摘要
目的:观察针刺联合推拿治疗风痰阻络型特发性面神经麻痹的临床疗效。方法:纳入2022年1月—2023年12月于杭州市第三人民医院治疗的70例风痰阻络型特发性面神经麻痹患者作为研究对象,根据抽签法随机分为联合组34例、对照组36例。2组均采用现代医学常规疗法治疗,对照组予针刺疗法治疗,联合组予针刺疗法联合面部推拿治疗,7天为1个疗程,2组均治疗1个疗程。治疗前后评定2组患者的面神经麻痹严重程度House-Brackmann(H-B)分级情况、面部神经功能(Portmann临床简易评分法评分),检测肌电图。比较2组的临床疗效、总有效率及不良反应发生率。结果:治疗7天,联合组总有效率高于对照组,疗效优于对照组,差异均有统计学意义(P<0.05)。2组皱眉、闭眼、动鼻翼、鼓腮、吹口哨、微笑评分及总分均较治疗前增加(P<0.05);联合组闭眼、鼓腮、吹口哨评分及总分均高于对照组,差异均有统计学意义(P<0.05)。2组颊肌、额肌、眼轮匝肌、鼻肌、口轮匝肌的阻力指数(RI)潜伏期均较治疗前缩短,患健侧波幅比值、患健侧均方根(RMS)值均较治疗前升高,差异均有统计学意义(P<0.05);联合组各面区肌肉的RI潜伏期均短于对照组,患健侧波幅比值、患健侧RMS值均高于对照组,差异均有统计学意义(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在现代医学常规疗法基础上对风痰阻络型特发性面神经麻痹患者应用针刺疗法联合面部推拿治疗,可提高临床疗效,有助于恢复肌张力、修复面神经,安全性较好。
Objective:To observe the clinical effect of the combination use of acupuncture and massage on idiopathic facial palsy of wind-phlegm obstructing the collaterals type.Methods:A total of 70 patients with idiopathic facial paralysis of wind-phlegm obstructing the collaterals type treated in the Hangzhou Third People's Hospital from January 2022 to December 2023 were included as the study subjects and randomly divided into the combination group(34 cases)and the control group(36 cases)according to the drawing lots.Both groups were treated with conventional therapy of modern medicine.The control group was additionally treated with acupuncture,and the combination group was additionally treated with acupuncture combined with facial massage.With seven days as a course of treatment,both groups were treated for one course.Before and after treatment,the House-Brackmann(H-B)facial paralysis grading,facial nerve function(scores of Modified Portmann Scale)and electromyographies in both groups were evaluated.After treatment,the clinical effects and incidence of adverse reactions were compared between the two groups.Results:After one course of treatment,the total effective rate in the combination group was higher than that in the control group,and the curative effect was better than that in the control group,differences being significant(P<0.05).The scores of frowning,closing eyes,moving alar,bulging cheeks,whistling,smiling and the total scores in the two groups were increased compared with those before treatment(P<0.05);the scores of closing eyes,bulging cheeks,whistling and the total scores in the combination group were higher than those in the control group(P<0.05).The resistance index(RI)incubation period of buccinator,frontal muscle,sphincter of eye,nasalis muscle and orbicularis oris in the two groups was respectively shortened when compared with that before treatment,and the amplitude ratio and root mean square(RMS)of the affected side were increased when compared with those before treatment,differences being significant(P<0.05);the RI incubation period of the muscles in each facial area in the combination group was shorter than that in the control group,and the amplitude ratio and RMS of the affected side were higher than those in the control group,differences being significant(P<0.05).There was no significant difference being found in the comparison of incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combination use of acupuncture and massage based on conventional therapy of modern medicine can improve the clinical effect on patients with idiopathic facial palsy of wind-phlegm obstructing the collaterals type,help the recovery of muscle strength and repair the facial nerve with great safety.
作者
叶文雄
徐纬
陈娜
YE Wenxiong;XU Wei;CHEN Na(Department of Rehabilitation Medicine,Hangzhou Third People's Hospital,Hangzhou Zhejiang 310009,China)
出处
《新中医》
2025年第12期114-119,共6页
New Chinese Medicine
基金
杭州市卫生计生科技计划项目(2018A28)。
关键词
特发性面神经麻痹
针刺疗法
面部推拿
风痰阻络证
Idiopathic facial palsy
Acupuncture
Facial massage
Syndrome of wind-phlegm obstructing the collaterals
作者简介
叶文雄(1985-),男,主治中医师,E-mail:yefan0328@163.com。
