温和灸人迎联合针刺治疗重度周围性面瘫气虚血瘀证:随机对照试验OA
Mild moxibustion at Renying(ST9)combined with acupuncture in treatment of severe peripheral facial paralysis of qi deficiency and blood stagnation:a randomized controlled trial
目的:观察温和灸人迎联合针刺治疗重度周围性面瘫(PFP)气虚血瘀证的临床疗效.方法:将66例重度PFP气虚血瘀证患者随机分为观察组和对照组,每组33例.对照组仅接受针刺治疗,穴取患侧阳白、四白、地仓、翳风、牵正等;观察组在对照组基础上加用温和灸患侧人迎,两组治疗均隔日1次,每周 3次,连续治疗8 周.比较两组患者治疗前后面神经功能评分、面部残疾指数(FDI)评分,采用表面肌电图(sEMG)检测两组患者健侧和患侧面部肌群均方根(RMS)平均值比值,并评定两组临床疗效和安全性.结果:治疗后,两组患者面神经功能评分及 FDI 总分、FDIP 评分、FDIS 评分均较治疗前升高(P＜0.01),观察组面神经功能评分、FDI总分、FDIP 评分高于对照组(P＜0.01,P＜0.05);治疗后,两组患者健侧和患侧额肌群、颊肌群、口轮匝肌群RMS平均值比值均较治疗前升高(P＜0.01),且观察组升高幅度大于对照组(P＜0.05).观察组总有效率为87.9%(29/33),高于对照组的66.7%(22/33,P＜0.05).研究过程中,两组均未出现明显不良反应.结论:在常规针刺基础上,温和灸人迎可以促进重度PFP气虚血瘀证患者患侧面肌恢复,改善面神经功能及面神经传导.
Objective To observe the clinical effect of mild moxibustion at Renying(ST9)combined with acupuncture on severe peripheral facial paralysis(PFP)of qi deficiency and blood stagnation.Methods Sixty-six patients with severe PFP of qi deficiency and blood stagnation were randomly divided into an observation group and a control group,with 33 cases in each group.In the control group,acupuncture was operated at Yangbai(GB14),Sibai(ST2),Quanliao(SI18),Jiache(ST6),Dicang(ST4),Yifeng(TE17),Qianzheng(Extra)and etc.,on the affected side;and in the observation group,besides the administration as the control group,mild moxibustion was delivered at Renying(ST9)on the affected side.The intervention was given once every other day,3 sessions weekly,for 8 consecutive weeks in the two groups.The scores of facial nerve function and facial disability index(FDI)were compared before and after treatment in the two groups.The ratio of the root mean square(RMS)average values of the affected facial muscles to those of the healthy side was measured using surface electromyography(sEMG)in both groups,and the clinical effect and safety were evaluated.Results After treatment,both groups showed the increase in facial nerve function scores,the total scores of FDI and the scores on FDIP(physical function)and FDIS(social function)in comparison with those before treatment in the two groups(P＜0.01);and the facial nerve function score,the total score of FDI and the score on FDIP in the observation group were higher than those in the control group(P＜0.01,P＜0.05).After treatment,the ratio of the RMS average values of the affected facial muscles(frontalis,buccinator,and orbicularis oris)to those of the healthy side was elevated in the two groups when compared with that before treatment(P＜0.01),and the increase amplitude in the observation group was larger than that in the control group(P＜0.05).The total effective rate in the observation group was 87.9%(29/33),higher than that(66.7%,22/33)in the control group(P＜0.05).No obvious adverse reaction was found in the two groups during trial.Conclusion On the basis of conventional acupuncture,mild moxibustion at Renying(ST9)may promote the recovery of facial muscles and improve facial nerve function and facial nerve conduction in patients with severe PFP of qi deficiency and blood stagnation.
陈斌;杨诗彦;卢宏坤;王晨林;陈良华;林万庆
福建中医药大学附属人民医院,福州 350004福建中医药大学附属人民医院,福州 350004福建中医药大学附属人民医院,福州 350004福建中医药大学附属人民医院,福州 350004福建中医药大学附属人民医院,福州 350004福建中医药大学附属人民医院,福州 350004
重度周围性面瘫气虚血瘀证针刺温和灸人迎面神经功能
severe peripheral facial paralysisqi deficiency and blood stagnationacupuncturemild moxibustionRenying(ST9)facial nerve function
《中国针灸》 2026 (5)
713-718,6
福建中医药大学优势学科专项:X2022004-专项福建省中医药重点学科建设项目:闽卫中医函[2024]363号
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