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基于表面肌电图观察针刺对急性期贝尔面瘫患者的影响

[Effects of acupuncture on Bell's palsy patients in the acute stage based on the surface electromyography].

作者信息

Li Xiao-Wei, Chen Jia-Jie, Shu Yu-Ling, Deng Xin-Yuan, Zhang Yu, Yang Jun, Shi Hai-Ping

机构信息

Department of Tuina, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China.

College of Acupuncture-Moxibustion and Tuina, Anhui University of Chinese Medicine, Hefei 230031.

出版信息

Zhen Ci Yan Jiu. 2025 Mar 25;50(3):327-333. doi: 10.13702/j.1000-0607.20240016.

Abstract

OBJECTIVES

To investigate the effects of acupuncture on the muscle strength and fatigue levels of facial muscles of the patients with Bell's facial paralysis in the acute stage, using surface electromyography.

METHODS

Sixty patients diagnosed with acute Bell's facial paralysis were randomly assigned to an observation group (30 cases) and a control group (30 cases). In the observation group, the routine acupuncture was applied to Quanliao (SI18), Yangbai (GB14), Yifeng (TE17), Jiache (ST6) and Dicang (ST4) on the affected side and Hegu (LI4) on the healthy side. The needles were retained for 30 min, and acupuncture was delivered once every two days. In the control group, prednisone acetate combined with methylcobalamin tablets were administered orally. The interventions lasted till to the 28 day of illness in the two groups. At the baseline and after treatment, the root mean square amplitude (RMS) ratio and the median frequency (MF) of the frontal muscle, zygomatic muscle and orbicularis oculi muscle and the changes in the scores of H-B scale and Sunnybrook facial nerve function were observed in the two groups. The correlation was analyzed between the indicators detected by surface electromyography and the scale score, the clinical effect was compared and recovery time survival analysis was performed.

RESULTS

The RMS ratio and MF of the facial muscles (frontal, zygomatic, and orbicularis oculi muscles) were increased in both groups compared with pretreatment (0.01, 0.05), and RMS ratio in the observation group was higher than that of the control group after treatment (0.05). After intervention, the H-B scale score and Sunnybrook score were improved in both groups compared with those pretreatment (0.01), and the scores in the observation groups were superior to the control group (0.01). Survival analysis of curative time showed that the curative time in the observation group was shorter than that of the control group (0.05). After interventions, the cured and markedly effective rate of the observation group was 93.33% (28/30), which was higher than that (76.67%, 23/30) of the control group (<0.05). Correlation analysis revealed that the H-B and Sunnybrook scores were negatively correlated with the RMS ratios of the frontal, zygomatic and orbicularis oculi muscles at the baseline and after treatment (<0.01);and the correlation was not presented with MF.

CONCLUSIONS

The intervention with acupuncture in the acute stage of Bell's palsy markedly increases the muscle strength of facial muscles, relieves muscular fatigue and shortens the curative time. The correlation analysis between the scale score and RMS ratios indicates that RMS ratios can be taken as one of the objective indicators in clinical assessment of the severity of facial paralysis.

摘要

目的

采用表面肌电图,探讨针刺对急性期贝尔面瘫患者面部肌肉力量及疲劳程度的影响。

方法

将60例确诊为急性贝尔面瘫的患者随机分为观察组(30例)和对照组(30例)。观察组在患侧针刺颧髎(SI18)、阳白(GB14)、翳风(TE17)、颊车(ST6)、地仓(ST4),健侧针刺合谷(LI4),留针30分钟,每两天针刺1次。对照组口服醋酸泼尼松联合甲钴胺片。两组干预均持续至发病第28天。观察两组在基线期及治疗后额肌、颧肌、眼轮匝肌的均方根振幅(RMS)比值、中位频率(MF)以及H-B量表评分和Sunnybrook面神经功能评分的变化。分析表面肌电图检测指标与量表评分的相关性,比较临床疗效并进行恢复时间生存分析。

结果

与治疗前相比,两组面部肌肉(额肌、颧肌、眼轮匝肌)的RMS比值和MF均升高(P<0.01,P<0.05),且治疗后观察组的RMS比值高于对照组(P<0.05)。干预后,两组H-B量表评分和Sunnybrook评分均较治疗前改善(P<0.01),且观察组评分优于对照组(P<0.01)。疗效时间生存分析显示,观察组的治愈时间短于对照组(P<0.05)。干预后,观察组的痊愈和显效率为93.33%(28/30),高于对照组的76.67%(23/30)(P<0.05)。相关性分析显示,基线期及治疗后H-B量表评分和Sunnybrook评分与额肌、颧肌、眼轮匝肌的RMS比值呈负相关(P<0.01);与MF无相关性。

结论

贝尔面瘫急性期针刺干预可显著增强面部肌肉力量,缓解肌肉疲劳,缩短治愈时间。量表评分与RMS比值的相关性分析表明,RMS比值可作为临床评估面瘫严重程度的客观指标之一。

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