揣穴促通电针法联合牵正散合芍药甘草汤对急性贝尔氏面瘫口面部肌肉功能恢复、面部微循环及面神经重建的机制研究OA
Mechanism Study of Chuai Xue Promoting Conduction Electroacupuncture Combined with Qianzheng Powder and Shaoyao Gancao Decoction on Orofacial Muscle Function Recovery,Facial Microcirculation and Facial Nerve Reconstruction in Acute Bell's Palsy
目的 观察揣穴促通电针法联合牵正散合芍药甘草汤治疗急性贝尔氏面瘫临床效果.方法 将108例贝尔氏面瘫患者采用随机数字表法分为观察组(脱落2例,n=52)与对照组(脱落3例,n=51).对照组在西医常规治疗的基础上给予牵正散合芍药甘草汤治疗,观察组在对照组基础上联合揣穴促通电针法,疗程为14 d.治疗前后分别进行表面肌电图、面部血流灌注量(PU)值检测,最大刺激试验(MST),House-Brackmann(H-B)面神经功能分级量表、Sunnybrook面神经评定系统(SFGS)、面部残疾指数(FDI)量表[身体功能(FDIP)和社会功能(FDIS)]和中医证候积分评估,检测血清神经生长因子(NGF)、脑源性神经营养因子(BDNF),比较额纹恢复时间、闭眼功能改善时间、口角对称恢复时间,并评估临床疗效.结果 观察组总有效率为98.08％,高于对照组的86.27％(P＜0.05).治疗后,两组RMS比值、MF值、PU值、mMSD均较治疗前提高(P＜0.05),且观察组均高于对照组(P＜0.05).治疗后,两组收缩强度比值、H-B、SFGS、FDIP、FDIS、血清NGF、BDNF均较治疗前提高,中医证候积分均较治疗前下降(P＜0.05),其中观察组提高或降低幅度更为明显(P＜0.05).观察组额纹恢复时间、闭眼功能改善时间、口角对称恢复时间较对照组均明显缩短(P＜0.05).结论 揣穴促通电针法联合牵正散合芍药甘草汤治疗急性贝尔氏面瘫疗效确切,可有效促进肌肉功能恢复,提高面神经重建效率,改善面部微循环,其机制可能与电针刺激提高NGF/BDNF分泌有关.
Objective:To investigate the clinical effect of Chuai Xue promoting conduction electroacupuncture combined with Qianzheng Powder and Shaoyao Gancao Decoction in the treatment of acute Bell's palsy.Methods:A total of 108 patients with Bell's palsy treated were selected and divided into the observation group(2 cases dropped out,n=52)and the control group(3 cases dropped out,n=51)by random number table meth-od.The control group was treated with Qianzheng Powder and Shaoyao Gancao Decoction on the basis of conven-tional Western medicine treatment,and the observation group was additionally treated with Chuai Xue promoting conduction electroacupuncture on the basis of the control group,with a treatment course of 14 days.Surface elec-tromyography,facial blood perfusion(Perfusion Unit,PU)value,maximal stimulation test(MST),House-Brackmann(H-B)facial nerve function grading scale,Sunnybrook Facial Grading System(SFGS),facial disability index(FDI)scale[physical function(FDIP)and social function(FDIS)],TCM syndrome score,and serum nerve growth factor(NGF)and brain-derived neurotrophic factor(BDNF)were detected before and after treatment.The recovery time of forehead wrinkles,improvement time of eye closure function,recovery time of mouth angle symmetry were compared,and clinical efficacy was evaluated.Results:The overall efficacy of the observation group(98.08％)was better than that of the control group(86.27％)(P＜0.05).After treatment,root mean square(RMS)ratio,mean frequency(MF),PU value and mean motion synkinesis distance(mMSD)in both groups were increased compared with those before treatment(P＜0.05),and those in the observation group were higher than those in the control group(P＜0.05).After treatment,contraction intensity ratio,H-B,SFGS,FDIP,FDIS,serum NGF and BDNF in both groups were increased compared with those before treatment,and TCM syndrome scores were decreased com-pared with those before treatment(P＜0.05),with more significant changes in the observation group(P＜0.05).The recovery time of forehead wrinkles,improvement time of eye closure function and recovery time of mouth angle symmetry in the observation group were significantly shorter than those in the control group(P＜0.05).Conclu-sion:Chuai Xue promoting conduction electroacupuncture combined with Qianzheng Powder and Shaoyao Gancao Decoction has definite efficacy in the treatment of acute Bell's palsy.It can effectively promote muscle function re-covery,improve facial nerve reconstruction efficiency and facial microcirculation.Its mechanism may be related to the increased secretion of NGF/BDNF induced by electroacupuncture stimulation.
左少恩;田常冬;何晓玲;吕丹丽
安徽省阜阳市妇女儿童医院,安徽阜阳 236000安徽省阜阳市妇女儿童医院,安徽阜阳 236000安徽省阜阳市妇女儿童医院,安徽阜阳 236000安徽省阜阳市妇女儿童医院,安徽阜阳 236000
医药卫生
贝尔氏面瘫揣穴促通法电针牵正散芍药甘草汤肌肉功能微循环面神经
Bell's palsyChuai Xue promoting conduction methodElectroacupunctureQianzheng PowderSha-oyao Gancao DecoctionMuscle functionMicrocirculationFacial nerve
《中国中医急症》 2026 (4)
450-454,5
2022年安徽省重点研究与开发计划项目(2022e07020026)
评论