世界中医药

目的:观察透刺联合桃红四物汤对静止期瘀血性面瘫的临床疗效、肌电表现和面神经运动情况。方法:随机选取2016年2月至2017年2月在乌鲁木齐市中医医院门诊及住院部就诊的静止期瘀血性面瘫患者60例。通过抽取随机数字法分为观察组与对照组,每组30例,对照组在基础治疗的基础上加用桃红四物汤;观察组在对照组治疗方案基础上施予透刺疗法。采用House-Brackman分级量表评估面神经功能;应用肌电图机在患侧额肌、眼轮匝肌、上唇方肌和口轮匝肌,记录肌肉的肌电表现和测量运动诱发动作电位起始处的潜伏期和M波波幅。结果:1）治疗后干预组House-Brackman评分低于对照组（P<0.05）。2）观察组痊愈率（66.67%）明显高于对照组（46.67%）（P<0.05）。3）2组患者治疗前肌电表现以静息电位和去神经电位为主（P>0.05）;治疗后2组患者再生电位、减弱运动电位和正常电位产生较治疗前多（P<0.05）,观察组优于对照组（P<0.05）。4）治疗后2组患者潜伏期均缩短（P<0.05）,而M波波幅增大（P<0.05）;观察组的改善情况面神经运动潜伏期和M波波幅均优于对照组（P<0.05）。结论:透刺联合桃红四物汤能有效改善静止期瘀血性面瘫的症状,其机制可能与激活更多的再生电位、减弱运动电位和正常电位有关。

English Summary:

To observe the clinical curative effect of Taohong Siwu Decoction with penetrative acupuncture on facial paralysis of blood stasis at rest stage and its impact on facial nerve and EMG movement. Methods: Sixty cases with facial paralysis of blood stasis at rest stage were randomly selected from February 2016 to February 2017 in the outpatient and inpatient department of Acupuncture Department of the hospital and were randomly divided into the observation group and control group, with 30 cases in each group. Patients in the control group received conventional treatment combined with Taohong Siwu Decoction, while patients in the observation group additionally were given penetrative acupuncture. The House-Brackman grading scale was applied to assess facial nerve function. EMG device was used in the ipsilateral frontal muscle, orbicularis muscle and upper lip muscle and orbicularis muscle to record electromyography and measure action potentials induced by exercise at the start of the latency and amplitude of M wave. Results: 1） The House-Brackman score of the observation group was lower than that of the control group （P<0.05）. 2） The curative rate of the observation group （66.67%） was significantly higher than that of the control group （46.67%）（P<0.05）. 3） EMG resting potentials and denervation potentials were mainly manifested in the two groups before the treatment （P>0.05）; regeneration potential, decreased movement potential and the normal potential of the two groups after treatment were increased than those before the treatment （P<0.05） and the observation group was superior to the control group （P<0.05）. 4） After treatment, the latency of both the two groups were shortened （P<0.05） and the M-wave amplitude was increased （P<0.05）. The improvement of facial nerve latency and M-wave amplitude in the observation group were better than those of the control group （P<0.05）. Conclusion: Taohong Siwu Decoction combined with penetrative acupuncture may improve the symptoms of facial paralysis of blood stasis at stationary phase, and its mechanism may be related to the increase of regeneration potential, decreased movement potential and normal potential.

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