温针灸联合中医辨证治疗周围性面瘫及对表面肌电图的影响

目的:探讨温针灸联合中医辨证治疗周围性面瘫的临床疗效以及对患者表面肌电图(s EMG)检测指标的影响。方法:选取2016年5月至2017年12月成都市第三人民医院收治的周围性面瘫患者60例,随机分为观察组与对照组,每组30例。对照组采用常规穴位进行针灸治疗,观察组应用温针灸联合中药辨证治疗,2周为1个疗程,2组患者共治疗2个疗程,于治疗前后应用House-Brackmann(H-B)面神经功能评价分级系统评价患者面神经功能恢复情况,治疗结束后采用s EMG观察患者面部肌群恢复情况,统计临床疗效。结果:治疗后,观察组治疗有效率96.67%显著高于对照组的80.00%(P0.05);治疗后2组患者H-B评分均较治疗前有所下降,且治疗后14 d、21 d、28 d观察组低于对照组(P0.05);观察组痊愈时间较对照组短(P0.05)。治疗结束后,观察组颊肌群、口轮匝肌群、额肌群及鼻肌群RMS值均高于对照组(P0.05)。结论:温针灸联合中医辨证治疗周围性面瘫可明显改善患者面神经功能,提高治疗有效率,缩短治疗时间;同时s EMG可客观准确地进行预后评估。

Effects of Warming Needle Moxibustion Combined with Traditional Chinese Medicine Syndrome Differentiation in Treating Peripheral Facial Paralysis and its Effects on SEMG

To observe the clinical effects on peripheral facial paralysis treated with warming needle moxibustion and traditional Chinese medicine (TCM) syndrome differentiation, and effects on surface electromyography (SEMG) testing. Methods:Sixty patients with peripheral facial paralysis admitted in our hospital from May 2016 to December 2017 were randomly divided into observation group and control group, with 30 cases in each group. Control group were treated with routine acupuncture treatment, while observation group were treated with warming needle moxibustion and TCM syndrome differentiation. Patients in 2 groups were treated for 2 courses lasting 4 weeks. Facial nerve function recovery was evaluated by the application of House-Brackman (H-B) facial nerve function evaluation grading system before and after treatment. Facial muscle recovery in patients was observed by using SEMG, and added up the efficiency in 2 groups after treatment. Results:The efficiency of observation group (96.67%) was significantly higher than control group (80.00%) after treatment (P<0.05). The H-B scores of both groups were decreased compared with those before treatment, and observation group was lower than control group, at 14 d, 21 d and 28 d after treatment. The H-B scores of observation group was lower than that of control group (P<0.05 or P<0.01). The recovery time of observation group was significantly shorter than that of control group after treatment (P<0.05). After the treatment, the RMS values of buccal muscle group, orbicularis muscle group, frontal muscle group and nasal muscle group in observation group were all higher than that of control group (P<0.01). Conclusion:The combination of warming needle moxibustion and TCM syndrome differentiation in the treatment of peripheral facial paralysis can improve the facial nerve function of patients, shorten the treatment time; at the same time, SEMG can objectively and accurately estimate the prognosis with broad clinical application prospects.