分期针刺治疗周围性面神经麻痹的研究进展

Research Progress on Stage-Specific Acupuncture Treatment for Peripheral Facial Paralysis

摘要: 周围性面神经麻痹临床主要分为急性期、恢复期、后遗症期。针刺作为其特色疗法，有着早期干预、分期施治的临床特点。不同分期针刺治疗的主要作用机制和治疗方案各不相同：急性期以调节免疫抑制状态、控制面神经炎症反应为核心，治疗多采用局部轻刺激、远端重刺激、巨刺法等；恢复期核心机制为上调神经营养因子，促进面神经再生与修复，提高神经兴奋性，促进面神经功能修复为主，此期间多采用较强刺激疗法，如电针疗法、滞针提拉法、透刺法等；后遗症期，机制重点在于调节脑功能连接和可塑性，治疗上多采用辩证分型疗法、头针疗法等。本文通过总结国内外研究进展，来探讨不同分期针刺治疗周围性面神经麻痹的作用机制以及主要治疗方法，为临床治疗提供参考。

Abstract: Peripheral facial paralysis is clinically categorized into three stages: the acute stage, recovery stage, and sequelae stage. As a distinctive therapeutic approach, acupuncture is characterized by early intervention and stage-specific treatment. The primary mechanisms and treatment regimens vary across different stages: In the acute stage, the focus is on modulating the state of immune suppression and controlling inflammatory responses of the facial nerve. Treatment strategies primarily include mild local stimulation, heavy distal stimulation, and opposite needling (Ju-ci method). In the recovery stage, the core mechanism involves upregulating neurotrophic factors to promote facial nerve regeneration and repair, enhance neuronal excitability, and facilitate the restoration of nerve function. Stimulation intensity is typically increased during this period, using methods such as electroacupuncture, twirling-lifting needle manipulation, and point-through-point needling. In the sequelae stage, the therapeutic emphasis shifts to regulating brain functional connectivity and plasticity, often employing treatment based on syndrome differentiation and scalp acupuncture. By summarizing domestic and international research progress, this article explores the mechanisms and primary treatment methods of stage-specific acupuncture for peripheral facial paralysis, aiming to provide a reference for clinical practice.