中医药学报

基于经筋理论针刺联合放血疗法治疗风寒型周围性面瘫患者的临床研究

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胡静 ¹ , 昝蕊 ² , 祁欢 ¹ , 赵欲晓 ¹^,^* , 李华丽 ³

中医药学报 | 针灸经络 2026,54(8): 51-57

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中医药学报 |针灸经络 2026 , 54 (8) : 51 -57

基于经筋理论针刺联合放血疗法治疗风寒型周围性面瘫患者的临床研究

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胡静¹, 昝蕊², 祁欢¹, 赵欲晓¹^,^*, 李华丽³

作者信息

^1.郑州市中心医院，河南郑州 450007

^2.联勤保障部队第988医院，河南郑州 450042

^3.郑州大学附属洛阳中心医院，河南洛阳 471000

通讯作者:

^* 赵欲晓（1969-），男，主任医师，从事针灸治疗疼痛及神经系统疾病相关研究。

作者简介:

胡静（1984-），女，硕士，主治医师，从事针灸理疗相关研究。

Clinical Study of Acupuncture Combined with Bloodletting Therapy Based on Meridian Sinew Theory in Patients with Peripheral Facial Palsy of the Wind-Cold Pattern

Jing HU¹, Rui ZAN², Huan QI¹, Yuxiao ZHAO¹^,^*, Huali LI³

Affiliations

^1.Zhengzhou Central Hospital, Zhengzhou 450007, China

^2.No. 988 Hospital of the Joint Logistics Support Force, Zhengzhou 450042, China

^3.Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang 471000, China

出版时间: 2026-08-20 doi: 10.19664/j.cnki.1002-2392.260160

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摘要

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目的：

观察基于经筋理论针刺联合放血疗法治疗风寒型周围性面瘫患者的临床效果。

方法：

选取2022年5月—2024年5月郑州市中心医院针灸理疗科就诊的风寒型周围性面瘫患者120例，采取随机分组法将其分为针刺组（筋针疗法）及联合组（筋针联合翳风穴刺血疗法），每组60例。针刺组基于经筋理论选穴，采用筋针针刺法，针刺组选穴为颧髎、攒竹、四白、阳白、太阳、地仓、颊车、合谷。进行皮下纵向、横向浅刺，联合组则在针刺组选穴基础上配合翳风穴放血疗法，以左手拇、食、中三指将翳风穴被刺处夹紧，点刺数下后再对点刺区域进行拔罐。连续治疗5 d 为1个疗程，每个疗程间隔2 d，共治疗2个疗程。在2个疗程结束后对两组患者治疗前后的House-Brackmann（H-B）分级量表、面部残疾指数（FDI）、周围性面神经炎治疗评分（Portmann）、瞬目反射、面部肌电图指标进行观察，对比两组患者临床疗效。

结果：

治疗后，FDI量表评分结果显示，联合组的躯体功能维度（FDIP）积分提升幅度显著优于针刺组，而社会功能维度（FDIS）评分下降趋势更为明显，差异具有统计学意义（P < 0.05），提示联合疗法对患者生理功能及社会适应能力的综合改善更具优势。Portmann评分结果显示，联合组评分显著高于针刺组，差异具有统计学意义（P < 0.05），联合组能更好地改善面神经功能；两组口轮匝肌、眼轮匝肌、鼻肌潜伏期均较同组治疗前显著缩短（P < 0.05），联合组口轮匝肌、眼轮匝肌、鼻肌潜伏期均明显短于针刺组（P < 0.05）；两组治疗后R1、R2波与对侧R2’波潜伏期均显著短于同组治疗前，同时联合组相比针刺组明显偏短，差异均具有统计学意义（P < 0.05），显示联合组在修复面神经功能上具有更好的疗效。

结论：

基于经筋理论针刺联合放血疗法可有效改善风寒型周围性面瘫患者的临床症状，对风寒型周围性面瘫患者均有显著疗效，其中采用筋针联合翳风穴刺血疗法治疗效果优于单用针刺，其能够减轻神经炎症、改善局部血液循环，修复受损的神经纤维，调节神经的兴奋性，较好地促进患者面神经功能康复。

关键词

筋针 / 翳风穴刺血 / 风寒型 / 急性周围性面瘫 / 临床疗效 / 作用机制

Abstract

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Objective:

To observe the treatment of patients with wind-cold type peripheral facial palsy using acupuncture combined with bloodletting therapy based on meridian sinew theory.

Methods:

A total of 120 patients with wind-cold type peripheral facial palsy treated at the Acupuncture and Physiotherapy Department of Zhengzhou Central Hospital from May 2022 to May 2024 were enrolled. They were randomly divided into an acupuncture group (sinew acupuncture therapy) and a combination group (sinew acupuncture combined with bloodletting at Yifeng acupoint), with 60 cases in each group. The acupuncture group received sinew acupuncture based on meridian sinew theory, with acupoint selection including: Quanliao (SI18), Cuanzhu (BL2), Sibai (ST2), Yangbai (GB14), Taiyang (EX-HN5), Dicang (ST4), Jiache (ST6), and Hegu (LI4). Subcutaneous longitudinal and transverse shallow needling was performed. In the combination group, in addition to the acupuncture points used in the acupuncture group, bloodletting therapy at Yifeng (TE17) was performed. The area around Yifeng acupoint was clamped with the thumb, index, and middle fingers of the left hand, pricked several times, followed by cupping on the pricked area. Five consecutive days of treatment constituted one course, with a 2-day interval between courses. A total of two courses were administered. After the two courses of treatment, the House-Brackmann (H-B) grading scale, Facial Disability Index (FDI), Portmann scale for peripheral facial neuritis, blink reflex, and facial electromyography parameters were observed in both groups before and after treatment to evaluate and compare the clinical efficacy.

Results:

After treatment, the FDI scale scores showed that the improvement in the physical function dimension (FDIP) score was significantly greater in the combination group than in the acupuncture group, while the decrease in the social function dimension (FDIS) score was more pronounced in the combination group, with statistically significant differences (P <0.05), indicating that the combined therapy had superior comprehensive improvement in patients' physiological function and social adaptability. The Portmann scale scores showed that the combination group had significantly higher scores than the acupuncture group (P < 0.05), indicating better improvement in facial nerve function in the combination group. The latencies of the orbicularis oris muscle, orbicularis oculi muscle, and nasalis muscle were significantly shortened in both groups compared with before treatment (P < 0.05). The latencies of the orbicularis oris muscle, orbicularis oculi muscle, and nasalis muscle in the combination group were significantly shorter than those in the acupuncture group (P <0.05). After treatment, the latencies of R1, R2, and contralateral R2' waves in both groups were significantly shorter than those before intervention, and the combination group showed significantly shorter latencies than the acupuncture group, with statistically significant differences (P <0.05), indicating that the combination group had better efficacy in repairing facial nerve function.

Conclusion:

Acupuncture combined with bloodletting therapy based on meridian sinew theory can effectively improve the clinical symptoms of patients with wind-cold type peripheral facial palsy. Both treatments have significant efficacy in patients with wind-cold type peripheral facial palsy, but the combination of sinew acupuncture and bloodletting at Yifeng acupoint is superior to acupuncture alone. This combined therapy can reduce nerve inflammation, improve local blood circulation, repair damaged nerve fibers, regulate nerve excitability, better promote the recovery of facial nerve function.

Key words

Sinew acupuncture / Bloodletting at Yifeng (TE17) acupoint / Wind-cold type / Acute peripheral facial palsy / Clinical efficacy / Mechanism of action

引用本文

胡静, 昝蕊, 祁欢, 赵欲晓, 李华丽. 基于经筋理论针刺联合放血疗法治疗风寒型周围性面瘫患者的临床研究. 中医药学报, 2026 , 54 (8) : 51 -57 . DOI: 10.19664/j.cnki.1002-2392.260160

Jing HU, Rui ZAN, Huan QI, Yuxiao ZHAO, Huali LI. Clinical Study of Acupuncture Combined with Bloodletting Therapy Based on Meridian Sinew Theory in Patients with Peripheral Facial Palsy of the Wind-Cold Pattern[J]. Acta Chinese Medicine and Pharmacology, 2026 , 54 (8) : 51 -57 . DOI: 10.19664/j.cnki.1002-2392.260160

基金

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河南医学科技攻关计划联合共建项目(LHGJ20200872)

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2026年第54卷第8期

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文章信息

doi: 10.19664/j.cnki.1002-2392.260160

接收时间：2025-03-26
首发时间：2026-09-17
出版时间：2026-08-20

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收稿日期：2025-03-26
修回日期：2026-03-23

基金

河南医学科技攻关计划联合共建项目(LHGJ20200872)

作者信息

^1.郑州市中心医院，河南郑州 450007

^2.联勤保障部队第988医院，河南郑州 450042

^3.郑州大学附属洛阳中心医院，河南洛阳 471000

通讯作者:

^* 赵欲晓（1969-），男，主任医师，从事针灸治疗疼痛及神经系统疾病相关研究。

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https://castjournals.cast.org.cn/joweb/zyyxb/CN/10.19664/j.cnki.1002-2392.260160

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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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