中国针灸2026，Vol.46Issue(3)：328-334,7.DOI:10.13703/j.0255-2930.20250205-k0007
针刀联合针刺治疗急性期周围性面瘫伴乳突区疼痛:随机对照试验
Acupotomy combined with acupuncture for acute peripheral facial paralysis with mastoid region pain:a randomized controlled trial
摘要
Abstract
Objective To observe the clinical efficacy of acupotomy combined with acupuncture for acute peripheral facial paralysis with mastoid region pain.Methods Sixty patients of acute peripheral facial paralysis with mastoid region pain were randomly divided into an observation group(30 cases,1 case dropped out)and a control group(30 cases,1 case dropped out and 1 case excluded).The control group was treated with conventional acupuncture at affected-side Yangbai(GB14),Yifeng(TE17),Xiaguan(ST7),Quanliao(SI18),Yingxiang(LI20),Dicang(ST4),Chengjiang(CV24),Wangu(GB12),Qianzheng(EX-HN16),Taiyang(EX-HN5),Cuanzhu(BL2),as well as bilateral Hegu(LI4)and Zusanli(ST36),the treatment was administered once daily,six days per week with one day of rest,for a total of three weeks.In addition to the above acupuncture regimen,the observation group was treated with acupotomy treatment targeting areas near Wangu(GB12),Yifeng(TE17),Fengchi(GB20),Tianzhu(BL10),and muscular knotting sites of the hand and foot yangming,taiyang,and hand shaoyang meridians,treatment was performed once per week for three weeks.Before and after treatment,House-Brackmann(H-B)facial nerve grading scores,Sunnybrook facial grading scores,and the duration of mastoid region pain were evaluated.Electromyography(EMG)was used to assess latency and amplitude ratios(affected/healthy side)of the frontal,orbicularis oculi,and orbicularis oris muscles.Adler blood flow grading of the facial nerve was evaluated by ultrasound.Serum levels of hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6)were measured.Clinical efficacy was also assessed in both groups.Results The duration of mastoid region pain in the observation group was shorter than that in the control group(P＜0.05).Compared with before treatment,both groups showed increased H-B facial nerve grading scores and Sunnybrook facial grading scores after treatment(P＜0.05);latency of frontal,orbicularis oculi,and orbicularis oris muscles on the affected side was reduced(P＜0.05);amplitude ratios of affected/healthy side were increased(P＜0.05);Adler blood flow grades were improved(P＜0.05);and serum levels of hs-CRP,TNF-α,and IL-6 were decreased(P＜0.05).Compared with the control group,the observation group showed better outcomes in all the above indexes after treatment(P＜0.05).The total effective rate in the observation group was 93.1%(27/29),higher than that in the control group(82.1%,23/28,P＜0.05).Conclusion Acupotomy combined with acupuncture could promote recovery of facial nerve function and shorten the duration of mastoid region pain in patients with acute peripheral facial paralysis with mastoid region pain.关键词
周围性面瘫,急性期/乳突区疼痛/针刀/针刺/随机对照试验Key words
peripheral facial paralysis,acute stage/mastoid region pain/acupotomy/acupuncture/randomized controlled trial(RCT)引用本文复制引用
严保雷,张振丰,闫银力,吴伟伟,姜天鑫,李飞..针刀联合针刺治疗急性期周围性面瘫伴乳突区疼痛:随机对照试验[J].中国针灸,2026,46(3):328-334,7.基金项目
国家青年岐黄学者支持项目:国中医药人教函[2022]256号 （）
安徽省高等学校科学研究项目:2023AH050794 （）
安徽省自然研究重点项目:2024AH050918 （）
安徽省第三批师承继承项目:0252-02-01 （）
