针刺研究2025，Vol.50Issue(12)：1449-1455,7.DOI:10.13702/j.1000-0607.20240877
不同强度电针治疗周围性面瘫患者的疗效及对脑干兴奋性的影响
Therapeutic effect of electroacupuncture at different intensities on peripheral facial paralysis and its influence on brainstem excitability
摘要
Abstract
Objective To observe the clinical effect of electroacupuncture(EA)at different intensities on peripheral facial paralysis(PFP)and its influence on brainstem excitability.Methods Sixty-six patients with PFP were randomly assigned to a motion-threshold EA group(22 cases,2 dropped out),a sensory-threshold EA group(22 cases,1 dropped out)and a sham-EA group(22 cases,2 dropped out).Sibai(ST2),Dicang(ST4),Hegu(LI4)and Yuji(LU10)on the affected side were selected in 3 groups and stimulated with EA.In the motion-threshold EA group,the stimulation intensity was determined by the visible muscle jumping in the local area.In the sensory-threshold EA group,the minimal sensory stimulation was adjusted.In the sham-EA group,the skin was not invaded and no electric stimulation was delivered.In each group,the intervention was given once every 3 days,30 min each time and the duration of treatment was composed of 20 interventions.At the baseline(T0),after the 10th intervention(T1),after the 20th intervention(T2)and in 1 month followup after treatment completion(T3),the House-Brackmann scale for grading facial nerve function(H-B score)and the facial disability index(FDI,comprising physical function[FDIP]and social function[FDIS])were assessed separately.Besides,the changes of facial nerve injury rate and blink reflex(BR)were observed before and after treatment.Results In the self-group comparison,H-B score at T2 and T3 was improved significantly compared with that at T0(P<0.001,P<0.05)in the motion-threshold EA and sensory-threshold EA groups separately;FDIP score was increased significantly at T2 and T3 in the motion-threshold EA group(P<0.001),and FDIP score was increased significantly at T2 in the sensory-threshold EA group(P<0.01);the FDIS score was reduced significantly from T1 to T3 in the motion-threshold EA group(P<0.05,P<0.001),and it was reduced significantly at T2 and T3 in the sensory-threshold EA group(P<0.001,P<0.05).In comparison with the sham-EA group at the same time point,H-B score and FDIS score at T2 and T3 were decreased in the motion-threshold EA group and the sensory-threshold EA group(P<0.01,P<0.05,P<0.001).After treatment completion,in the motion-threshold EA group and the sensory-threshold EA group,the injury rate of the temporal and buccal branches of the facial nerve was declined(P<0.01,P<0.001)compared with baseline,and it was lower than that of the sham-EA group(P<0.001,P<0.01).Besides,the R2 latency was shorter in comparison with the baseline in the motion-threshold EA group and the sensory-threshold EA group(P<0.01),and the latency in the motion-threshold EA group was superior to the sensory-threshold EA group(P<0.05).Conclusion EA at both motion threshold and sensory threshold obtains a similar therapeutic effect on PFP,and it effectively relieves symptoms of PFP and presents a certain long-term effect.Motor-threshold EA demonstrates modulatory effect on the brainstem's neural reflex pathway.关键词
周围性面瘫/后遗症/电针/刺激强度/随机对照试验/脑干兴奋性Key words
Peripheral facial paralysis/Sequelae/Electroacupuncture/Stimulation intensity/Randomized controlled trial/Brainstem excitability引用本文复制引用
HUANG Jian-peng,ZHONG Chen-xin,ZHENG Yu-miao,LI Wen-ting,LIANG Xiu-ya,LI Sheng,LI Kai,LIU Jian-hua..不同强度电针治疗周围性面瘫患者的疗效及对脑干兴奋性的影响[J].针刺研究,2025,50(12):1449-1455,7.基金项目
广东省中医药管理局科研项目(No.20221169) （No.20221169）
国家自然科学基金项目(No.82104979) （No.82104979）
广东省中医院中医药科学技术研究专项资助项目(No.YN2022QN14) （No.YN2022QN14）
