李德华 李季 叶小琪 彭倩

摘要  目的：探究懸灸早期介入对急性期面瘫（BP）的抗炎效果，为悬灸急性期介入治疗面瘫提供理论依据。方法：选取2016年3月至2019年3月成都中医药大学附属医院收治的BP患者132例作为研究对象，按照治疗方法的不同分为悬灸组（ n =38）、激素组（ n =46）和悬灸加激素组（ n =48）;同时随机抽取体检中心体检结果无特殊异常者作为正常人群（ n =126）。将正常人群同急性期BP患者相关血清炎性因子比较，观察BP患者血清炎性因子有无改变;采用随机对照研究，将急性期BP患者132例分为悬灸组、激素组、悬灸加激素组，均治疗2周，比较患者治疗前后血清炎性因子水平，并同时采用House-Brackmann（H-B）整体评分量表进行疗效评价，观察组间差异。结果：与正常人群比较，急性期BP患者血清相关炎性因子均呈升高趋势，组间比较差异有统计学意义（ P <0.05）;治疗2周后，3组BP患者血清WBC、NEUT、PLT、TNF、NLR和H-B整体评分与治疗前比较，差异均有统计学意义（ P <0.05）;治疗后3组间比较，WBC、NEUT、LC差异有统计学意义（ P <0.05），其他指标和H-B整体评分3组间比较，差异无统计学意义（ P >0.05）。结论：和正常人比较，急性期BP患者血清相关炎性因子呈增高趋势;3种方法均能在一定程度上降低急性期BP患者相关血清炎性因子水平，3种方法疗效差异无统计学意义，悬灸可作为激素的一种替代和补充。

关键词  面瘫;贝尔氏麻痹;急性期;悬灸;激素;抗炎;血清炎性因子;疗效评价

Effects of Early Intervention of Suspended Moxibustion on Serum Inflammatory Factors in Acute Facial Paralysis

LI Dehua，LI Ji，YE Xiaoqi，PENG Qian

（Affiliated Hospital of Chengdu University of Traditional Chinese Medicine，Chengdu 610072，China）

Abstract Objective： To explore the anti-inflammatory effects of suspended moxibustion in early interventional treatment of acute Bell′s palsy（BP），and to provide theoretical evidence for the treatment of acute facial paralysis with hanging moxibustion. Methods： A total of 132 patients with BP who were admitted to the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from March 2016 to March 2019 were selected as the research objects and were divided into a moxibustion group（ n =38），a hormone group（ n =46）and a suspension moxibustion plus hormone group（ n =48），1）compared with the serum inflammatory factors of normal population，observe whether there were changes in serum inflammatory factors of BP patients; 2）A randomized controlled study was used to compare 132 cases of acute BP patients，who were divided into a suspension moxibustion group，a hormone group，a suspension moxibustion plus hormone group for 2 weeks of treatment.Serum inflammatory factors in patients′ serum were compared before and after treatment，and House-Brackmann overall score scale was used for curative effects.The differences between groups were evaluated and observed. Results： 1）Compared with the normal population，the related inflammatory factors in the serum of BP patients in the acute phase were all increased，and there was statistical difference between the groups（ P <0.05）. 2）After 2 weeks of treatment，the overall scores of WBC，NEUT，PLT，TNF，NLR，and H-B in the serum of the 3 groups of patients were significantly improved compared with those before treatment and there was a statistical difference between the groups（ P <0.05）; there were statistical differences in WBC，NEUT，and LC in the 3 groups after treatment（ P <0.05）.There was no statistical difference between the other indicators and the overall HB score among the 3 groups（ P >0.05）. Conclusion： 1）Compared with normal people，serum inflammatory factors in patients with BP in the acute stage showed an increasing trend. 2）All of the 3 methods can reduce the relevant serum inflammatory factors of BP patients in the acute stage to a certain extent，and the 3 methods have no significant difference in the efficacy.Suspension moxibustion can be used as an alternative and supplement to hormones.

Keywords  Facial paralysis; Bell′s palsy; Acute phase; Suspended moxibustion; Hormone; Anti-inflammatory; Serum inflammatory factor; Curative effect evaluation

中圖分类号：R245 文献标识码：A  doi： 10.3969/j.issn.1673-7202.2020.14.027

Bell′s麻痹（Bell′s Palsy，BP）又称急性特发性周围性面神经麻痹，俗称面瘫，每年发病率为15～30/10万，男女发病率相同[1]，其发病原因可能与潜伏的1型单纯疱疹病毒（HSV-1）复活感染导致神经炎性反应有关[2-3]。《贝尔氏面瘫治疗指南》[4]中要求将糖皮质激素作为治疗BP的首选治疗方案，但在临床实际工作中发现许多BP患者因合并糖尿病、消化道溃疡、骨质疏松等疾病而有使用激素禁忌，以及部分患者对激素治疗认识的局限性而不愿使用激素治疗，导致部分患者疾病早期得不到及时有效的抗炎治疗而影响愈后。……