星状神经节阻滞联合针灸治疗周围性面瘫的效果分析

薛艳; 顾梦婷; 秦夏蓉; 夏燕飞; 刘涛

doi:10.16766/j.cnki.issn.1674-4152.004039

星状神经节阻滞联合针灸治疗周围性面瘫的效果分析

doi: 10.16766/j.cnki.issn.1674-4152.004039

1.
浙江医院麻醉科，浙江杭州 310007
2.
浙江医院针灸科

基金项目:

浙江省中医药科技计划临床研究应用项目 2023ZL225

浙江省中医药科技计划项目 2018ZT001

详细信息

通讯作者:
秦夏蓉，E-mail：qinxr13588477081@163.com

中图分类号: R745.12 R614.4
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- 文章访问数: 15
- HTML全文浏览量: 9
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-12-18
- 网络出版日期: 2025-09-04

Effect of stellate ganglion block combined with acupuncture and moxibustion on peripheral facial paralysis

1.
Department of Anesthesiology, Zhejiang Hospital, Hangzhou, Zhejiang 310007, China

摘要

摘要: 目的探讨星状神经节阻滞(SGB)联合针灸治疗周围性面瘫(PFP)的疗效以及对面神经功能等指标的影响，为临床制定治疗方案提供借鉴。方法选取2020年1月—2024年10月浙江医院收治的112例PFP患者，根据不同疗法分为A组(72例)与B组(40例)。A组采用针灸治疗，B组采用SGB联合针灸治疗，治疗4周。观察2组患者中医证候积分、面神经功能[House-Brakmann面神经功能分级标准(H-B分级)评分、Pormann评分]、面部残疾指数(FDI评分)、临床疗效、不良反应(恶心、呕吐、食欲不振、星状神经节损伤、局部血肿、血糖波动、血压波动)发生情况。结果 B组治疗后的中医证候积分低于A组(P＜0.05)；B组治疗后的H-B分级评分低于A组(P＜0.05)，Pormann评分高于A组(P＜0.05)；B组治疗后FDI量表中的躯体功能评分高于A组(P＜0.05)，社会生活功能障碍评分低于A组(P＜0.05)；B组总有效率为95.00%(38/40)，高于A组[80.56%(58/72)，P＜0.05]；B组的不良反应发生率为15.00%(6/40)，A组为13.89%(10/72)，2组不良反应发生率比较差异无统计学意义(P＞0.05)。结论 SGB联合针灸治疗PFP的疗效较好，可减轻患者症状，改善面神经功能及面部残疾指数，且不良反应少，有效性与安全性兼具，值得推行。
- 周围性面瘫 /
- 星状神经节阻滞 /
- 针灸 /
- 疗效
Abstract: Objective To investigate the efficacy of stellate ganglion block (SGB) combined with acupuncture in the treatment of peripheral facial palsy (PFP) and its effects on facial nerve function and related indicators, thereby providing a reference for clinical treatment strategies. Methods A total of 112 patients with PFP admitted to Zhejiang Hospital from January 2020 to October 2024 were selected and divided into group A (72 cases) and group B (40 cases) according to different therapies. Group A was treated with acupuncture and moxibustion, and group B was treated with SGB combined with acupuncture and moxibustion for 4 weeks. The traditional Chinese medicine (TCM) syndrome score, facial nerve function (H-B grading score, Pormann score), facial disability index (FDI score), clinical efficacy, and adverse reactions (nausea, vomiting, loss of appetite, stellate ganglion injury, local hematoma, blood glucose fluctuations, blood pressure fluctuations) of two groups were observed. Results The TCM syndrome score of group B after treatment was lower than that of group A (P < 0.05). The H-B grading score of group B after treatment was lower than that of group A (P < 0.05), and the Pormann score was higher than that of group A (P < 0.05). After treatment, the physical function score in the FDI scale of group B was higher than that of group A (P < 0.05), and the social life dysfunction score was lower than that of group A (P < 0.05). The total effective rate of group B was 95.00% (38/40), which was higher than group A [80.56% (58/72), P < 0.05]. The incidence of adverse reactions in group B was 15.00% (6/40), and that in group A was 13.89% (10/72). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion SGB combined with acupuncture and moxibustion is effective in the treatment of PFP, which can alleviate the symptoms of patients, improve facial nerve function and facial disability index, with less adverse reactions, and has both effectiveness and safety, and is worth promoting.
- Peripheral facial paralysis /
- Stellar ganglion block /
- Acupuncture and moxibustion /
- Therapeutic effect

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表 1 2组PFP患者治疗前后中医证候积分比较(x±s，分)

Table 1. Comparison of traditional Chinese medicine syndrome scores between the two groups of PFP patients before and after treatment (x±s, points)

组别	例数	口角歪斜		面肌麻痹		眼不能闭		鼻唇沟和额纹变浅		舌前味觉减退
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
A组	72	3.46±0.35	2.15±0.27^b	3.16±0.47	1.66±0.32^b	3.20±0.51	1.71±0.35^b	3.34±0.36	1.52±0.21^b	3.26±0.35	1.84±0.20^b
B组	40	3.49±0.33	1.43±0.22^b	3.20±0.45	1.08±0.24^b	3.22±0.48	0.98±0.25^b	3.38±0.33	0.74±0.18^b	3.29±0.33	1.19±0.18^b
统计量		0.443^a	16.852^c	0.438^a	11.230^c	0.203^a	13.348^c	0.580^a	21.098^c	0.443^a	19.644^c
P值		0.658	＜0.001	0.662	＜0.001	0.840	＜0.001	0.563	＜0.001	0.658	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 2 2组PFP患者面神经功能比较(x±s，分)

Table 2. Comparison of facial nerve function between the two groups of PFP patients (x±s, points)

组别	例数	H-B分级评分		Pormann评分
组别	例数	治疗前	治疗后	治疗前	治疗后
A组	72	4.41±0.33	3.20±0.31^b	6.24±1.35	14.72±2.52^b
B组	40	4.45±0.30	2.36±0.27^b	6.19±1.38	17.05±2.11^b
统计量		0.634^a	8.976^c	0.186^a	7.854^c
P值		0.527	＜0.001	0.853	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 3 2组PFP患者面部残疾指数比较(x±s，分)

Table 3. Comparison of facial disability index between the two groups of PFP patients (x±s, points)

组别	例数	躯体功能评分		社会生活功能障碍评分
组别	例数	治疗前	治疗后	治疗前	治疗后
A组	72	15.42±1.85	18.26±2.04^b	25.67±2.53	17.34±2.13^b
B组	40	15.37±1.88	20.12±2.23^b	25.73±2.45	14.10±2.02^b
统计量		0.136^a	5.682^c	0.122^a	8.923^c
P值		0.892	＜0.001	0.903	＜0.001
注：^a为t值，^c为F值；与同组治疗前比较，^bP＜0.05。

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表 4 2组PFP患者临床疗效比较[例(%)]

Table 4. Comparison of clinical efficacy between the two groups of PFP patients [cases (%)]

组别	例数	治愈	显效	好转	无效	总有效
A组	72	17(23.61)	23(31.95)	18(25.00)	14(19.44)	58(80.56)
B组	40	15(37.50)	17(42.50)	6(15.00)	2(5.00)	38(95.00)
注：2组疗效比较，Z=4.530, P＜0.001。

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