基于表面肌电图观察针刺对急性期贝尔氏面瘫患者的影响  

Effects of acupuncture on Bell’s palsy patients in the acute stage based on the surface electromyography

作　　者：李肖伟 陈嘉杰 舒玉铃 邓新源 张宇 杨骏[3] 石海平[1] LI Xiao-wei;CHEN Jia-jie;SHU Yu-ling;DENG Xin-yuan;ZHANG Yu;YANG Jun;SHI Hai-ping(Department of Tuina,The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;College of Acupuncture-Moxibustion and Tuina,Anhui University of Chinese Medicine,Hefei 230031;Department of Acupuncture and Rehabilitation,The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031)

机构地区：[1]安徽中医药大学第一附属医院推拿科,合肥230031 [2]安徽中医药大学针灸推拿学院,合肥230031 [3]安徽中医药大学第一附属医院针灸康复科,合肥230031

出　　处：《针刺研究》2025年第3期327-333,共7页Acupuncture Research

基　　金：安徽省教育厅高校协同创新项目(No.GXXT-2021-083)。

摘　　要：目的:基于表面肌电图观察针刺对急性期贝尔氏面瘫患者面部肌群肌力、疲劳值的影响。方法:将60例急性期贝尔氏面瘫患者随机分为观察组(30例)和对照组(30例)。观察组常规针刺患侧颧髎、阳白、翳风、颊车、地仓及健侧合谷等穴,每次30 min,隔日针刺1次,治疗至病程第28天;对照组口服醋酸泼尼松联合甲钴胺片治疗至病程第28天。观察两组治疗前后额肌、颧肌及口轮匝肌的均方根振幅(RMS)比值和中位频数(MF)、H-B分级量表、Sunnybrook评分变化,对表面肌电图检测指标与量表评分结果做相关性分析,比较临床疗效并对两组患者进行痊愈时间生存分析。结果:治疗后两组患者面肌肌群(额肌、颧肌及口轮匝肌)RMS比值、MF值均高于治疗前(P<0.01,P<0.05),RMS比值观察组高于对照组(P<0.05);两组患者H-B量表评分与Sunnybrook面神经功能评分均优于治疗前(P<0.01),且观察组高于对照组(P<0.01);两组患者痊愈时间生存分析显示,观察组痊愈时间少于对照组(P<0.05);治疗后,观察组愈显率93.33%(28/30)高于对照组76.67%(23/30,P<0.05);相关性分析显示,治疗前后H-B分级量表及Sunnybrook评分与额肌、颧肌及口轮匝肌RMS比值均成负相关(P<0.01),与MF值无相关性。结论:针刺在贝尔氏面瘫急性期介入,能显著提高面部肌群肌力、缓解肌肉疲劳并缩短患者痊愈时间;量表与RMS比值的相关性分析表明,RMS比值可作为临床评估面瘫病症程度的客观指标之一。Objective To investigate the effects of acupuncture on the muscle strength and fatigue levels of facial muscles of the patients with Bell’s facial paralysis in the acute stage,using surface electromyography.Methods Sixty patients diagnosed with acute Bell’s facial paralysis were randomly assigned to an observation group(30 cases)and a control group(30 cases).In the observation group,the routine acupuncture was applied to Quanliao(SI18),Yangbai(GB14),Yifeng(TE17),Jiache(ST6)and Dicang(ST4)on the affected side and Hegu(LI4)on the healthy side.The needles were retained for 30 min,and acupuncture was delivered once every two days.In the control group,prednisone acetate combined with methylcobalamin tablets were administered orally.The interventions lasted till to the 28th day of illness in the two groups.At the baseline and after treatment,the root mean square amplitude(RMS)ratio and the median frequency(MF)of the frontal muscle,zygomatic muscle and orbicularis oculi muscle and the changes in the scores of H-B scale and Sunnybrook facial nerve function were observed in the two groups.The correlation was analyzed between the indicators detected by surface electromyography and the scale score,the clinical effect was compared and recovery time survival analysis was performed.Results The RMS ratio and MF of the facial muscles(frontal,zygomatic,and orbicularis oculi muscles)were increased in both groups compared with pretreatment(P<0.01,P<0.05),and RMS ratio in the observation group was higher than that of the control group after treatment(P<0.05).After intervention,the H-B scale score and Sunnybrook score were improved in both groups compared with those pretreatment(P<0.01),and the scores in the observation groups were superior to the control group(P<0.01).Survival analysis of curative time showed that the curative time in the observation group was shorter than that of the control group(P<0.05).After interventions,the cured and markedly effective rate of the observation group was 93.33%(28/30),which was higher than t

关 键 词：贝尔氏面瘫 急性期 针刺疗法 表面肌电图 

分 类 号：R246.6[医药卫生—针灸推拿学]