Clinical Study on Thum- tack Needling for Subcutaneous Embedding Combined with Transcranial Magnetic Stimulation and Routine Therapy for Central Facial Palsy After Ischemic Stroke
Abstract:Objective:To observe the curative effect of thum-tack needling for subcutaneous embedding combined with transcranial magnetic stimulation and routine therapy for central facial palsy after ischemic stroke. Methods:The clinical data of 202 patients with central facial palsy after ischemic stroke were given retrospective analysis, and divided into Group A , Group B and Group C according to their treatment methods , with 78 , 60 and 64 cases in each group respectively. All the three groups were treated with routine therapies such as medication and rehabilitation training; Group A was additionally treated with transcranial magnetic stimulation,Group B was additionally treated with thum-tack needling for subcutaneous embedding therapy,and Group C was additionally treated with transcranial magnetic stimulation and thumtack needling for subcutaneous embedding therapy. All the three groups were treated for 4 weeks. The Modified House- Brackmann (MHBN), Facial Disability Index (FDI) score, Facial Clinimetric Evaluation Scale (FaCE) score, transient reflexes R1, R2, R2' wave rate, and blink reflex abnormality rate of the affected side were compared among the three groups before treatment and after 4 weeks of treatmen. Results: After treatment, the overall comparison of MHBN data among the three groups showed significant difference (P<0.05);the facial nerve function in Group C was better than those in Group A and Group B (P<0.05),and there was no significant difference in MHBN data between Group A and Group B (P>0.05). The scores of physical function and social life function among the three groups showed significant differences (P<0.05). The physical function scores in all the three groups were increased when compared with those before treatment, and the social life function scores were decreased when compared with those before treatment,differences being significant (P<0.05). The physical function score in Group C was higher than those in Group A and Group B,and the social life function score was lower than those in Group A and Group B,differences being significant (P<0.05). The physical function score in Group B was higher than that in Group A,and the social life function score was lower than that in Group A,differences being significant (P<0.05). The scores of facial movement,facial sensation,oral function,eye sensation,and tear secretion of FaCE among the three groups showed significant differences (P<0.05). The scores of facial movement, facial sensation, oral function, eye sensation, and tear secretion in the three groups were all increased when compared with those before treatment, differences being significant (P<0.05). The above scores in Group C were higher than those in Group A and Group B (P<0.05),and there was no significant difference being found in the scores between Group A and Group B (P>0.05). There was no significant difference being found in the wave rates of blink reflex R1 of the affected side among the three groups (P>0.05). There were significant differences being found in the wave rates of blink reflex R2 and R2' of the affected side among the three groups (P>0.05). The wave rates of blink reflex R1,R2,and R2' of the affected side in the three groups were higher than those before treatment (P<0.05), and the wave rates of blink reflex R2 and R2' of the affected side in Group C were higher than those in Group A and Group B (P<0.05). There was no significant difference being found in the blink reflex R2 and R2' wave rates of the affected side between Group A and Group B (P>0.05). The abnormality rates of blink reflex among the three groups showed significant difference (P<0.05). The abnormality rates of blink reflex on the affected side in all the three groups were lower than those before treatment (P<0.05), and the abnormality rate of blink reflex on the affected side in Group C was lower than those in Group A and Group B (P<0.05). There was no significant difference being found in the abnormality rates of blink reflex between Group A and Group B (P> 0.05). Conclusion:Thum-tack needling for subcutaneous embedding combined with transcranial magnetic stimulation and routine therapy has good clinical effects in treating patients with central facial palsy after ischemic stroke. It can effectively reduce the degree of facial nerve injury,improve facial function and nerve excitation conduction,promote the recovery of facial nerve function,and effectively treat facial paralysis.