Objective: To observe the effect of electroacupuncture (EA) at Yifeng (TE17) and Fengchi (GB20) on the prognosis in the patients with moderate-to-severe peripheral facial paralysis in the acute stage.
Methods: A total of 68 patients with moderate-to-severe peripheral facial paralysis in the acute stage were randomly allocated to an EA group (2 cases dropped out, 1 case was eliminated) and an acupuncture group (2 cases dropped out, 1 case was eliminated). Both groups received basic administration with western medication, and the conventional acupuncture was operated at Yangbai (GB14), Sibai (ST2), Quanliao (SI18), Jiache (ST6), Dicang (ST4), Yifeng (TE17), Fengchi (GB20), etc. on the affected side. Additionally, in the EA group, Yifeng (TE17) and Fengchi (GB20) were connected to an electroacupuncture apparatus and stimulated with continuous wave, at the frequency of 4 Hz, and the current intensity of 1-5 mA for 20 min; and in the acupuncture group, no electric stimulation was exerted at these two acupoints after connected to the apparatus. In both groups, the intervention was delivered twice weekly, at the interval of 3 days, and for 12 consecutive weeks. In 12 weeks after treatment completion, the incidence of complications was observed in both groups. The Sunnybrook facial nerve grading system (SFGS) and facial disability index (FDI) were scored and compared between the two groups before and after treatment, and the safety was assessed.
Results: The incidence of complications was 6.5% (2/31) in the EA group and 16.1% (5/31) in the acupuncture group, with no statistically significant difference between the two groups (P>0.05). After treatment, the total scores of SFGS, the total voluntary movement scores and the scores on raising eyebrows, closing eyes tightly, showing teeth in a smile, wrinkling nose and puckering lips were all increased (P<0.01), the total static symmetry scores, and the scores on facial symmetry at rest (eye, cheek and oral commissure) were reduced when compared with those before treatment in the two groups (P<0.01); and the EA group was higher in the total score of SFGS, the total voluntary movement score and the scores on wrinkling nose and puckering lips when compared with those in the acupuncture group (P<0.05, P<0.01). After treatment, FDI-physical function (FDIP) scores increased, and FDI-social function (FDIS) scores decreased in both groups compared with those before treatment (P<0.01), and in the EA group, FDIP score was higher and FDIS score was lower in comparison with those in the acupuncture group (P<0.05). The differences were not statistically significant in the incidence of subcutaneous hematoma between the two groups (P>0.05).
Conclusion: Electroacupuncture at Yifeng (TE17) and Fengchi (GB20) can effectively promote the recovery of voluntary movement in the middle and lower facial muscles of patients with moderate-to-severe peripheral facial paralysis in the acute stage, and improve their physical and social functions, demonstrating a high clinical application value.
目的：观察电针翳风、风池对急性期中重度周围性面瘫患者预后的影响。 方法：将68例急性期中重度周围性面瘫患者随机分为电针组（脱落2例，剔除1例）和针刺组（脱落2例，剔除1例）。两组均予西药基础治疗，在此基础上，两组均取患侧阳白、四白、颧髎、颊车、地仓、翳风、风池等行常规针刺；电针组翳风、风池连接电针仪，予连续波，频率4 Hz，电流1~5 mA，电针20 min；针刺组则翳风、风池连接无电流输出的电针仪。两组均每周针刺2次，两次治疗间隔3 d，连续12周。治疗结束后12周，观察两组患者并发症发生率。分别于治疗前后比较两组患者Sunnybrook面神经评定量表评分、面部残疾指数（FDI）评分，并评定安全性。 结果：电针组并发症发生率为6.5%（2/31），针刺组并发症发生率为16.1%（5/31），两组并发症发生率比较差异无统计学意义（P>0.05）。治疗后，两组患者Sunnybrook面神经评定量表总分，随意运动总分及抬额头、轻轻闭眼、张嘴微笑、耸鼻子、唇吸吮评分均较治疗前升高（P<0.01）；静态评分总分及眼、颊、嘴评分较治疗前降低（P<0.01）。治疗后，电针组Sunnybrook面神经评定量表总分，随意运动总分及耸鼻子、唇吸吮评分高于针刺组（P<0.05，P<0.01）。治疗后，两组患者躯体运动功能（FDIP）评分较治疗前升高、社会生活功能（FDIS）评分较治疗前降低（P<0.01），电针组FDIP评分高于针刺组、FDIS评分低于针刺组（P<0.05）。两组皮下血肿发生率比较差异无统计学意义（P>0.05）。 结论：电针翳风、风池可有效促进急性期中重度周围性面瘫患者中下部面部肌肉随意运动恢复，改善其躯体运动功能与社会生活功能，具有较高的临床应用价值。.
Keywords: Fengchi (GB20); Yifeng (TE17); complications of facial paralysis; electroacupuncture; moderate-to-severe peripheral facial paralysis in the acute stage.