中国针灸

目的：观察浮针治疗非急性期特发性面神经麻痹的临床疗效及对血清一氧化氮（NO）、内皮素（ET含量的影响。方法：将76例非急性期特发性面神经麻痹患者随机分为观察组（38例，脱落2例）和对照组（38例，脱落2例）。对照组予基础治疗（口服甲钴胺片、特定电磁波谱照射、面肌康复训练），观察组在对照组的基础上予浮针治疗，进针点包括肱桡肌、胸锁乳突肌、斜方肌等，于患肌周边进针，扫散同时配合再灌注活动，隔日1次，每周3次。两组均治疗4周。分别于治疗前及治疗2、4周后观察两组患者House-Brackmann(H-B)分级、H-B症状评分，比较两组患者治疗前、治疗4周后面部残疾指数（FDI）评分[包括躯体功能（FDIP）评分和社会生活功能（FDIS）评分]及血清NO、ET含量，并比较两组患者临床疗效和安全性。结果：治疗2、4周后，两组患者H-B分级较治疗前降低、H-B症状评分较治疗前升高（P<0.001,P<0.05），且观察组H-B分级低于对照组、H-B症状评分高于对照组（P<0.01,P<0.05）。治疗4周后，两组患者FDIP评分均较治疗前升高、FDIS评分均较治疗前降低（P<0.05），且观察组FDIP评分高于对照组、FDIS评分低于对照组（P<0.05）。治疗4周后，观察组患者血清NO含量较治疗前升高、ET含量较治疗前降低（P<0.05），观察组血清NO含量升高幅度、ET含量降低幅度大于对照组（P<0.05）。观察组治愈率为55.6%(20/36)，高于对照组的22.2%(8/36,P<0.05)。两组均未出现严重不良反应。结论：浮针配合基础治疗可有效改善非急性期特发性面神经麻痹患者面肌运动功能，可能与调节血清NO、ET含量有关。

Objective To observe the effect of Fu's subcutaneous needling in the treatment of non-acute idiopathic facial paralysis and its effect on serum levels of nitric oxide(NO) and endothelin(ET). Methods A total of 76 patients with non-acute idiopathic facial paralysis were randomly divided into an observation group(38 cases, 2 cases dropped out) and a control group(38 cases, 2 cases dropped out). The patients in the control group received basic treatment(mecobalamin tablets orally, specific electromagnetic spectrum irradiation, facial muscle rehabilitation training). The patients in the observation group were treated with Fu's subcutaneous needling on the basis of the control group. The needling points included brachioradialis muscle, sternocleidomastoid muscle, trapezius muscle, etc., and the needling was inserted around the affected muscle, and the reperfusion activity was carried out at the same time, once every other day, 3 times a week. Both groups were treated for 4 weeks. The House-Brackmann(H-B) grade and H-B symptom score were observed before treatment,after 2 and 4 weeks of treatment in the two groups. The facial disability index(FDI) score [including physical function(FDIP)score and social life function(FDIS) score] and the serum levels of NO and ET were compared before and after 4 weeks of treatment in the two groups. The clinical effect and safety of the two groups were assessed. Results After 2 and 4 weeks of treatment, the H-B grade of the two groups was lower than that before treatment, and the H-B symptom scores were higher than those before treatment(P<0.001, P<0.05); the H-B grade of the observation group was lower than that of the control group, and the H-B symptom score was higher than that of the control group(P<0.01, P<0.05). After 4 weeks of treatment,the FDIP scores of the two groups were higher than those before treatment, and the FDIS scores were lower than those before treatment(P<0.05); the FDIP score of the observation group was higher than that of the control group, and the FDIS score was lower than that of the control group(P<0.05). After 4 weeks of treatment, the serum level of NO in the observation group was higher than that before treatment, and the serum level of ET was lower than that before treatment(P<0.05); the increase of serum level of NO and the decrease of serum level of ET in the observation group were greater than those in the control group(P<0.05). The cure rate of the observation group was 55.6%(20/36), which was higher than 22.2%(8/36) of the control group(P<0.05). There were no serious adverse reactions in both groups. Conclusion Fu's subcutaneous needling combined with basic treatment can effectively improve the motor function of facial muscles in patients with non-acute idiopathic facial paralysis, which may be related to the regulation of serum NO and ET levels.