针刺人迎穴为主配合星状神经节阻滞术治疗周围性面瘫:随机对照研究

目的:探寻治疗周围性面瘫的较佳疗法。方法:120例患者随机分为常规针刺组(穴取阳白、四白、迎香为主)、人迎针刺组(人迎穴为主针刺)以及术针组(人迎穴为主针刺配合星状神经节阻滞术),每组40例。每天治疗1次,7次为一疗程,3个疗程后,比较3组治疗前后的面神经直接刺激诱发电位(ENoG)潜伏期和波幅,以及瞬目反射(BR)的R1值、R2值,并评定临床总疗效。结果:3组治疗均能显著缩短ENoG潜伏期,且诱发电位波幅显著升高;治疗后术针组ENoG潜伏期较常规针刺组显著降低(P<0.05),人迎针刺组诱发电位波幅较其他两组升高(均P<0.05);各组治疗后R1、R2值显著缩短,人迎针刺组和术针组治疗前后R1差值、R2差值均显著大于常规针刺组(均P<0.05),且术针组R1差值显著大于人迎针刺组(P<0.05);术针组临床愈显率为87.5%(35/40),优于人迎针刺组的77.5%(31/40),且显著高于常规针刺组的65.0%(26/40)(P<0.05)。结论:与常规针刺比较,人迎针刺组和术针组治疗周围性面瘫疗效更优,且术针组较人迎针刺组能更好地恢复受损面神经的早发反射功能。

Treatment of peripheral facial paralysis with acupuncture at Renying (ST9) mairly cooperated with stellate ganglion block: a randomized controlled trial

Objective To explore the better therapy for peripheral facial paralysis.Methods One hundred and twenty patients were randomized into three groups:a common acupuncture group:acupuncture at Yangbai(GB 14),Sibai(ST 2) and Yingxiang(LI 20) as main acupoints,a ST 9 group:acupuncture at Renying(ST 9) as main and a ST 9 plus SGB group:acupuncture at Renying(ST 9) as main cooperated with stellate ganglion block(SGB).Once daily,7 treatments made one session.After three sessions of treatment,the latency period and amplitude of evoked potential in ENoG,R1 value and R2 value of blink reflex were compared before and after the treatment in different groups separately.The total therapeutic effect was evaluated after treatment.Results All the treatments shortened the latency period of ENoG,and elevated the amplitude evoked potential significantly.After treatment,the latency period in ST 9 plus SGB group was reduced significantly as compared with common acupuncture group(P<0.05).The amplitude of evoked potential in ST 9 group was increased significantly as compared with the other two groups(both P<0.05).After treatment,in each group,R1 and R2 values were shortened significantly.The difference values of R1 and R2 in ST 9 group and ST 9 plus SGB group were all significantly higher as compared with common acupuncture group(both P<0.05).Additionally,the difference value of R1 in ST 9 plus SGB group was higher significantly than that in ST 9 group(P<0.05).The clinical cured and remarkably effective rate was 87.5%(35/40) in ST9 plus SGB group,which was higher than 77.5%(31/40) in ST 9 group,and 65.0%(26/40) in common acupuncture group(P<0.05).Conclusion As compared with common acupuncture group,ST 9 group and ST 9 plus SGB group achieve the much superior efficacy on peripheral facial paralysis.The treatment with ST 9 acupuncture and SGB can better repair the early reflex induced by the injury of facial nerve.