摘要
目的:比较急性期和恢复期介入针灸对特发性面神经麻痹(IFP)的影响。方法:根据是否在急性期内接受针灸干预将198例IFP患者分为早期针灸组(118例)和非早期针灸组(80例),经倾向性评分匹配(PSM),最终早期针灸组与非早期针灸组各纳入70例。在西医常规治疗基础上,两组均接受针灸治疗,早期针灸组于急性期(病程≤7 d)介入针灸,非早期针灸组于恢复期(病程>7 d)介入针灸。急性期予温针灸治疗,穴取患侧翳风、下关、合谷、足三里;恢复期予电针治疗,穴取患侧攒竹、丝竹空、阳白等,予疏密波,频率2 Hz/100 Hz。均每次30 min,隔日1次,每周3次,共治疗4周。比较两组患者治疗前、治疗1周和治疗4周后House-Brackmann(H-B)面神经功能分级、Sunnybrook面神经功能评分和面部残疾指数(FDI)评分。并于治疗1、4周后评定两组临床疗效和安全性。结果:治疗1、4周后,两组患者H-B面神经功能分级均较治疗前改善(P<0.05);治疗4周后,早期针灸组H-B面神经功能分级优于非早期针灸组(P<0.05)。治疗1、4周后,两组患者Sunnybrook面神经功能评分、躯体功能评定(FDIP)评分较治疗前升高(P<0.05);治疗4周后,早期针灸组Sunnybrook面神经功能评分、FDIP评分升高幅度大于非早期针灸组(P<0.05)。治疗4周后,两组社会生活功能评定(FDIS)评分较治疗前降低(P<0.05)。治疗4周后,早期针灸组总有效率(97.1%,68/70)高于非早期针灸组(87.1%,61/70,P<0.05)。两组不良事件发生率比较差异无统计学意义(P>0.05)。结论:在急性期介入针灸较恢复期介入针灸更有利于IFP患者受损面神经功能康复。
Objective To compare the effect of acupuncture-moxibustion on idiopathic facial palsy(IFP)at acute phase and recovery phase.Methods According to whether received acupuncture-moxibustion at acute phase or not,198 IFP patients were divided into an early-phase intervention group(118 cases)and a non-early-phase intervention group(80 cases).With the propensity score matching employed,70 cases were included in each group.On the basis of the conventional treatment of western medicine,acupuncture-moxibustion was supplemented in the two groups.In the early-phase intervention group,acupuncture-moxibustion was delivered at the acute phase(duration of illness≤7 days);in the non-early-phase intervention group,acupuncture-moxibustion was operated at the recovery phase(duration of illness>7 days).At the acute phase,warm needling was performed at Yifeng(TE17),Xiaguan(ST7),Hegu(LI4)and Zusanli(ST36)on the affected side;and at the recovery phase,electroacupuncture was delivered at Cuanzhu(BL2),Sizhukong(TE23)and Yangbai(GB14),etc.on the affected side,with the disperse-dense wave and 2 Hz/100 Hz of frequency.The intervention was operated for 30 min each time,once every two days,three treatments weekly and for 4 weeks.Before treatment,1 week and 4 weeks of treatment,the House-Brackmann(H-B)facial nerve function grade,the score of Sunnybrook facial nerve function,and the score of facial disability index(FDI)were compared between the two groups.The clinical effect in 1 and 4 weeks of treatment and safety were evaluated.Results In 1 and 4 weeks of treatment,the H-B grade was improved when compared with that before treatment in each group(P<0.05),and in 4 weeks of treatment,H-B grade in the early-phase intervention group was superior to that of the non-early-phase intervention group(P<0.05).In 1 and 4 weeks of treatment,Sunnybrook scores and the scores of physical function of FDI were elevated in comparison with those before treatment in the two groups(P<0.05);and in 4 weeks of treatment,the elevation of these two indexes in the early-phase intervention group was greater than that of the non-early-phase intervention group(P<0.05).In 4 weeks of treatment,the scores of social function in FDI were reduced when compared with those before treatment in the two groups(P<0.05).In 4 weeks of treatment,the total effective rate(97.1%,68/70)in the early-phase intervention group was higher than that(87.1%,61/70)of the non-early-phase intervention group(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).Conclusion Acupuncture-moxibustion therapy starting at the acute phase is more beneficial to the functional recovery of the impaired facial nerve than at the recovery phase in the IFP patients.
作者
胡林雁
孙建华
裴丽霞
陈璐
HU Linyan;SUN Jianhua;PEI Lixia;CHEN Lu(Department of Acupuncture and Rehabilitation,Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Provincial Hospital of TCM,Nanjing 210029,China)
出处
《中国针灸》
北大核心
2025年第2期133-138,共6页
Chinese Acupuncture & Moxibustion
基金
江苏省中医药科技发展计划项目:ZD202223
江苏省中医院高峰学术人才培养资金资助项目:y2021rc04。
关键词
特发性面神经麻痹
急性期
针灸
真实世界研究
介入时机
倾向性评分匹配
idiopathic facial nerve palsy,acute phase
acupuncture-moxibustion
real-world study
opportunity of intervention
propensity score matching
