针刺结合中药熏洗治疗周围性面瘫患者的临床研究

叶雅仙; 徐霖; 陈希; 宋子瑜

doi:10.16766/j.cnki.issn.1674-4152.004016

针刺结合中药熏洗治疗周围性面瘫患者的临床研究

doi: 10.16766/j.cnki.issn.1674-4152.004016

叶雅仙^1, ,,
徐霖¹,
陈希²,
宋子瑜³

1.
建德市第一人民医院针灸推拿科，浙江建德 311600
2.
建德市第一人民医院药剂科
3.
浙江中医药大学附属第一医院中医科, 浙江杭州 310018

基金项目:

浙江省卫生健康科技计划项目 2021RC197

详细信息

通讯作者:
叶雅仙，E-mail：15658198518@163.com

中图分类号: R745 R245.3
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出版历程
- 收稿日期: 2024-08-20
- 网络出版日期: 2025-08-14

Clinical study of acupuncture combined with TCM fumigation in the treatment of patients with peripheral facial paralysis

YE Yaxian^{1
, ,},
XU Lin¹,
CHEN Xi²,
SONG Ziyu³

1.
Department of Acupuncture and Massage, the First People ' s Hospital of Jiande, Jiande, Zhejiang 311600, China

摘要

摘要: 目的对比针刺法结合中药熏洗与传统西医疗法治疗周围性面瘫患者的疗效，为临床治疗周围性面瘫患者提供更多参考。方法选取2022年1月—2024年2月建德市第一人民医院收治的104例周围性面瘫患者，使用随机数字表法分为对照组与观察组，各52例。对照组采用西医疗法，观察组采用针刺法结合中药熏洗。比较2组患者的临床疗效、中医证候积分、面部残疾指数(FDI)评分、面部神经功能[神经功能分级量表(H-B)]、营养神经指标[胶质细胞源性神经营养因子(GDNF)、神经生长因子(NGF)]、血清免疫球蛋白(IgA、IgG、IgM)、生活质量[生活质量简表(SF-36)]。结果观察组总有效率为94.23%(49/52)，高于对照组的80.77%(42/52, P＜0.05)。治疗6个疗程末，观察组中医症候积分、FDI社会功能评分、NGF、IgA、IgG、IgM均低于对照组(P＜0.05)。治疗6个疗程末，观察组FDI躯体功能评分、GDNF、SF-36生理限制维度评分、SF-36活力维度评分、SF-36总体健康维度评分均高于对照组(P＜0.05)。治疗6个疗程末观察组患者H-B分级整体优于对照组(P＜0.05)。结论针刺法结合中药熏洗治疗周围性面瘫患者疗效良好，可改善患者症状、FDI评分、面部神经功能、免疫球蛋白水平，促进受损神经修复，提高患者生活质量。
- 周围性面瘫 /
- 针刺 /
- 中药熏洗 /
- 面部残疾指数评分 /
- 面部神经功能
Abstract: Objective To compare the curative effect of acupuncture combined with traditional Chinese medicine (TCM) fumigation and traditional Western medicine in patients with peripheral facial paralysis so as to provide more reference for clinical treatment. Methods A total of 104 patients with peripheral facial paralysis admitted to the First People ' s Hospital of Jiande were enrolled between January 2022 and February 2024. According to the random number table method, they were divided into a control group (western medicine) and an observation group (acupuncture combined with TCM fumigation), with 52 cases in each group. The clinical curative effect, scores of TCM syndromes, facial disability index (FDI) and facial nerve function [House-Brackmann (H-B)], trophic nerve indexes [glial cell line-derived neurotrophic factor (GDNF), nerve growth factor (NGF)], serum immunoglobulins (IgA, IgG, IgM) and quality of life [the MOS item shot form health survey (SF-36)] were compared between the two groups. Results The total response rate of the observation group was higher than that of the control group [94.23% (49/52) vs. 80.77% (42/52), P < 0.05]. Compared with the control group after 6 courses of treatment, scores of TCM symptoms and FDI social function, levels of NGF, IgA, IgG, and IgM were lower in the observation group (P < 0.05), and the score of FDI physical function, GDNF and scores of SF-36 (physiological limitation, vitality, overall health) were higher (P < 0.05). After 6 courses of treatment, H-B grading was better in the observation group than that in the control group (P < 0.05). Conclusion The curative effect of acupuncture combined with TCM fumigation is significant in patients with peripheral facial paralysis, as it can improve symptoms, FDI scores, facial nerve function, and immunoglobulins, promote the repair of damaged nerves, and enhance quality of life.
- Peripheral facial paralysis /
- Acupuncture /
- Traditional Chinese medicine fumigation /
- Facial disability index /
- Facial nerve function

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表 1 2组周围性面瘫患者总有效率比较[例(%)]

Table 1. Comparison of total response rates between the two groups[cases(%)]

组别	例数	显效	有效	好转	无效	总有效
观察组	52	14(26.92)	27(51.92)	8(15.38)	3(5.77)	49(94.23)
对照组	52	7(13.46)	25(48.08)	10(19.23)	10(19.23)	42(80.77)
注：2组总有效率比较，χ²=4.308，P=0.038。

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表 2 2组周围性面瘫患者治疗前后中医症候积分比较(x±s, 分)

Table 2. Comparison on scores of TCM Syndromes between the two groups before and after treatment(x±s, points)

组别	例数	口眼歪斜		眼闭不实		面部麻木		恶寒发热
组别	例数	治疗前	治疗6个疗程	治疗前	治疗6个疗程	治疗前	治疗6个疗程	治疗前	治疗6个疗程
观察组	52	4.24±0.81	2.01±0.48^b	4.31±0.77	2.15±0.63^b	3.96±0.87	1.94±0.45^b	3.68±0.81	1.72±0.42^b
对照组	52	4.18±0.99	2.55±0.52^b	4.28±0.86	2.82±0.77^b	3.92±0.95	2.51±0.59^b	3.73±0.95	2.26±0.38^b
统计量		0.338^a	15.709^c	0.187^a	13.857^c	0.224^a	15.434^c	0.289^a	20.385^c
P值		0.736	＜0.001	0.852	＜0.001	0.823	＜0.001	0.773	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 3 2组周围性面瘫患者治疗前后FDI评分比较(x±s, 分)

Table 3. Comparison of FDI scores between the two groups before and after treatment(x±s, points)

组别	例数	躯体功能		社会功能
组别	例数	治疗前	治疗6个疗程	治疗前	治疗6个疗程
观察组	52	11.71±3.89	19.01±2.48^b	16.45±3.62	10.09±2.83^b
对照组	52	12.26±4.07	16.43±3.52^b	16.97±3.12	13.61±3.23^b
统计量		0.705^a	12.965^c	0.785^a	17.438^c
P值		0.483	＜0.001	0.435	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 4 2组周围性面瘫患者H-B分级比较(例)

Table 4. Comparison of H-B grading between the two groups(cases)

组别	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	Ⅴ级	Ⅵ级
观察组	52	11	30	6	5	0	0
对照组	52	5	27	5	12	3	0
注：2组H-B分级比较，Z=2.480，P=0.013。

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表 5 2组周围性面瘫患者治疗前后营养神经指标比较(x±s, μg/mL)

Table 5. Comparison of trophic nerve indexes between the two groups before and after treatment(x±s, μg/mL)

组别	例数	GDNF		NGF
组别	例数	治疗前	治疗6个疗程	治疗前	治疗6个疗程
观察组	52	2.21±0.48	7.14±1.75^b	9.27±2.51	4.01±1.12^b
对照组	52	2.34±0.52	5.53±1.38^b	9.14±2.06	5.38±1.27^b
统计量		1.325^a	16.780^c	0.289^a	17.534^c
P值		0.188	＜0.001	0.773	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 6 2组周围性面瘫患者治疗前后免疫球蛋白水平比较(x±s, g/L)

Table 6. Comparison of immunoglobulins between the two groups before and after treatment(x±s, g/L)

组别	例数	IgG		IgA		IgM
组别	例数	治疗前	治疗6个疗程	治疗前	治疗6个疗程	治疗前	治疗6个疗程
观察组	52	15.23±3.54	10.10±2.29^b	4.58±1.19	3.24±0.33	4.90±0.90	2.22±0.53
对照组	52	15.47±3.22	12.14±2.78^b	4.56±1.21	3.57±0.38	4.67±0.79	2.89±0.65
统计量		0.362^a	12.534^c	0.085^a	13.854^c	1.385^a	17.463^c
P值		0.718	＜0.001	0.932	＜0.001	0.169	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 7 2组周围性面瘫患者治疗前后生活质量比较(x±s, 分)

Table 7. Comparison of quality of life between the two groups before and after treatment(x±s, points)

组别	例数	生理限制		活力		总体健康
组别	例数	治疗前	治疗6个疗程	治疗前	治疗6个疗程	治疗前	治疗6个疗程
观察组	52	42.38±6.57	69.59±8.28^b	51.04±10.82	82.53±7.52^b	63.74±8.25	80.82±8.51^b
对照组	52	44.02±6.82	62.13±7.53^b	50.26±9.87	72.38±9.86^b	65.03±8.60	72.28±7.96^b
统计量		1.343^a	14.788^c	0.384^a	17.960^c	0.781^a	15.231^c
P值		0.182	＜0.001	0.702	＜0.001	0.437	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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