical mechanisms underlying the coordination imbalance of facial muscles in FS,utilizing the Hill-Zajac model to elucidate the disrupted coordination between agonist and antagonist muscles,the diminished elastic support of muscles,and the excessive elasticity of tendons in a denervated state,by describing the mechanical properties of active contractile(CE),passive elastic(PE),and series elastic(SEE)elements.Based on this theory,the study proposes bladed needle as a potentially effective treatment to mitigate local tissue tension and hypertonicity by loosening tense tendon fibers and fascia,thereby restoring the biomechanical balance of tension in the facial muscles.Preliminary observations from a single case study support the potential efficacy of bladed needle in treating FS,offering a theoretical foundation for future research on its therapeutic mechanisms.

关 键 词：面瘫后遗症 联带运动 生物力学 刃针疗法 针灸 

分 类 号：R245.31[医药卫生—针灸推拿学] R246.6[医药卫生—中医临床基础] R247.9[医药卫生—中医学]