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Article(id=1322923734813778382, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.05.022, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339197113, onlineDateStr=2026-10-30, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339197113, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339197113, creator=13701087609, updateTime=1793339197113, updator=13701087609, issue=Issue{id=1322923490592043032, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='5', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1746806400000', pubDateStr='2025-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339138887, creator='13701087609', updateTime=1793340572227, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929502539612595, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929502539612596, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=105, endPage=108, ext={EN=ArticleExt(id=1322923735010910671, articleId=1322923734813778382, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Study on Treatment of Wind-Cold Peripheral Facial Paralysis by Regulating Du Meridian and Harmonizing Stomach Acupuncture Combined with Warm Needle Moxibustion at Zusanli（ST36）, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the curative effect of regulating Du meridian and harmonizing stomach acupuncture combined with warm needle moxibustion at Zusanli（ST36）in the treatment of wind-cold type of peripheral facial paralysis and its influence on H-B grading.

Methods

A total of 132 patients with wind-cold type of peripheral facial paralysis admitted to the hospital from July 2020 to October 2022 were randomly divided into two groups with 66 cases in each group. The control group was given warm needle at Zusanli（ST36），and the treatment group was given regulating Du meridian and harmonizing stomach acupuncture on the basis of the control group. The clinical efficacy，H-B grading，facial disability index（FDI）score，Portmann score，TCM syndrome score and safety analysis after treatment were compared.

Results

After treatment，the curative effect of treatment group was higher（P<0.05）. After treatment，H-B grading，FDIPscore，FDISscore and Portmann score were significantly improved in two groups（P<0.05），and the improvement was more significant in the observation group（P<0.05）. The scores of incomplete eyelid closure，frontal striae disappearance，mouth angle skew and shallow nasolabial groove were significantly decreased in two groups（P<0.05），and were more significantly decreased in the observation group（P<0.05）. In the control group，there were 2 cases of headache and nausea，1 case of drowsiness，1 case of local congestion and swelling，and 1 case of acupuncture dizziness. The total incidence of adverse reactions was 7.58%（5/66）. In the treatment group，headache and nausea in 1 case，drowsiness in 2 cases，local congestion and swelling in 2 cases，and acupuncture dizziness in 1 case. The total incidence of adverse reactions was 9.09%（6/66）. There was no significant difference between the two groups（P>0.05）.

Conclusion

The treatment of wind-cold type of peripheral facial paralysis by regulating Du meridian and harmonizing stomach acupuncture combined with warm needle moxibustion at Zusanli（ST36）has good therapeutic effect，which can improve the function of facial nerve.

, authors=Wenhan JIA1, Jihong WANG1, Rui SUN2, authorsList=Wenhan JIA, Jihong WANG, Rui SUN, authorCompany=null, correspAuthors=Jihong WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923735459701200, articleId=1322923734813778382, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=调督和胃针法联合温针灸足三里治疗风寒型周围性面瘫临床研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

探讨调督和胃针法联合温针灸足三里治疗风寒型周围性面瘫的疗效及对H-B分级影响。

方法

选取风寒型周围性面瘫患者132例，随机分为两组。对照组66例给予温针灸足三里针刺治疗，治疗组66例在对照组基础上给予调督和胃针法，对比治疗后的临床疗效、H-B分级情况、面部残疾指数（FDI）评分、Portmann评分、中医证候积分及安全性分析。

结果

治疗后，治疗组疗效较高（P<0.05）；治疗后两组患者H-B分级、躯体功能（FDIP）评分、社会生活功能（FDIS）评分及Portmann评分明显改善（P<0.05），且治疗组改善更显著（P<0.05）；两组眼睑闭合不全、额纹消失、口角歪斜、鼻唇沟变浅积分明显降低（P<0.05），且治疗组降低更显著（P<0.05）；对照组不良反应总发生率为7.58%（5/66），治疗组不良反应总发生率为9.09%（6/66），差异无统计学意义（P>0.05）。

结论

风寒型周围性面瘫采用调督和胃针法结合温针灸足三里进行治疗具有较好的疗效，能改善面神经功能。

, authors=贾文瀚1, 王继红1, 孙瑞2, authorsList=贾文瀚, 王继红, 孙瑞, authorCompany=null, correspAuthors=王继红, authorNote=

贾文瀚（1995-），男，北京人，硕士在读，研究方向：通元针法治疗临床疾病、推拿量-效关系。

, correspAuthorsNote=
王继红（1969-），男，四川人，教授，博士研究生导师，博士，研究方向：通元针法治疗临床疾病、推拿量-效关系。E-mail：。
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贾文瀚（1995-），男，北京人，硕士在读，研究方向：通元针法治疗临床疾病、推拿量-效关系。

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贾文瀚（1995-），男，北京人，硕士在读，研究方向：通元针法治疗临床疾病、推拿量-效关系。

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articleTitle=温针灸治疗急性期周围性面瘫的临床观察, refAbstract=null), Reference(id=1322923740367036952, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, doi=null, pmid=null, pmcid=null, year=2022, volume=31, issue=2, pageStart=333, pageEnd=336, url=null, language=null, rfNumber=［30］, rfOrder=29, authorNames=王迎春, 孙新新, 张颖, journalName=中国中医急症, refType=null, unstructuredReference=王迎春，孙新新，张颖. 散寒解毒汤联合针刺治疗急性周围性面瘫（风寒证）疗效观察［J］. 中国中医急症，2022，31（2）：333-336., articleTitle=散寒解毒汤联合针刺治疗急性周围性面瘫（风寒证）疗效观察, refAbstract=null), Reference(id=1322923740446728729, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, doi=null, pmid=null, pmcid=null, year=2021, volume=30, issue=5, pageStart=877, pageEnd=879, url=null, language=null, rfNumber=［31］, rfOrder=30, authorNames=孙增春, 马腾, 黄夏莲, journalName=中国中医急症, refType=null, unstructuredReference=孙增春，马腾，黄夏莲，等. 大秦艽汤联合针刺治疗急性周围性面瘫疗效及对面神经肌电图的影响［J］. 中国中医急症，2021，30（5）：877-879., articleTitle=大秦艽汤联合针刺治疗急性周围性面瘫疗效及对面神经肌电图的影响, refAbstract=null), Reference(id=1322923740509643290, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, doi=null, pmid=null, pmcid=null, year=2021, volume=30, issue=21, pageStart=2340, pageEnd=2344, url=null, language=null, rfNumber=［32］, rfOrder=31, authorNames=刘华, 张丹, 夏铭蔚, journalName=现代中西医结合杂志, refType=null, unstructuredReference=刘华，张丹，夏铭蔚，等. 针刺联合马钱子外敷对顽固性面瘫患者面神经麻痹症状及面神经功能的影响［J］. 现代中西医结合杂志，2021，30（21）：2340-2344., articleTitle=针刺联合马钱子外敷对顽固性面瘫患者面神经麻痹症状及面神经功能的影响, refAbstract=null), Reference(id=1322923740585140763, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, doi=null, pmid=null, pmcid=null, year=2022, volume=31, issue=8, pageStart=1233, pageEnd=1236, url=null, language=null, rfNumber=［33］, rfOrder=32, authorNames=王悦, 房其军, 王淑兰, journalName=中国中医急症, refType=null, unstructuredReference=王悦，房其军，王淑兰，等. 针药结合加穴位注射对周围性面瘫近远期的疗效观察［J］. 中国中医急症，2022，31（8）：1233-1236., articleTitle=针药结合加穴位注射对周围性面瘫近远期的疗效观察, refAbstract=null), Reference(id=1322923740643861020, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, doi=null, pmid=null, pmcid=null, year=2022, volume=43, issue=4, pageStart=527, pageEnd=530, url=null, language=null, rfNumber=［34］, rfOrder=33, authorNames=王萍, 冯树军, 王宇, journalName=陕西中医, refType=null, unstructuredReference=王萍，冯树军，王宇，等. 透刺经筋法对周围性面瘫患者血清SOD、NO水平及免疫功能的影响［J］. 陕西中医，2022，43（4）：527-530., articleTitle=透刺经筋法对周围性面瘫患者血清SOD、NO水平及免疫功能的影响, refAbstract=null), Reference(id=1322923740710969885, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, doi=null, pmid=null, pmcid=null, year=2022, volume=31, issue=4, pageStart=690, pageEnd=693, url=null, language=null, rfNumber=［35］, rfOrder=34, authorNames=高超, 庄杰, 张帆, journalName=中国中医急症, refType=null, unstructuredReference=高超，庄杰，张帆. 常规针刺配合浅针法对急性期周围性面瘫患者疼痛、面动脉血流动力学及面部肌电图的影响［J］. 中国中医急症，2022，31（4）：690-693., articleTitle=常规针刺配合浅针法对急性期周围性面瘫患者疼痛、面动脉血流动力学及面部肌电图的影响, refAbstract=null)], funds=[Fund(id=1322923738215358970, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, awardId=81873395, language=CN, fundingSource=国家自然科学基金项目(81873395), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322923735665222097, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, xref=1., ext=[AuthorCompanyExt(id=1322923735677805010, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, companyId=1322923735665222097, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.Guangzhou University of Chinese Medicine，Guangzhou 510006，Guangdong，China), AuthorCompanyExt(id=1322923735681999315, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, companyId=1322923735665222097, language=CN, 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figs=[ArticleFig(id=1322923737321972206, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数痊愈显效有效无效总有效
对照组66291781254（81.82）
治疗组66321912363（95.45）
χ2值7.352
P值P<0.05
), ArticleFig(id=1322923737397469679, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=CN, label=表1, caption=

两组风寒型周围性面瘫患者疗效比较

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组别例数痊愈显效有效无效总有效
对照组66291781254（81.82）
治疗组66321912363（95.45）
χ2值7.352
P值P<0.05
), ArticleFig(id=1322923737464578544, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别时间Ⅵ级Ⅴ级Ⅳ级Ⅲ级Ⅱ级Ⅰ级
对照组治疗前27213600
治疗后1#4#6#10#14#31#
治疗组治疗前36233400
治疗后0#1#3#7#11#44#*
), ArticleFig(id=1322923737540076017, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=CN, label=表2, caption=

两组风寒型周围性面瘫患者H-B分级情况比较

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组别时间Ⅵ级Ⅴ级Ⅳ级Ⅲ级Ⅱ级Ⅰ级
对照组治疗前27213600
治疗后1#4#6#10#14#31#
治疗组治疗前36233400
治疗后0#1#3#7#11#44#*
), ArticleFig(id=1322923737607184882, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数FDIP评分FDIS评分
治疗前治疗后治疗前治疗后
对照组6615.43±0.4818.45±0.4918.37±0.141.85±1.94
治疗组6615.41±0.5322.69±4.1518.26±0.231.17±1.74
t值0.0466.3530.985.237
P值0.9630.0010.8430.001
), ArticleFig(id=1322923737670099443, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=CN, label=表3, caption=

两组风寒型周围性面瘫患者FDI评分比较

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组别例数FDIP评分FDIS评分
治疗前治疗后治疗前治疗后
对照组6615.43±0.4818.45±0.4918.37±0.141.85±1.94
治疗组6615.41±0.5322.69±4.1518.26±0.231.17±1.74
t值0.0466.3530.985.237
P值0.9630.0010.8430.001
), ArticleFig(id=1322923737737208308, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数噘嘴闭眼示齿
治疗前治疗后治疗前治疗后治疗前治疗后
对照组661.28±0.291.91±0.311.21±0.212.06±0.301.12±0.211.74±0.28
治疗组661.22±0.282.35±0.391.16±0.232.41±0.391.18±0.192.26±0.36
t值1.2097.1751.3045.7791.7219.262
P值0.2290.0010.1940.0010.0880.001
组别例数抬眉张大鼻孔鼓腮
治疗前治疗后治疗前治疗后治疗前治疗后
对照组661.09±0.181.81±0.261.14±0.171.92±0.291.26±0.211.92±0.28
治疗组661.12±0.172.41±0.311.16±0.182.44±0.381.21±0.192.36±0.36
t值0.9841.0480.6568.8381.4347.838
P值0.3270.0010.5130.0010.1540.001
), ArticleFig(id=1322923737825288693, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=CN, label=表4, caption=

两组风寒型周围性面瘫患者Portmann评分比较

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组别例数噘嘴闭眼示齿
治疗前治疗后治疗前治疗后治疗前治疗后
对照组661.28±0.291.91±0.311.21±0.212.06±0.301.12±0.211.74±0.28
治疗组661.22±0.282.35±0.391.16±0.232.41±0.391.18±0.192.26±0.36
t值1.2097.1751.3045.7791.7219.262
P值0.2290.0010.1940.0010.0880.001
组别例数抬眉张大鼻孔鼓腮
治疗前治疗后治疗前治疗后治疗前治疗后
对照组661.09±0.181.81±0.261.14±0.171.92±0.291.26±0.211.92±0.28
治疗组661.12±0.172.41±0.311.16±0.182.44±0.381.21±0.192.36±0.36
t值0.9841.0480.6568.8381.4347.838
P值0.3270.0010.5130.0010.1540.001
), ArticleFig(id=1322923737904980470, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数眼睑闭合不全额纹消失口角歪斜鼻唇沟变浅
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
对照组665.12±0.783.43±0.324.99±0.763.15±0.465.03±0.782.87±0.415.14±0.612.89±0.42
治疗组665.09±0.672.61±0.295.02±0.732.48±0.365.07±0.762.06±0.325.08±0.632.21±0.35
t值0.23716.0940.2319.3180.2981.6520.55610.105
P值0.8130.0010.8170.0010.7660.0010.5790.001
), ArticleFig(id=1322923737984672247, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=CN, label=表5, caption=

两组风寒型周围性面瘫患者中医证候积分比较

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组别例数眼睑闭合不全额纹消失口角歪斜鼻唇沟变浅
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
对照组665.12±0.783.43±0.324.99±0.763.15±0.465.03±0.782.87±0.415.14±0.612.89±0.42
治疗组665.09±0.672.61±0.295.02±0.732.48±0.365.07±0.762.06±0.325.08±0.632.21±0.35
t值0.23716.0940.2319.3180.2981.6520.55610.105
P值0.8130.0010.8170.0010.7660.0010.5790.001
), ArticleFig(id=1322923738064364024, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数头痛、恶心困倦局部淤血、肿胀晕针总不良反应
对照组6621115（7.58）
治疗组6612216（9.09）
χ2值0.099
P值>0.05
), ArticleFig(id=1322923738127278585, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923734813778382, language=CN, label=表6, caption=

两组风寒型周围性面瘫患者安全性比较

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组别例数头痛、恶心困倦局部淤血、肿胀晕针总不良反应
对照组6621115（7.58）
治疗组6612216（9.09）
χ2值0.099
P值>0.05
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调督和胃针法联合温针灸足三里治疗风寒型周围性面瘫临床研究
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贾文瀚 1 , 王继红 1 , 孙瑞 2
中华中医药学刊 | 国家项目点击 2025,43(5): 105-108
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中华中医药学刊 |国家项目点击 2025 , 43 (5) : 105 -108
调督和胃针法联合温针灸足三里治疗风寒型周围性面瘫临床研究
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贾文瀚1, 王继红1 , 孙瑞2
作者信息
  • 1.广州中医药大学，广东 广州 510006
  • 2.广东药科大学附属第一医院，广东 广州 510699
通讯作者:
王继红（1969-），男，四川人，教授，博士研究生导师，博士，研究方向：通元针法治疗临床疾病、推拿量-效关系。E-mail：。
作者简介:

贾文瀚（1995-），男，北京人，硕士在读，研究方向：通元针法治疗临床疾病、推拿量-效关系。

Clinical Study on Treatment of Wind-Cold Peripheral Facial Paralysis by Regulating Du Meridian and Harmonizing Stomach Acupuncture Combined with Warm Needle Moxibustion at Zusanli（ST36）
Wenhan JIA1, Jihong WANG1 , Rui SUN2
Affiliations
  • 1.Guangzhou University of Chinese Medicine，Guangzhou 510006，Guangdong，China
  • 2.The First Affiliated Hospital of Guangdong Pharmaceutical University，Guangzhou 510699，Guangdong，China
出版时间: 2025-05-10 doi: 10.13193/j.issn.1673-7717.2025.05.022
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摘要
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目的

探讨调督和胃针法联合温针灸足三里治疗风寒型周围性面瘫的疗效及对H-B分级影响。

方法

选取风寒型周围性面瘫患者132例，随机分为两组。对照组66例给予温针灸足三里针刺治疗，治疗组66例在对照组基础上给予调督和胃针法，对比治疗后的临床疗效、H-B分级情况、面部残疾指数（FDI）评分、Portmann评分、中医证候积分及安全性分析。

结果

治疗后，治疗组疗效较高（P<0.05）；治疗后两组患者H-B分级、躯体功能（FDIP）评分、社会生活功能（FDIS）评分及Portmann评分明显改善（P<0.05），且治疗组改善更显著（P<0.05）；两组眼睑闭合不全、额纹消失、口角歪斜、鼻唇沟变浅积分明显降低（P<0.05），且治疗组降低更显著（P<0.05）；对照组不良反应总发生率为7.58%（5/66），治疗组不良反应总发生率为9.09%（6/66），差异无统计学意义（P>0.05）。

结论

风寒型周围性面瘫采用调督和胃针法结合温针灸足三里进行治疗具有较好的疗效，能改善面神经功能。

调督和胃针法  /  温针灸足三里  /  风寒型周围性面瘫  /  H-B分级
Objective

To investigate the curative effect of regulating Du meridian and harmonizing stomach acupuncture combined with warm needle moxibustion at Zusanli（ST36）in the treatment of wind-cold type of peripheral facial paralysis and its influence on H-B grading.

Methods

A total of 132 patients with wind-cold type of peripheral facial paralysis admitted to the hospital from July 2020 to October 2022 were randomly divided into two groups with 66 cases in each group. The control group was given warm needle at Zusanli（ST36），and the treatment group was given regulating Du meridian and harmonizing stomach acupuncture on the basis of the control group. The clinical efficacy，H-B grading，facial disability index（FDI）score，Portmann score，TCM syndrome score and safety analysis after treatment were compared.

Results

After treatment，the curative effect of treatment group was higher（P<0.05）. After treatment，H-B grading，FDIPscore，FDISscore and Portmann score were significantly improved in two groups（P<0.05），and the improvement was more significant in the observation group（P<0.05）. The scores of incomplete eyelid closure，frontal striae disappearance，mouth angle skew and shallow nasolabial groove were significantly decreased in two groups（P<0.05），and were more significantly decreased in the observation group（P<0.05）. In the control group，there were 2 cases of headache and nausea，1 case of drowsiness，1 case of local congestion and swelling，and 1 case of acupuncture dizziness. The total incidence of adverse reactions was 7.58%（5/66）. In the treatment group，headache and nausea in 1 case，drowsiness in 2 cases，local congestion and swelling in 2 cases，and acupuncture dizziness in 1 case. The total incidence of adverse reactions was 9.09%（6/66）. There was no significant difference between the two groups（P>0.05）.

Conclusion

The treatment of wind-cold type of peripheral facial paralysis by regulating Du meridian and harmonizing stomach acupuncture combined with warm needle moxibustion at Zusanli（ST36）has good therapeutic effect，which can improve the function of facial nerve.

regulating Du meridian and harmonizing stomach acupuncture  /  warm needle moxibustion at Zusanli（ST36）  /  wind-cold type of peripheral facial paralysis  /  H-B classification
贾文瀚, 王继红, 孙瑞. 调督和胃针法联合温针灸足三里治疗风寒型周围性面瘫临床研究. 中华中医药学刊, 2025 , 43 (5) : 105 -108 . DOI: 10.13193/j.issn.1673-7717.2025.05.022
Wenhan JIA, Jihong WANG, Rui SUN. Clinical Study on Treatment of Wind-Cold Peripheral Facial Paralysis by Regulating Du Meridian and Harmonizing Stomach Acupuncture Combined with Warm Needle Moxibustion at Zusanli（ST36）[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (5) : 105 -108 . DOI: 10.13193/j.issn.1673-7717.2025.05.022
正文
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周围性面瘫主要是由于患者茎乳孔内发生面神经炎性反应从而导致面部肌功能及表情发生障碍，主要临床表现为鼻唇沟变浅、眼裂增大、额纹消失、患侧口角歪斜等[1]。在急性期主要以消局部水肿、抗炎、促进神经功能恢复等手段进行治疗，但是长期临床疗效较差[2]。在急性发作期时治疗原则主要是通过改善局部血液循环、减轻面神经炎症水肿及防治并发症，能够用补充B族维生素、肾上腺皮质激素、抗病毒等治疗，并且可通过局部热敷或红外线照射治疗，有助于消除神经水肿和改善局部血液循环。面瘫在中医上属于“经筋病”范畴，面瘫的形成以痰、风、瘀、虚为基本病理基础，风痰、瘀为标，正虚为本，针刺用于治疗周围性面瘫具有较好的疗效，可松解局部粘连组织，改善局部血液循环，提高肌力，恢复面部肌肉收缩力，本研究结合调督和胃针法和温针灸足三里用于治疗周围性面瘫[3]。本研究选取风寒型周围性面瘫患者132例，探讨风寒型周围性面瘫采用调督和胃针法结合温针灸足三里进行治疗的临床疗效。
1　资料和方法
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1.1　研究对象和分组
选取2020年7月—2022年10月我院收治的132例周围性面瘫患者，采用随机分配原则分为两组各66例，对照组男35例，女31例，平均年龄（56.69±6.68）岁，平均病程（5.21±1.68）d。治疗组男36例，女30例，平均年龄（56.81±6.78）岁，平均病程（5.13±1.62）d。两组一般资料具有临床可比性（P>0.05）。
1.2　诊断标准、纳入标准和排除标准
西医诊断标准[4]：患者病侧面部表情肌瘫痪，临床表现为：泪液分泌减少或/和眼睑闭合不全；蹙眉、皱额不全或均不能；鼻唇沟平坦，张口或口角下垂时被牵向健侧；鼓腮、示齿、吹哨、噘嘴任意一项不全或不能；病侧角膜反射消失；可有舌前2/3出现味觉障碍，听觉障碍或听觉过敏。
中医辨证标准[5]：中医诊断及辨证分型符合《针灸学》中有关面瘫的相关诊断标准：①起病突然；②出现眼睑闭合不全、额纹消失、口角歪斜、鼻唇沟变浅等面部表情肌瘫等表现；③部分患者可伴有耳部疱疹、耳后疼痛、听觉障碍、舌前2/3味觉丧失等表现。中医辨证分型为风寒型；风寒证：多见于患者发病初期，有受寒或受风史，脉浮紧，苔薄白，舌淡。
纳入标准：患者符合周围性面瘫的诊断标准，患者发病于10 d之内。
排除标准：患者为中枢性面瘫；伴有严重心脑血管疾病、精神疾病者；由于外伤导致面瘫者；凝血功能障碍者；晕针、惧针患者。
1.3　治疗方法
对照组给予温针灸足三里针刺治疗，保持患者处于俯卧位，取穴：足三里（双侧），保持全身放松，采用华佗牌毫针（0.25 mm×40 mm）针刺，直刺进针20～30 mm，采用平补平泻手法，得气之后，将2 cm左右的药用灸条插入针柄，然后点燃施灸，当艾条燃完之后，去除灰烬，将针取出，留针时间为30 min，1次/d。治疗组在同时联用调督和胃针法，取穴：取中脘、解溪、天枢、迎香、足三里、颧髎、丝竹空、合谷、颊车、太阳、地仓、四白、承泣阳明经穴及神庭、大椎、百会等督脉腧穴。快速刺大椎穴，不留针，针刺中脘、天枢、足三里，针刺头面部穴及合谷、解溪等腧穴；每次取面部腧穴5～6个，然后轮流应用；合谷（健侧）、中脘（双侧）、足三里（双侧）、天枢（双侧）。操作方法：采用华佗牌毫针（0.25 mm×40 mm）直刺约为16.67～20.00 mm，患侧针刺留针时间短、手法轻浅，采用补法；面部健侧针刺手法采用泻法；面部患侧及健侧腧穴进行交替针刺；中脘和足三里采用补法；合谷和天枢采用平补平泻针刺手法；1次/d，留针20 min。两组持续治疗4周。
1.4　观察指标
1.4.1　临床疗效[6]
痊愈：治疗后H-B分级为Ⅰ和Ⅱ，面部神经功能基本恢复，体征和临床症状消失，中医证候积分较治疗前减少>80%。显效：治疗后H-B分级为Ⅲ，面部神经功能轻度减弱，体征和临床症状明显改善，中医证候积分较治疗前减少50% ～80%；有效：治疗后H-B分级为Ⅳ，症状与体征减轻，在静止时嘴角明显不对称，面部肌肉张力正常，眼可完全闭合但是须用力，中医证候积分减少<50%，≥30%；无效：未达到以上标准者。治疗有效率＝痊愈率＋显效率＋有效率。
1.4.2　观察指标
H-B分级[7]：采用H-B面神经功能分级系统评价面神经功能，分级共分为Ⅰ～Ⅵ级，Ⅵ级为完全麻痹，Ⅴ级为严重功能障碍，Ⅳ级为中重度功能障碍，Ⅲ级为中度功能障碍，Ⅱ级为轻度功能障碍，Ⅰ级为正常，面部神经分级越低代表患者面神经功能越好；面部残疾指数（FDI）：治疗前后采用FDI评分评估两组面部功能，包括躯体功能（FDIP）和社会生活功能（FDIS），其中FDIP量表包括5个项目，总分为25分，评分越高其功能越好，FDIS量表包括5个评分项目，评分越低功能越好；Portmann评分：治疗前后采用Portmann评分评估两组面部情况，包括噘嘴、闭眼、示齿、抬眉、张大鼻孔、鼓腮6项，每项评分为0～3分，评分越高患者面部功能恢复越好；中医证候积分：治疗前后对两组眼睑闭合不全、额纹消失、口角歪斜、鼻唇沟变浅等证候根据严重程度进行评分，每项评分为0～6分，评分越高证候越严重；安全性：对比两组不良反应发生情况。
1.5　统计学方法
采用SPSS 19.0软件处理数据。计量和计数资料比较分别进行t检验和卡方检验。
2　结果
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2.1　临床疗效比较
治疗后对照组总有效率为81.82%，治疗组总有效率为95.45%；治疗组疗效明显较高（P<0.05）。见表1。
2.2　H-B分级情况比较
治疗前两组患者H-B分级差异无统计学意义（P>0.05）；治疗后两组患者H-B分级明显改善（P<0.05），并且治疗组改善较多（P<0.05）。见表2。
2.3　FDI评分比较
治疗前两组FDIP评分和FDIS评分间差异无统计学意义（P>0.05）；治疗后两组FDIP评分和FDIS评分显著改善（P<0.05），并且治疗组改善较多（P<0.05）。见表3。
2.4　Portmann评分比较
治疗后两组Portmann评分较治疗前均明显升高（P<0.05），且治疗组升高更多（P<0.05）。见表4。
2.5　中医证候积分比较
治疗后两组眼睑闭合不全、额纹消失、口角歪斜、鼻唇沟变浅积分较治疗前均明显降低（P<0.05），且治疗组降低更多（P<0.05）。见表5。
2.6　安全性比较
治疗后，对照组不良反应总发生率为7.58%；治疗组不良反应总发生率为9.09%；两组差异无统计学意义（P>0.05）。见表6。
3　讨论
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根据“经脉所过，主治所及”及“腑穴所在，主治所在”的理论，目前在临床上采用远端取穴和局部取穴相结合，以补虚泻实，调整阴阳，激发经气，有助于面瘫的快速恢复[8-11]。脾胃属于后天之本，足三里穴是五输穴之一，属于足阳明胃经的合穴，其性属土经土穴，“胃者五脏六腑之海也”。“合治内脏，凡六腑之病皆可用之。”故脾和胃相表里，均是仓廪之官。胃是谷之海，能够包容五谷[12-15]。足三里穴又是胃下合穴，属于四总穴的首穴，生命之根，气血生化之源。针刺足三里穴能够增气血生化之源，暖脾胃之气，温通经脉、益气升阳，畅达机体气血[15-18]。足阳明胃经能够在面部循行到额角，并与督脉在神庭穴交会，所以温针灸足三里能够疏通面部脉络，并且具有养血活血、健脾益气的功效，有助于面瘫的康复[19-22]。治疗组患者同时联用调督和胃针法，督脉总督诸阳，属于“阳脉之海”。大椎穴归属督脉，故针刺大椎穴具有疏通督脉、振奋阳气的功效，应该通过通调诸经及益气补虚治疗，发挥调节阳经气血作用[23-24]。百会穴位又被称为“三阳五会”，属督脉，与足厥阴及手足三阳相交会，针刺百会穴能使机体阳气旺盛，并且鼓动精气上荣到髓海，所谓“调督”。《素问·阴阳应象大论篇》中记载“阳病治阴”，故以调和阳明治疗为主，既有浅刺调整阳明经筋、手足阳明经健侧局部选穴，又取手足阳明经远端腧穴调和经脉，有助于面瘫的恢复[25-26]。所谓“和胃”，调督和胃针法选穴中脘、天枢、合谷、足三里、解溪等阳明经穴位，起到调和经脉的功效，通过浅刺起到调节阳明经筋的功效，兼用胃、大肠之募穴，从脏腑、经脉、经筋等调整阳明经气，扶正祛邪，有助于面瘫恢复；百会、大椎、神庭等督脉腧穴与脏腑气血功能联系密切，能够统领诸经，调节阴阳。两者相结合能够起到“调督和胃”的作用[27-28]。
本研究选取2020年7月—2022年10月我院收治的风寒型周围性面瘫患者132例，治疗后治疗组疗效较高（P<0.05），提示周围性面瘫采用调督和胃针法结合温针灸足三里治疗具有较好的疗效，可能是由于调督和胃针法具有调节阳经气血的功效，可疏通督脉，改善局部微循环，缓解面神经水肿症状，从而提高治疗效果[29-30]。治疗后治疗组FDIP评分和FDIS评分显著优于对照组（P<0.05），提示联用调督和胃针法治疗可改善神经功能，可能是由于针刺百会、大椎、神庭等督脉腧穴，其与脏腑气血功能相关，可统领诸经，继而减轻或者消除相关临床症状[31-33]。治疗后两组Portmann评分和H-B分级明显改善（P<0.05），且治疗组改善更显著（P<0.05），提示联用调督和胃针法治疗可改善面部功能，使肌肉收缩力恢复，并且改善患者面神经局部的微环境，有助于面部功能的快速恢复。治疗后治疗组眼睑闭合不全、额纹消失、口角歪斜、鼻唇沟变浅积分明显较低（P<0.05），提示联用调督和胃针法治疗既浅刺调整阳明经筋、手足阳明经健侧局部选穴，又取手足阳明经远端腧穴调和经脉，可使机体阳气旺盛，改善中医证候，可松解局部粘连组织，改善局部血液循环，提高肌力，恢复面部肌肉收缩力[20，24，34-35]。
综上所述，周围性面瘫采用调督和胃针法结合温针灸足三里治疗具有较好的疗效，可改善局部血液循环，松解局部粘连组织，值得在临床上推广应用。
基金
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  • 国家自然科学基金项目(81873395)
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2025年第43卷第5期
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doi: 10.13193/j.issn.1673-7717.2025.05.022
  • 首发时间：2026-10-30
  • 出版时间：2025-05-10
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国家自然科学基金项目(81873395)
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    1.广州中医药大学，广东 广州 510006
    2.广东药科大学附属第一医院，广东 广州 510699

通讯作者:

王继红（1969-），男，四川人，教授，博士研究生导师，博士，研究方向：通元针法治疗临床疾病、推拿量-效关系。E-mail：。
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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2025.05.022
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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