| ObjectiveLiterature shows that acupuncture treatment of facial paralysis sequelae is effective.Modern studies have shown that there is a competitive activity-dependent interaction between the cortical crossovers,leading to functional recombination of the hand and facial regions.This study observed the different part of acupuncture in patients with facial paralysis sequelae period curative effect,and to observe the acupuncture cerebral motor cortex in patients with facial paralysis sequelae stage hand area and area,and then explore the acupuncture treatment of surrounding brain plasticity mechanism of patients with facial paralysis sequelae,to reveal the scientific connotation of near and far way find and clinical acupuncture treatment of facial paralysis and facial spasm facial disorders provide detailed scientific basis and clinical guidance.MethodsSixty-six patients with peripheral facial paralysis sequelae meeting the diagnostic criteria were recruited from the acupuncture and moxibustion clinic of guangdong hospital of traditional Chinese medicine,6 of whom fell off,and 60 were included,including 14 males,aged 18-63 years old,with an average of 36.52 years old and an average course of disease of 46.72 months.Each patient was randomly treated with 3 intervention measures(electroacupuncture facial acupoint,electroacupuncture hegu point and false acupuncture)for 30min with a frequency of 2Hz.The intensity was determined by the patient’s tolerance degree.The motor evoked potential(MEPs)of the first dorsal interosseous muscle(FDI),orbicularis oculi muscle(00)and the effective sites of cortical stimulation were detected by transcranial magnetic stimulation(TMS)before and after electroacupuncture.The subject was registered in the Chinese clinical trial registry.The subject was the study on the effect of electroacupuncture on the functional recombination of cerebral motor cortex in patients with sequelae of peripheral facial paralysis.The registration number was ChiCTR1800019809.Results1.Comparison of basic data:there was no significant difference in gender composition,age composition and disease course of subjects in each group,and there was no significant difference in scale score and emg assessment of subjects in each group before treatment.2.Comparison of basic state:subjects in each group had the same baseline state,and the total MEPs,average MEPs,and the number of effective cortical stimulation sites in the hand and face areas of the motor cortex of the subjects had no statistical significance and were comparable.3.Therapeutic effect of electroacupuncture on patients with facial paralysis sequelae(1)after treatment,the grade evaluation of the h-b scale in sibai group was significantly improved,with an apparent efficiency of 70%,and the scores of the FDI scale and symptom scale were significantly improved(P<0.05).There was no change in hegu group and sham acupuncture group.(2)after treatment,the degree of injury of temporal and buccal nerves showed by emg in sibai group was significantly improved(P=0.004,P=0.0015),and there was no change in hegu group and sham acupuncture group.4.Comparison of hand surface excitability(MEPs amplitude)before and after electroacupuncture in each group(1)intra-group comparison①Electroacupuncture on ST2 point makes the sum and the average of MEPs in face area of the motor cortex significantly increased(P<0.05),the sum and the average of MEPs in hand area of motor cortex significantly decreased(P<0.05).②Electroacupuncture on LI4 point makes the sum and the average of MEPs in the face area decreased significantly(P<0.05),while the sum and the average of MEPs in the hand area increased significantly(P<0.05).③In the sham acupuncture group,there was no significant change in MEPs in the hand area and face area.(2)comparison between groups The difference of MEPs in the hand area and face area of the cerebral motor cortex before and after electroacupuncture was tested by shapiro-wilk test,and it did not follow normal distribution.Therefore,kruskal-wallis test was used,and the difference between the three groups was significant(P<0.05).Pairwise comparison was conducted among the groups and the results were as follows:ST2 group,compared with the sham acupuncture group,the sum of MEPs of hand and face area in cerebral motor cortex have a significant differences.ST2 group,compared with the sham acupuncture group,the average of MEPs of hand area in cerebral motor cortex have significant differences.LI4 group,compared with the sham acupuncture group,the sum of MEPs of hand and face area in cerebral motor cortex have a significant differences.LI4 group,compared with the sham acupuncture group,the average of MEPs of hand area in cerebral motor cortex have significant differences.4.Changes of hand area before and after electroacupuncture in each group:(1)intra-group comparison①The hand area decreased in ST2 group and the area of face representation did not change significantly.②The face area decreased in LI4 group and the area of hand representation did not change significantly.③In the sham acupuncture group,there was no significant change in the hand area and face area.(2)comparison between groupsThe difference between the hand area and the face area of the cerebral motor cortex before and after electroacupuncture was tested by shapiro-wilk,which followed a normal distribution.One-way test of variance was selected,and the difference between the groups was statistically significant(P<0.05),indicating comparability.Further pairwise comparison showed that the changes in the number of effective stimulating hand area in the electroacupuncture sibai group were significantly different from that in the sham acupuncture group(P=0.036<0.05),and there was no difference in the surface area.Compared with the sham acupuncture group,there was a significant difference in the number of effective stimulation surface area in the electroacupuncture hegu group(P=0.024<0.05),and no difference in the hand area.Conclusion:Electroacupuncture facial acupoint has obvious curative effect on sequelae of peripheral facial paralysis.Electroacupuncture at ST2 and LI4 can lead to competitive inhibition between the hand surface areas of the motor cortex(acupuncture at ST2 can stimulate the motor skin area of the brain and inhibit the hand area of the motor cortex;Acupuncture LI4 can stimulate the hand area of cerebral motor cortex and inhibit the motor skin area;),and the efficacy of acupuncture is related to the competitive inhibition of the hand area of the cerebral cortex,which has important clinical significance for brain injury diseases. |
PDF Full Text Request