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[攒竹(BL2)、鱼腰(EX-HN4)透刺配合申脉(BL62)直刺对面神经炎患者眼轮匝肌的影响]

[Influence on orbicularis oculi muscle in the patients with facial neuritis treated with the penetra-ting needling at Cuanzhu (BL2) and Yuyao (EX-HN4) combined with the perpendicular needling at Shenmai (BL62)].

作者信息

Xu Li-Wei, Quan Xing-Miao, Song Chun-Xia, Liu Yu-Lan, Xu Hong-Yan

机构信息

Department of Chinese Medicine, Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China.

出版信息

Zhen Ci Yan Jiu. 2020 Sep 25;45(9):735-9. doi: 10.13702/j.1000-0607.190894.

Abstract

OBJECTIVE

To explore the therapeutic effect on incomplete eyelid in the patients with facial neuritis treated with the penetrating needling at Cuanzhu (BL2) and Yuyao (EX-HN4) combined with the perpendicular needling at Shenmai (BL62).

METHODS

A total of 64 patients with facial neuritis, in compliance with the inclusion criteria, were randomized into a treatment group and a control group, with 32 cases in each. In the treatment group, the penetrating needling was applied to BL2 and EX-HN4 on the affected side, combined with the perpendicular needling at bilateral BL62. Besides, on the affected side, the penetrating needling was applied from Yangbai (GB14) toward four directions, named Shangxing (GV23), Touwei (ST8), Cuanzu (BL2) and Sizukong (TE23), the mutual penetrating needling was adopted between Dicang (ST4) and Jiache (ST6). Between Yingxiang (LI20) and Xiaguan (ST7), a row-arranged needling technique was applied. All of the needles were retained for 10 to 30 min in each treatment. The treatment was given once daily and the treatment for 10 days was as 1 course. A total of 2 courses of treatment were required. In the control group, prednisone acetate (30 mg/d), was administered consecutively for 5 days. Afterward, the dose was reduced to be 10 mg/d and the medication stopped after taking consecutively for 1 week. Muscular injection with vitamin B (0.5 mg) and B (0.1 mg) was given, once daily. 10 days later, vitamin B1 was taken for oral administration, 10 mg each time, three times a day, for 10 days totally. Before and after the treatment, the clinical effect was compared between the two groups in terms of the analysis on the Hourse-Brackman (H-B) grade of facial nerve function, the distance between the upper and the lower eyelids, muscle strength, degree of eyelid closure and electromyogram (EMG).

RESULTS

The total effective rate of treatment group was 96.9 % (31/32), better than 84.4%(27/32) in the control group (<0.05). After treatment, in the treatment group, the distance between the upper and lower eyelids, the muscle strength, the degree of eyelid closure, the wave amplitude of motor nerve conduction and the latent period, as well as the blink reflex were all improved as compared with those before the treatment (<0.01, <0.05). In the control group, the distance between the upper and lower eyelids, the muscle strength, the degree of eyelid closure, the latent period of motor nerve conduction and the blink reflex were all improved as compared with those before the treatment (<0.01, <0.05). After the treatment, the results of the distance between the upper and lower eyelids, the muscle strength, the degree of eyelid closure, the wave amplitude of motor nerve conduction and the latent period, as well as the blink reflex in the treatment group were all better than those in the control group (<0.05,<0.01).

CONCLUSION

The treatment with the penetrating needling at Cuanzhu (BL2) and Yuyao (EX-HN4) combined with the perpendicular needling at Shenmai (BL62) greatly promotes the recovery of orbicularis oculi muscle in the patients with facial neuritis, reduces the complications and presents the satisfactory clinical effect.

摘要

目的

探讨攒竹(BL2)、鱼腰(EX-HN4)透刺配合申脉(BL62)直刺治疗面神经炎致眼睑闭合不全的疗效。

方法

将符合纳入标准的64例面神经炎患者随机分为治疗组和对照组,每组32例。治疗组采用患侧攒竹、鱼腰透刺,配合双侧申脉直刺;患侧自阳白(GB14)分别向头维(ST8)、攒竹(BL2)、丝竹空(TE23)、上星(GV23)四个方向透刺,地仓(ST4)与颊车(ST6)互透,迎香(LI20)与下关(ST7)排刺。每次留针10~30分钟,每日1次,10天为1疗程,共治疗2个疗程。对照组口服醋酸泼尼松,第1~5天30mg/d,之后减为10mg/d,连服1周停药;肌肉注射维生素B₁0.5mg、维生素B₁₂0.1mg,每日1次,10天后改为口服维生素B₁,每次10mg,每日3次,连服10天。比较两组治疗前后面神经功能House-Brackman(H-B)分级、上下睑距离、肌力、眼睑闭合程度及肌电图(EMG)等情况,评价临床疗效。

结果

治疗组总有效率为96.9%(31/32),优于对照组的84.4%(27/32)(P<0.05)。治疗后,治疗组上下睑距离、肌力、眼睑闭合程度、运动神经传导波幅及潜伏期、瞬目反射等指标均较治疗前改善(P<0.01,P<0.05);对照组上下睑距离、肌力、眼睑闭合程度、运动神经传导潜伏期及瞬目反射等指标较治疗前改善(P<0.01,P<0.05)。治疗后,治疗组上下睑距离、肌力、眼睑闭合程度、运动神经传导波幅及潜伏期、瞬目反射等指标均优于对照组(P<0.05,P<0.01)。

结论

攒竹(BL2)、鱼腰(EX-HN4)透刺配合申脉(BL62)直刺治疗面神经炎,能促进患侧眼轮匝肌恢复,减少并发症,临床疗效满意。

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