关键词: H-B facial nerve function grading TCM syndrome score facial disability index (FDI) parallel needling technique peripheral facial paralysis, qi deficiency and blood stasis

Mesh : Humans Facial Paralysis / therapy Percutaneous Collagen Induction Qi Acupuncture Therapy Needles Treatment Outcome Acupuncture Points

来  源:   DOI:10.13703/j.0255-2930.20230703-k0002

Abstract:
OBJECTIVE: To observe the clinical efficacy of the parallel needling technique for peripheral facial paralysis with qi deficiency and blood stasis.
METHODS: Sixty-two patients with peripheral facial paralysis of qi deficiency and blood stasis were randomly assigned to a parallel needling group and a conventional acupuncture group, with 31 patients in each group. The conventional acupuncture group received needling at Yangbai (GB 14), Quanliao (SI 18), Jiache (ST 6), Dicang (ST 4), Yifeng (TE 17) on the affected side, Hegu (LI 4) on the healthy side, and bilateral Zusanli (ST 36), Sanyinjiao (SP 6), Xuehai (SP 10) and Qihai (CV 6) etc. The parallel needling group, in addition to the conventional acupuncture points, received parallel needling at three additional groups of acupoints, i.e. forehead wrinkle group, mid-face group, and corner of the mouth group. Both groups retained needles for 30 min, with one session every other day and a total of three sessions per week, lasting for four weeks. The House-Brackmann (H-B) facial nerve function grading, physical function (FDIP) and social function (FDIS) scores of facial disability index (FDI), TCM syndrome score before and after treatment were compared between the two groups, and the clinical efficacy was assessed.
RESULTS: Compared with before treatment, after treatment, both groups showed improvements in H-B facial nerve function grading (P<0.05), FDIP total scores and sub-item scores were increased (P<0.05), FDIS total scores, sub-item scores, and TCM syndrome scores were decreased (P<0.05). After treatment, the parallel needling group showed the higher FDIP total score and eating sub-item score and lower FDIS total score and insomnia sub-item score compared with those in the conventional acupuncture group (P<0.05). The total effective rate was 90.3% (28/31) in the parallel needling group and 87.1% (27/31) in the conventional acupuncture group, with no statistically significant difference between the two groups (P>0.05).
CONCLUSIONS: The parallel needling technique combined with conventional acupuncture, is as effective as conventional acupuncture alone in treating facial paralysis with qi deficiency and blood stasis. However, the parallel needling technique combined with conventional acupuncture shows advantages in the improvement of food intake and sleep quality.
目的: 观察平行对刺法治疗气虚血瘀型周围性面瘫的临床疗效。方法: 将62例气虚血瘀型周围性面瘫患者随机分为平行对刺组和常规针刺组,每组31例。常规针刺组穴取患侧阳白、颧髎、颊车、地仓、翳风,健侧合谷,双侧足三里、三阴交、血海及气海等;平行对刺组在常规针刺组基础上,增加3组平行对刺组穴,分别为额纹组、面中组、口角组。两组均留针30 min,隔日1次,每周3次,共治疗4周。比较两组患者治疗前后House-Brackmann(H-B)面神经功能分级、面部残疾指数(FDI)量表中的躯体功能(FDIP)和社会生活功能(FDIS)评分、中医证候积分,并评定两组临床疗效。结果: 与治疗前比较,两组患者治疗后H-B面神经功能分级改善(P<0.05),FDIP总分及各分项评分升高(P<0.05),FDIS总分及各分项评分、中医证候积分均降低(P<0.05);治疗后,平行对刺组FDIP总分及进食评分高于常规针刺组(P<0.05)、FDIS总分及失眠程度评分低于常规针刺组(P<0.05)。平行对刺组总有效率为90.3%(28/31),常规针刺组总有效率为87.1%(27/31),两组比较差异无统计学意义(P>0.05)。结论: 平行对刺法结合常规针刺和常规针刺法治疗气虚血瘀型周围性面瘫疗效相当,但平行对刺法结合常规针刺在改善进食、失眠程度方面有优势。.
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