赵伟++曲芳++梁战华++孙英健

[摘要] 目的 比较不同频率的电刺激治疗面肌痉挛疗效。方法 该研究病例来源于2012年4月—2015年4月大连市第二人民医院神经内科门诊就诊的HFS患者62例。该研究中应用1Hz和2Hz两种频率的电刺激疗法治疗面肌痉挛，根据治疗频率的不同分为两组，1Hz治疗组为A组，2Hz治疗组为B组。观察指标为患者面肌痉挛的COHEN分级，记录两组的有效率及治愈率，通过对比研究的方式来比较两组的疗效，进而寻找最佳的治疗频率。结果 共治疗偏侧面肌痉挛患者62例，A组治疗30例，B组治疗32例。A组的治愈率10%，缓解率70%；B组治愈率6.25%，缓解率40.6%。两组治愈率χ2=0.006， P=0.940，差异无统计学意义（P>0.05）；两组缓解率χ2=7.005，P=0.008，差异有统计学意义（P<0.05）。A组患者治疗过程中的疼痛感较轻，依从性更好。结论 1Hz频率电刺激治疗面肌痉挛的效果较2Hz更好。

[关键词] 频率；电刺激；治疗；面肌痉挛

[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2015）10（a）-0022-03

Study of Hemifacial Spasm Patients Treated by Electric Stimulation of Different Frequencies

ZHAO Wei， QU Fang， LIANG Zhan-hua， SUN Ying-jian

Department of Neurology， The Second Hospital of Dalian， Dalian， Liaoning Province， 116011 China

[Abstract] Objective To compare the effect of different frequencies of electric stimulation in the treatment of hemifacial spasm（HFS）. Methods Sixty-two patients with HFS treated in the Neurology Clinic of The Second Hospital of Dalian from April 2012 to April 2015 were selected as the subjects. We used electric stimulation of 1Hz and 2Hz frequency to treat the HFS patients in this study. The patients were divided into two groups， group A and group B in accordance with the frequency of electric stimulation. Patients in group A were treated by 1Hz electric stimulation， and those in group B were treated by 2Hz electric stimulation. Cohen classification was used as the observation index of hemifacial spasm. The response rate and cure rate of the two groups was recorded. The efficacy of the two groups was compared for finding the best treatment frequency of electric stimulation. Results A total of 62 patients with HFS were treated， including 30 cases in group A and 32 cases in group B. The cure rate was 10% in group A， and 6.25% in group B， the difference between the two groups was not statistically significant， χ2=0.006， P=0.940. The remission rate was 70% in group A， and 40.6% in group B， the difference between the two groups was statistically significant， χ2=7.005， P=0.008. Group A had less pain and better compliance. Conclusion 1Hz electric stimulation has better effect than 2Hz electric stimulation on hemifacial spasm patients.

[Key words] Frequency； Electrical stimulation； Treatment； Hemifacial spasm

偏侧面肌痉挛（hemifacial spasm HFS）的表现为一侧面神经支配的面肌反复不自主抽搐，这种疾病严重影响患者的个人形象及生活质量，有研究报道HFS患者的焦虑及抑郁评分明显高于正常人[1]，HFS的治疗目前以A型肉毒毒素注射法和微血管减压术（microvacular decompression MVD）为主，尚无特效治疗方法。该研究应用一种新的疗法——神经电刺激的治疗方法治疗面肌痉挛，旨在探索治疗这种疾病更为安全有效便捷的治疗方法。

近年来，国外也曾有学者应用电刺激的治疗方法治疗HFS，Etsuo yamamoto等在1983—1985年间用神经电刺激法治疗了21名偏侧面肌痉挛的患者，治疗后有效率占81%。2007—2009年间大连医科大学附属一院梁战华教授应用电刺激的治疗方法治疗了66例早期HFS的患者，有效率84.8%。近……