摘要
目的:观察鼠神经生长因子穴位注射结合针刺治疗周围性面瘫患儿的临床疗效。方法:选取符合诊断及纳入标准的89例周围性面瘫患儿为研究对象,按照随机数字表法分为观察组与对照组,观察组45例,对照组44例。2组均给予针刺治疗,依据患儿病症进行辨证分型取穴,采取平补平泻手法,每天1次,每周6次,共治疗3周。观察组同时给予穴位注射鼠神经生长因子,依据患儿症状于患侧面部取穴,选取童子髎、迎香、承浆等,每次选取2穴,穴位可交替选用。每周3次,共治疗3周。比较2组治疗前后H-B面神经功能分级、平均显效时间、Portmann评分、复合肌肉动作电位(CMAP)波幅、神经传导速度、瞬目反射(BR)潜伏期、临床疗效及不良反应。结果:2组治疗前H-B面神经功能分级比较,差异无统计学意义(P>0.05);治疗3周后,观察组H-B面神经功能分级改善明显优于对照组(P<0.05)。观察组平均显效时间为(15.37±4.25)d,少于对照组的(18.69±5.64)d,差异有统计学意义(P<0.05)。观察组患儿Portmann评分差值为(2.72±0.82)分,大于对照组的(1.58±0.52)分,差异有统计学意义(P<0.05)。2组治疗前CMAP波幅、神经传导速度和BR潜伏期比较,差异均无统计学意义(P>0.05);治疗3周后,观察组CMAP波幅、神经传导速度和BR潜伏期明显优于对照组(P<0.05)。2组临床疗效比较,观察组总有效率(91.11%)明显优于对照组(75.00%),差异有统计学意义(P<0.05)。2组均未出现严重不良反应,观察组有1例出现局部疼痛。结论:鼠神经生长因子穴位注射结合针刺治疗周围性面瘫患儿的临床效果较好,面神经功能改善明显,显效时间短,术后不良反应少,安全性高。
Objective:To observe the clinical efficacy of acupoint injection of mouse nerve growth factor combined with acupuncture on peripheral facial paralysis children.Methods:A total of 89 peripheral facial paralysis children who met the diagnostic and inclusion criteria were randomly assigned to the observation group(n=45)and the control group(n=44).Both groups were treated with acupuncture treatment.Acupuncture points were selected according to syndrome differentiation based on symptoms of the children.Acupuncture therapy was conducted in a mild reinforcing-reducing method,once a day,six times per week and three weeks was considered as a treatment course.The observation group was given an extra acupoint injection of mouse nerve growth factor.Acupoints were selected on the affected side according to the symptoms of the child,including Tongziliao,Yingxiang,Chengjiang,etc..Two acupoint were selected each time,three times a week,and these points were used alternately.After three weeks of treatment,the clinical efficacy,H-B facial nerve function grading,average effective time,Portmann score,compound muscle action potential(CMAP),nerve conduction velocity,blink reflex(BR)latency and adverse reactions were compared between the two groups.Results:Before treatment,there was no significant difference in H-B facial nerve function grading between the two groups(P>0.05).After treatment,the improvement of H-B facial nerve function grading in the observation group was significantly better than that of the control group(P<0.05).The average effective time in the observation group was less than that in the control group(P<0.05).The difference of Portmann score in the observation group was greater than that in the control group(P<0.05).Before treatment,there was no significant difference in CMAP amplitude,nerve conduction velocity and BR latency between the two groups(P>0.05).After treatment,the CMAP amplitude,nerve conduction velocity and BR latency of the observation group were significantly higher than those of the control group(P<0.05).The total effective rate of the observation group(91.11%)was significantly superior to that of the control group(75.00%)(P<0.05).No serious adverse reactions occurred in this study.One case with local pain occurred in the observation group but without statistical difference(P>0.05).Conclusion:The total effective rate of acupoint injection of mouse nerve growth factor combined with acupuncture in the treatment of children with peripheral facial paralysis is higher than that of acupuncture only,and the effective time is significantly shorter than that of acupuncture only.The improvement of H-B facial nerve function grading is significant,the average effective time is short,the difference of Portmann score is large,the CMAP amplitude is better,and the nerve conduction velocity is improved,and the postoperative adverse reaction is low,which could effectively improve the facial nerve of children,with quick response and high safety.
作者
孔勉
刘巍
余志华
方明
KONG Mian;LIU Wei;YU Zhihua;FANG Ming(Chengdu First People's Hospital,Chengdu,Sichuan 610017,China;Medical College of Chengdu University,Chengdu Sichuan,610106,China)
出处
《康复学报》
CSCD
2019年第4期49-53,共5页
Rehabilitation Medicine
基金
成都市卫计委局级项目(2015122)
关键词
周围性面瘫
针刺
鼠神经生长因子
穴位注射
儿童
peripheral facial paralysis
acupuncture
mouse nerve growth factor
acupoint injection
children
