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重复经颅针刺刺激联合电针治疗伴耳后疼痛的急性面神经麻痹:一项随机对照试验

[Repetitive transcranial acupuncture stimulation combined with electroacupuncture in treatment of acute facial palsy with retroauricular pain: a randomized controlled trial].

作者信息

Zhu Pengyu, Sun Mingmei, Tang Xinying, Zhang Xinhaoning, Guo Ying

机构信息

Department of Acupuncture and Moxibustion, Second Affiliated Hospital of Heilongjiang University of CM, Harbin 150001, China.

First Affiliated Hospital of Heilongjiang University of CM.

出版信息

Zhongguo Zhen Jiu. 2024 May 12;44(5):489-94. doi: 10.13703/j.0255-2930.20231014-k0003.

DOI:10.13703/j.0255-2930.20231014-k0003
PMID:38764097
Abstract

OBJECTIVE

To observe the clinical effect of repetitive transcranial acupuncture stimulation (rTAS) combined with electroacupuncture (EA) in treatment of acute facial palsy with retroauricular pain.

METHODS

Sixty-eight patients of acute facial palsy with retroauricular pain were randomly divided into an observation group (34 cases, 3 cases dropped out) and a control group (34 cases, 3 cases dropped out). On the basis of conventional therapy, in the control group, Yangbai (GB 14), Cuanzhu (BL 2), Sibai (ST 2), Quanliao (SI 18), Dicang (ST 4), Yifeng (TE 17), Qianzheng (Extra point) and Taiyang (EX-HN 5) on the affected side, and bilateral Hegu (LI 4) were selected. EA was attached to Yangbai (GB 14) and Cuanzhu (BL 2), and Sibai (ST 2) and Dicang (ST 4), respectively, using intermittent wave. In the observation group, on the basis of the regimen as the control group, rTAS was delivered at Baihui (GV 20) and the 1/5 of the lower motor area on the bilateral sides; EA of dense wave was given at the sites of the mastoidⅠand Ⅱ. The intervention of each group was delivered once a day, 6 times a week as one course for 4 courses and taking a day off every course. Before treatment and at the moment after the first treatment completion, the score of visual analogue scale (VAS) was observed in the two groups and the days of retroauricular pain were recorded. Before and after treatment, the score of Sunnybrook facial grading system (SFGS), the grade of House-Brackmann facial nerve function evaluation system (H-B), the latency and amplitude of the motor conduction from the foramina stylomastoideum to the frontal muscle, the orbicularis oris muscle and the orbicularis oculi muscle on the affected facial nerve, were observed in the patients of two groups and the clinical effect was compared between the two groups after treatment.

RESULTS

After treatment, SFGS score was increased (<0.05), H-B grade was improved (<0.05), the latency was shortened in the motor conduction from the foramina stylomastoideum to the frontal muscle, the orbicularis oris muscle and the orbicularis oculi muscle on the affected facial nerve (<0.05) and its amplitude elevated (<0.05) when compared with those before treatment in the two groups. In the observation group, SFGS score was higher (<0.05), H-B grade was superior (<0.05), the latency was shorter in the motor conduction from the foramina stylomastoideum to the frontal muscle, the orbicularis oris muscle and the orbicularis oculi muscle on the affected facial nerve (<0.05) and its amplitude was higher (<0.05) when compared with those of the control group after treatment. After the completion of the first treatment, VAS score of either group was reduced in comparison with that before treatment (<0.05), and the score in the observation group was lower than that of the control group (<0.05). The duration of retroauricular pain was shortened in the observation group when compared with that of the control group (<0.05). The total effective rate was 87.1% (27/31) in the observation group, which was higher than 77.4% (24/31) of the control group (<0.05).

CONCLUSION

The rTAS combined with EA is effective for reducing neurologic impairment of acute facial palsy and alleviating retroauricular pain in the patients.

摘要

目的

观察重复经颅针刺刺激(rTAS)联合电针(EA)治疗急性面瘫伴耳后疼痛的临床疗效。

方法

将68例急性面瘫伴耳后疼痛患者随机分为观察组(34例,脱落3例)和对照组(34例,脱落3例)。两组均在常规治疗基础上,对照组选取患侧阳白(GB 14)、攒竹(BL 2)、四白(ST 2)、颧髎(SI 18)、地仓(ST 4)、翳风(TE 17)、牵正(奇穴)、太阳(EX-HN 5),双侧合谷(LI 4)。电针分别连接阳白(GB 14)与攒竹(BL 2)、四白(ST 2)与地仓(ST 4),采用疏密波。观察组在对照组治疗方案基础上,于百会(GV 20)及双侧面神经下运动神经元区1/5处进行rTAS;乳突Ⅰ、Ⅱ区给予密波电针。两组干预均每日1次,每周6次为1个疗程,共4个疗程,每个疗程间休息1天。观察两组治疗前及首次治疗结束后即刻的视觉模拟评分(VAS),记录耳后疼痛天数。观察两组患者治疗前后的Sunnybrook面部分级系统(SFGS)评分、House-Brackmann面神经功能评价系统(H-B)分级、患侧面神经从茎乳孔到额肌、口轮匝肌及眼轮匝肌运动传导的潜伏期和波幅,并比较两组治疗后的临床疗效。

结果

治疗后,两组SFGS评分升高(P<0.05),H-B分级改善(P<0.05),患侧面神经从茎乳孔到额肌、口轮匝肌及眼轮匝肌运动传导的潜伏期缩短(P<0.05),波幅升高(P<0.05)。治疗后,观察组SFGS评分更高(P<0.05),H-B分级更优(P<0.05),患侧面神经从茎乳孔到额肌、口轮匝肌及眼轮匝肌运动传导的潜伏期更短(P<0.05),波幅更高(P<0.05)。首次治疗结束后,两组VAS评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。观察组耳后疼痛持续时间短于对照组(P<0.05)。观察组总有效率为87.1%(27/31),高于对照组的77.4%(24/31)(P<0.05)。

结论

rTAS联合EA可有效减轻急性面瘫患者的神经功能损害,缓解耳后疼痛。

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