Zhou Zhang-ling, Li Cheng-xin, Jiang Yue-bo, Zuo Cong, Cai Yun, Wang Rui
Department of Acupuncture and Moxibustion, General Hospital of the People's Liberation Army, Beijing, China.
Zhong Xi Yi Jie He Xue Bao. 2012 Sep;10(9):997-1002. doi: 10.3736/jcim20120908.
To assess and grade facial nerve dysfunction according to the extent of facial paralysis in the clinical course of acupuncture treatment for Bell's palsy, and to observe the interrelationship between the grade, the efficacy and the period of treatment, as well as the effect on prognosis.
The authors employed the House-Brackmann scale, a commonly used evaluation scale for facial paralysis motor function, and set standards for eye fissure and lips. According to the improved scale, the authors assessed and graded the degree of facial paralysis in terms of facial nerve dysfunction both before and after treatment. The grade was divided into five levels: mild, moderate, moderately severe, severe dysfunction and complete paralysis. The authors gave acupuncture treatment according to the state of the disease without artificially setting the treatment period. The observation was focused on the efficacy and the efficacy was evaluated throughout the entire treatment process.
Fifty-three cases out of 68 patients with Bell's palsy were cured and the overall rate of efficacy was 97%. Statistically significant differences (P<0.01) were perceived among the efficacy of five levels of facial nerve dysfunction. Efficacy was correlated with the damage level of the disease (correlation coefficient r=0.423, P<0.01). The course of treatment also extended with the severity of facial nerve dysfunction (P<0.01).
Differences exist in patients with Bell's palsy in terms of severity of facial nerve dysfunction. Efficacy is reduced in correlation with an increase in facial nerve dysfunction, and the period of treatment varies in need of different levels of facial nerve dysfunction. It is highly necessary to assess and grade patients before observation and treatment in clinical study, and choose corresponding treatment according to severity of damage of the disease.
在贝尔面瘫针刺治疗的临床过程中，根据面瘫程度对面神经功能障碍进行评估和分级，观察分级、疗效与疗程之间的相互关系以及对预后的影响。
采用常用的面瘫运动功能评估量表House-Brackmann量表，并设定眼裂和嘴唇的标准。根据改良后的量表，在治疗前后对面神经功能障碍所致面瘫程度进行评估和分级。分级分为五个级别：轻度、中度、中重度、重度功能障碍和完全瘫痪。根据病情进行针刺治疗，不人为设定疗程。观察重点为疗效，并在整个治疗过程中对疗效进行评估。
68例贝尔面瘫患者中53例治愈，总有效率为97%。面神经功能障碍五个级别的疗效之间存在统计学显著差异（P<0.01）。疗效与疾病损伤程度相关（相关系数r=0.423，P<0.01）。疗程也随着面神经功能障碍的严重程度而延长（P<0.01）。
贝尔面瘫患者在面神经功能障碍严重程度方面存在差异。疗效随着面神经功能障碍的增加而降低，疗程因面神经功能障碍程度不同而各异。在临床研究中，观察和治疗前对患者进行评估和分级，并根据疾病损伤的严重程度选择相应的治疗方法非常必要。
