基于肌力分级法构建个性化周围性面神经炎治疗模式

目的：观察基于肌力分级法构建个性化治疗模式对周围性面神经炎运动功能的治疗效果。方法：选取周围性面神经炎患者90例，采用随机数字表法分为2组各45例。2组均接受相同的对症治疗和物理疗法。对照组接受面操训练，观察组接受基于肌力分级法的个性化康复治疗。分别于治疗前和治疗后第1、2、3、4周采用House-Brackmann面神经分级标准（H-B分级量表）和Sunnybrook评分量表评估治疗效果。治疗4周后评价2组的治愈率，6个月随访时评价2组的联带运动发生率。结果：与治疗前比较，2组均从第3周开始H-B分级量表评分明显下降（P＜0.01）；与对照组比较，观察组第3周和第4周的H-B分级量表评分明显下降（P＜0.05）；2组均从第2周开始Sunnybrook面神经评定量表评分明显升高（P＜0.01）；与对照组比较，观察组第3周和第4周的Sunnybrook面神经评定量表评分明显升高（P＜0.05）；治疗4周后，观察组治愈率明显高于对照组（60.0%、26.7%，χ2=10.181，P=0.003）；6个月后随访观察组的联带运动发生率显著低于对照组（4.4%、17.8%，χ2=4.050，P=0.044）。结论：基于肌力分级法构建的个性化治疗模式可以精准描述面部肌肉损伤情况，制定精确的治疗方案，提高治愈率，降低联带运动发生率，值得在临床中广泛应用与推广。

An individualized treatment model for peripheral facial neuritis based on the muscle strength classification method

Objective: To observe the therapeutic effect of personalized diagnosis and treatment model based on manual muscle testing on motor function of peripheral facial neuritis. Methods: A total of 90 patients with peripheral facial neuritis who received treatment in the Rehabilitation Center of Shengjing Hospital Affiliated to China Medical University from January 2020 to December 2021 were selected and divided into control group and experimental group by a random number table method, with 45 cases in each group. The control group received facial exercise training, and the experimental group received personalized rehabilitation therapy based on manual muscle testing, 20 min/time, once/day, 5 days/week, continuous treatment for 4 weeks. Both groups received the same symptomatic therapy (neurotrophic, anti-inflammatory, and antiviral) and physical therapy (ultra-short wave and ultraviolet light). House-Brackmann facial nerve grading criteria and Sunnybrook Score scale were used to evaluate the therapeutic effect before treatment and in the first, second, third and fourth weeks after treatment, respectively. The cure rate of the two groups was evaluated after 4 weeks of treatment, and the incidence of associated exercise was evaluated at 6 months of follow-up. Results: Compared with baseline, H-B rating scale scores of the two groups decreased significantly from the third week, and Sunnybrook Facial Nerve Rating Scale scores increased significantly from the second week, with statistical significance (P<0.001). Compared with the control group, the H-B rating scale score of the experimental group decreased significantly and the Sunnybrook Facial nerve Rating Scale score increased significantly in the third and fourth weeks, with a higher cure rate and a lower incidence of associated movement, with statistical significance (P<0.05). Conclusion: The personalized diagnosis and treatment model based on manual muscle testing can effectively improve the facial motor function of patients with peripheral facial neuritis, increase the cure rate, and reduce the incidence of associated motor, which is worthy of widespread application and promotion in clinical practice.