| 引用本文: |
肖云, 蒋胜利, 顾焱, 周思源, 岳露露, 陆少武.子午流注纳甲法联合揿针治疗特发性面神经麻痹的临床疗效观察[J].湖南中医药大学学报,2025,45(1):80-85[点击复制] |
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| 子午流注纳甲法联合揿针治疗特发性面神经麻痹的临床疗效观察 |
| 肖云,蒋胜利,顾焱,周思源,岳露露,陆少武 |
| (张家港市第五人民医院针灸理疗科, 江苏 苏州 215621;张家港市第五人民医院肝病科, 江苏 苏州 215621;张家港市第五人民医院中医科, 江苏 苏州 215621) |
| 摘要: |
| 目的 探讨子午流注纳甲法联合揿针治疗特发性面神经麻痹（IFP）的临床疗效。方法 选取2023年1月至2023年12月张家港市第五人民医院针灸理疗科收治的IFP患者96例作为研究对象，按照随机数字表法分为对照组（n=32）、治疗A组（n=32）和治疗B组（n=32）。对照组采用常规辨证取穴治疗，治疗A组采用常规辨证取穴与子午流注纳甲法取穴治疗，治疗B组采用常规辨证取穴与子午流注纳甲法取穴配合揿针治疗，3组均连续治疗4周。比较3组临床疗效、中医症候积分、神经功能[采用面部残疾指数（FDI）评分量表和Sunnybrook面神经评定系统评估]、神经营养因子[神经生长因子（NGF）、胶质细胞源性神经营养因子（GDNF）]、血流动力学指标[收缩期峰值血流速度（PSV）、阻力指数（RI）]和不良反应。结果 治疗B组总有效率高于治疗A组和对照组（P<0.05）。治疗后，治疗B组的中医症候积分（口眼(口呙)斜、面部僵硬麻木、眼睑下垂或闭合不全）低于治疗A组和对照组（P<0.05）；治疗B组面部残疾指数-躯体功能（FDIP）评分、面部残疾指数-社会功能（FDIS）评分和Sunnybrook评分高于治疗A组和对照组（P<0.05）。治疗后，治疗B组血清NGF、GDNF水平高于治疗A组和对照组（P<0.05）；治疗B组PSV水平高于治疗A组和对照组（P<0.05）,RI水平低于治疗A组和对照组（P<0.05）。3组不良反应发生率比较，差异无统计学意义（P>0.05）。结论 子午流注纳甲法联合揿针治疗IFP患者的效果显著，可有效提高神经功能，促进NGF、GDNF表达，改善面部血流动力学。 |
| 关键词: 特发性面神经麻痹 子午流注纳甲法 揿针 神经功能 神经营养因子 血流动力学 |
| DOI：10.3969/j.issn.1674-070X.2025.01.011 |
| 投稿时间：2024-06-24 |
| 基金项目:张家港市科技计划项目(ZKYL2254)。 |
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| Clinical observation on the efficacy of midnight-noon ebb-flow day-stem point selection combined with thumbtack needle therapy for idiopathic facial paralysis |
| XIAO Yun, JIANG Shengli, GU Yan, ZHOU Siyuan, YUE Lulu, LU Shaowu |
| (Department of Acupuncture and Physical Therapy, Zhangjiagang Fifth People's Hospital, Suzhou, Jiangsu 215621, China;Department of Hepatology, Zhangjiagang Fifth People's Hospital, Suzhou, Jiangsu 215621, China;Department of Chinese Medicine, Zhangjiagang Fifth People's Hospital, Suzhou, Jiangsu 215621, China) |
| Abstract: |
| Objective To explore the clinical efficacy of midnight-noon ebb-flow day-stem point selection combined with thumbtack needle therapy in treating idiopathic facial paralysis（IFP）. Methods Ninety-six patients with IFP admitted to the Department of Acupuncture and Physical Therapy of Zhangjiagang Fifth People’s Hospital from January 2023 to December 2023 were selected as the study subjects. They were divided into control group（n=32）, treatment group A（n=32）, and treatment group B（n=32） according to the random number table method. The control group was treated with conventional acupoint selection based on pattern identification, the treatment group A was treated with conventional acupoint selection based on pattern identification and midnight-noon ebb-flow day-stem method. The treatment group B was treated with conventional acupoint selection based on pattern identification and midnight-noon ebb-flow day-stem method combined with thumbtack needle therapy. All three groups were treated continuously for four weeks. The clinical efficacy, Chinese medicine pattern scores,neurological function [assessed using the Facial Disability Index（FDI） scale and the Sunnybrook facial nerve rating system],neurotrophic factors [nerve growth factor（NGF）, glial cell derived neurotrophic factor（GDNF）], hemodynamic parameters [peak systolic velocity（PSV）, resistance index（RI）], and adverse reactions were compared among the three groups. Results The total effective rate of treatment group B was higher than that of treatment group A and the control group（P＜0.05）. After treatment, the Chinese medicine pattern scores（including scores for facial asymmetry, facial stiffness and numbness, ptosis or incomplete eyelid closure） in treatment group B were lower than those in treatment group A and the control group（P＜0.05）. The scores for facial disability index physical functions（FDIP）, facial disability index social functions（FDIS）, and Sunnybrook in treatment group B were higher than those in treatment group A and the control group（P＜0.05）. After treatment, the serum levels of NGF and GDNF in treatment group B were higher than those in treatment group A and the control group（P＜0.05）. The PSV level in treatment group B was higher than that in treatment group A and the control group（P＜0.05）, while the RI level was lower（P＜0.05）. There was no statistically significant difference in the incidence of adverse reactions among the three groups（P＞0.05）. Conclusion Midnightnoon ebb-flow day-stem point selection combined with thumbtack needle therapy shows significant efficacy in patients with IFP,effectively improving neurological function, promoting the NGF and GDNF expressions, and enhancing facial hemodynamics. |
| Key words: idiopathic facial paralysis midnight-noon ebb-flow day-stem point selection thumbtack needle neural function neurotrophic factors hemodynamics |
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