Abstract:

Objective　To investigate the clinical efficacy of low-frequency pulse electrical stimulation combined with warm acupuncture in the treatment of refractory facial paralysis (RBFP) in the elderly and its effect on oxidative stress indicators. Methods　A prospective study was conducted to select 84 elderly patients with RBFP admitted to Weihai Central Hospital Affiliated to Qingdao University from January 2021 to December 2023. They were divided into two groups according to the random number method, with 42 cases in each group.Control group : 23 males and 19 females, aged (69.74±7.85) years, course of disease (98.43±22.79) d ; give warm acupuncture treatment.Observation group : 20 males and 22 females, aged (69.50±7.74) years, course of disease (100.15±21.34) d ; on the basis of the control group, low frequency pulse electrical stimulation was given.Both groups were treated once a day, 10 days as a course of treatment, a total of 2 courses of treatment.The clinical efficacy and Sunnybrook (Toronto) facial nerve assessment system score, facial disability index (FDI), oxidative stress index [ superoxide dismutase (SOD), malondialdehyde (MDA)] before and after treatment were compared between the two groups.The statistical methods were χ² test and t test. Results　After treatment, the curative effect of the observation group was better than that of the control group [78.57%(33/42) vs. 95.24%(40/42)], and the Sunnybrook facial nerve assessment system score was higher than that of the control group [(70.36±8.44) points vs. (62.89±7.02) points], the differences were statistically significant (χ²=5.126, t=4.410; both P<0.05);The physical function ( FDIP ) score of the observation group was higher than that of the control group, and the social function (FDIS) score was lower than that of the control group, the differences were statistically significant (t=8.887,9.799; both P<0.05);The serum SOD level in the observation group was higher than that in the control group [(113.97±10.25) nU/ml vs. (95.24±8.57) nU/ml], and the serum MDA level was lower than that in the control group [(3.28±0.39) nmol/L vs. (4.93±0.64) nmol/L], the differences were statistically significant (t=9.085,14.268; both P<0.05). Conclusion　Low-frequency pulse electrical stimulation combined with warm acupuncture can improve the clinical efficacy of elderly patients with RBFP, improve the facial nerve function score and FDIP/FDIS score, and synergistically optimize the balance of oxidative stress, which is more advantageous than single warm acupuncture.

Key words:

Refractory facial paralysis, Warm acupuncture, Low-frequency pulsed electrical stimulation, Oxidative stress, Clinical efficacy, The aged

摘要：

目的　探讨低频脉冲电刺激结合温针灸治疗老年顽固性面瘫（RBFP）的临床疗效及对氧化应激指标的影响。方法　采用前瞻性研究，选取2021年1月至2023年12月青岛大学附属威海市中心医院收治的84例老年RBFP患者，按照随机数字法分为两组，每组42例。对照组：男23例，女19例，年龄（69.74±7.85）岁，病程（98.43±22.79）d；给予温针灸治疗。观察组：男20例，女22例，年龄（69.50±7.74）岁，病程（100.15±21.34）d；在对照组基础上给予低频脉冲电刺激治疗。两组均每日治疗1次，10 d为1个疗程，共治疗2个疗程。比较两组临床疗效和治疗前后Sunnybrook（多伦多）面神经评定系统评分、面部残疾指数（FDI）、氧化应激指标［超氧化物歧化酶（SOD），丙二醛（MDA）］。统计学方法采用χ²检验、t检验。结果　治疗后，观察组疗效优于对照组［95.24%（40/42）比78.57%（33/42）］，Sunnybrook面神经评定系统评分高于对照组［（70.36±8.44）分比（62.89±7.02）分］，差异均有统计学意义（χ²=5.126，t=4.410，均P<0.05）；观察组躯体功能（FDIP）评分高于对照组，社会功能（FDIS）评分低于对照组，差异均有统计学意义（t=8.887、9.799，均P<0.05）；观察组血清SOD水平高于对照组［（113.97±10.25）nU/ml比（95.24±8.57）nU/ml］，血清MDA水平低于对照组［（3.28±0.39）nmol/L比（4.93±0.64）nmol/L］，差异均有统计学意义（t=9.085、14.268，均P<0.05）。结论　低频脉冲电刺激联合温针灸可提高老年RBFP患者的临床疗效，改善面神经功能评分及FDIP/FDIS评分，并协同优化氧化应激平衡，较单一温针灸更具优势。

关键词:

顽固性面瘫, 温针灸, 低频脉冲电刺激, 氧化应激, 临床疗效, 老年人