针灸治疗周围性面瘫急性期临床效果观察
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摘要
目的:通过治疗周围性面瘫急性期患者,探究针灸治疗的临床疗效与机制,并检测观察血清中IgG、IgA、IgM水平的变化及意义。方法:采用随机对照方法收集2015年4月—2017年12月于我院诊治的周围性面瘫急性期患者100例,采用随机数字表法将其随机分成对照组、观察组两组,各50例患者。观察组在患侧面部面瘫发作急性期(发病7 d内)即采取针灸治疗,以合谷(对侧)、迎香、阳白、四白、地仓、攒竹为主要针刺穴位,根据辨证论治的结果与证型特点取穴并施以合适的补泻操作手法;对照组在患侧面部面瘫发作急性期(发病7 d内)不进行面部的针刺治疗,但予以口服药强的松、VitB1、VitB6治疗,发病7 d后行面部针灸疗法,取穴与操作手法同观察组;治疗后比较两组的临床疗效,进行中医症状积分评价疗效以及H-B面神经功能分级量表评分评价面神经功能恢复情况,检测患者外周血清中IgG、IgA、IgM的水平并比较检测结果的差异与病情程度及疗效的关系。结果:治疗后,观察组与对照组比较总有效率明显升高,差异具有统计学意义(P<0.05);观察组中医症状积分改善情况明显优于对照组,差异具有统计学意义(P<0.05);观察组H-B面神经功能分级量表评分改善情况明显优于对照组,差异具有统计学意义(P<0.05);治疗后,两组患者血清中IgG、IgA、IgM水平均有明显下降(P<0.05),观察组下降更为明显,差异具有统计学意义(P<0.05)。结论:运用针灸治疗周围性面瘫急性期患者可明显提高临床疗效,有效促进中医症状改善及面神经功能的恢复,并且临床工作中可以通过血清中IgG、IgA、IgM水平联合检测值的异常变化来预测周围性面瘫急性期发作的病情严重程度与治疗效果,应在临床诊疗中广泛推广。
Objective :To explore the clinical effect and mechanism of acupuncture and moxibustion treatment on treating patients with peripheral facial paralysis in acute stage. The changes and significance of serum IgG,IgA and IgM in serum were detected. Methods :100 patients with peripheral facial paralysis who were diagnosed and treated in our hospital from April 2015 to December 2017 were randomly divided into two groups randomly :50 cases each. The observation group took acupuncture and moxibustion in the acute phase of onset of facial facial paralysis(within 7 days of onset). The main acupuncture points were Hegu(contralateral),Yingxiang,Yangbai,Sibai,the results were compared with the syndrome characteristics of acupoints and the appropriate method of reinforcing diarrhea. The control group received no facial acupuncture treatment in the acute stage(onset of 7 days),but prednisone,VitB1,VitB6 treatment,7 days after the onset of facial acupuncture,acupoints and operation practices with the observation group;After treatment,the clinical efficacy of two groups compared to evaluate the efficacy of Chinese medicine symptom scores and H-B Facial Nerve Function Scale scores to evaluate facial nerve function recovery,the levels of IgG,IgA and IgM in the peripheral blood of the patients were also tested. The differences of the test results were compared with the severity of the disease and the curative effect. Results :After treatment,the effective rate of treatment group was significantly higher than that of control group(P<0.05). The improvement of TCM symptom score in observation group was significantly better than that of control group(P<0.05). The scores of H-B Facial Nerve Function Scale in observation group were significantly better than those in control group(P<0.05). After treatment,the levels of IgG,IgA and IgM in serum of two groups were significantly decreased(P<0.05). The decrease of the observation group was more obvious,the difference was statistically significant(P<0.05). Conclusion :Acupuncture and moxibustion treatment of peripheral facial paralysis in patients with acute phase can significantly improve clinical efficacy and effectively promote the improvement of symptoms and facial nerve function recovery,and clinical work through the serum IgG,IgA,IgM levels combined with the detection of abnormal changes in the value to predict peripheral facial paralysis during the acute onset of the severity of the disease and treatment,should be widely promoted in clinical diagnosis and treatment.
Objective :To explore the clinical effect and mechanism of acupuncture and moxibustion treatment on treating patients with peripheral facial paralysis in acute stage. The changes and significance of serum IgG,IgA and IgM in serum were detected. Methods :100 patients with peripheral facial paralysis who were diagnosed and treated in our hospital from April 2015 to December 2017 were randomly divided into two groups randomly :50 cases each. The observation group took acupuncture and moxibustion in the acute phase of onset of facial facial paralysis(within 7 days of onset). The main acupuncture points were Hegu(contralateral),Yingxiang,Yangbai,Sibai,the results were compared with the syndrome characteristics of acupoints and the appropriate method of reinforcing diarrhea. The control group received no facial acupuncture treatment in the acute stage(onset of 7 days),but prednisone,VitB1,VitB6 treatment,7 days after the onset of facial acupuncture,acupoints and operation practices with the observation group;After treatment,the clinical efficacy of two groups compared to evaluate the efficacy of Chinese medicine symptom scores and H-B Facial Nerve Function Scale scores to evaluate facial nerve function recovery,the levels of IgG,IgA and IgM in the peripheral blood of the patients were also tested. The differences of the test results were compared with the severity of the disease and the curative effect. Results :After treatment,the effective rate of treatment group was significantly higher than that of control group(P<0.05). The improvement of TCM symptom score in observation group was significantly better than that of control group(P<0.05). The scores of H-B Facial Nerve Function Scale in observation group were significantly better than those in control group(P<0.05). After treatment,the levels of IgG,IgA and IgM in serum of two groups were significantly decreased(P<0.05). The decrease of the observation group was more obvious,the difference was statistically significant(P<0.05). Conclusion :Acupuncture and moxibustion treatment of peripheral facial paralysis in patients with acute phase can significantly improve clinical efficacy and effectively promote the improvement of symptoms and facial nerve function recovery,and clinical work through the serum IgG,IgA,IgM levels combined with the detection of abnormal changes in the value to predict peripheral facial paralysis during the acute onset of the severity of the disease and treatment,should be widely promoted in clinical diagnosis and treatment.
引文
[1]金明卜,徐萍,张叶熙,等.穴位针刺辅助刺络拔罐治疗周围性面瘫急性期疗效及对H-B分级的影响[J].中华中医药学刊,2017(10):2667-2669.
[2]陶天遵.临床常见疾病诊疗标准[M].北京:北京医科大学协和医科大学联合出版社,1993:112-116.
[3]张葆樽.神经疾病定位诊断[M].北京:人民卫生出版社,1975:112.
[4]朱春华,林学武.谈周围性面瘫针刺治疗时机[J].中国针灸,1994(4):117.
[5]郭润田.辨证治疗周围性面瘫临床总结[J].北京中医,1997,16(3):32.
[6]朱贻霖,肖姮,蔡嘉洛,等.电针治疗急性期周围性面瘫的Meta分析[J].中国中医基础医学杂志,2016(12):1673-1675.
[7]赵斌,杨颖婷,黄健澎,等.针刺治疗周围性面瘫的大脑运动皮层功能重组研究[J].中华中医药杂志,2016(5):1963-1966.
[8]夏剑锋.针灸联合祛风活络经验汤剂内服、熏洗辨治急性周围性面瘫的临床研究[J].中西医结合心脑血管病杂志,2017,15(21):2677-2679.
[9]鞠庆波,王鹏琴.眼针配合雷火灸治疗急性周围性面瘫临床观察[J].辽宁中医杂志,2017(5):1067-1069.
[10]王兵,杨金洪,陈枫,等.周围性面瘫临床研究中不同疗效评价方法的应用[J].中国中医基础医学杂志,2017(3):394-397.
[11]彭志杰,王妍妍,边涛,等.周围性面瘫的针灸取穴规律研究[J].针灸临床杂志,2016,32(5):55-57.
[12]梁晓婷,章海凤,付勇,等.热敏灸治疗周围性面瘫临床疗效的系统评价[J].中华中医药杂志,2016(2):648-652.
[13]鲍首燕,金红芳,魏琪.脑苷肌肽注射液联合针灸对小儿周围性面瘫血清MDA、SOD和NO水平的影响[J].中国现代医学杂志,2017,27(16):122-125.
[14]王海龙,宋永红,成敏锐,等.面瘫急性期(风寒证)针灸治疗优化方案的临床研究[J].中国中医急症,2017,26(2):320-323.
[15]李杰,陈挺,蒋悦,等.血清免疫球蛋白IgA、IgG、IgM水平与前列腺炎患者症状及治疗效果的关系[J].中国卫生检验杂志,2017(4):554-556.
[16] Parker A R,Allen S,Harding S. Concentration of antipneumococcal capsular polysaccharide IgM,IgG and IgA specific antibodies in adult blood donors[J]. Practical Laboratory Medicine,2016,5:1-5.
[17] Moschese V,Cavaliere F M,Graziani S,et al. Decreased IgM,IgA,and IgG response to pneumococcal vaccine in children with transient hypogammaglobulinemia of infancy[J]. Journal of Allergy&Clinical Immunology,2016,137(2):617-619.
[18]王春红,刘立安,戚其华.周围性面瘫急性期中医治疗方法研究进展[J].按摩与康复医学,2015,6(9):9-11.
[19]张加英,徐炳国,戴丽娟,等.周围性面瘫急性期针灸治疗的临床观察[J].中国中医急症,2014,23(2):347-348.
[20]张峻峰,王健雄.针刺治疗急性期周围性面瘫随机对照研究[J].针灸临床杂志,2014,30(4):9-11.
[2]陶天遵.临床常见疾病诊疗标准[M].北京:北京医科大学协和医科大学联合出版社,1993:112-116.
[3]张葆樽.神经疾病定位诊断[M].北京:人民卫生出版社,1975:112.
[4]朱春华,林学武.谈周围性面瘫针刺治疗时机[J].中国针灸,1994(4):117.
[5]郭润田.辨证治疗周围性面瘫临床总结[J].北京中医,1997,16(3):32.
[6]朱贻霖,肖姮,蔡嘉洛,等.电针治疗急性期周围性面瘫的Meta分析[J].中国中医基础医学杂志,2016(12):1673-1675.
[7]赵斌,杨颖婷,黄健澎,等.针刺治疗周围性面瘫的大脑运动皮层功能重组研究[J].中华中医药杂志,2016(5):1963-1966.
[8]夏剑锋.针灸联合祛风活络经验汤剂内服、熏洗辨治急性周围性面瘫的临床研究[J].中西医结合心脑血管病杂志,2017,15(21):2677-2679.
[9]鞠庆波,王鹏琴.眼针配合雷火灸治疗急性周围性面瘫临床观察[J].辽宁中医杂志,2017(5):1067-1069.
[10]王兵,杨金洪,陈枫,等.周围性面瘫临床研究中不同疗效评价方法的应用[J].中国中医基础医学杂志,2017(3):394-397.
[11]彭志杰,王妍妍,边涛,等.周围性面瘫的针灸取穴规律研究[J].针灸临床杂志,2016,32(5):55-57.
[12]梁晓婷,章海凤,付勇,等.热敏灸治疗周围性面瘫临床疗效的系统评价[J].中华中医药杂志,2016(2):648-652.
[13]鲍首燕,金红芳,魏琪.脑苷肌肽注射液联合针灸对小儿周围性面瘫血清MDA、SOD和NO水平的影响[J].中国现代医学杂志,2017,27(16):122-125.
[14]王海龙,宋永红,成敏锐,等.面瘫急性期(风寒证)针灸治疗优化方案的临床研究[J].中国中医急症,2017,26(2):320-323.
[15]李杰,陈挺,蒋悦,等.血清免疫球蛋白IgA、IgG、IgM水平与前列腺炎患者症状及治疗效果的关系[J].中国卫生检验杂志,2017(4):554-556.
[16] Parker A R,Allen S,Harding S. Concentration of antipneumococcal capsular polysaccharide IgM,IgG and IgA specific antibodies in adult blood donors[J]. Practical Laboratory Medicine,2016,5:1-5.
[17] Moschese V,Cavaliere F M,Graziani S,et al. Decreased IgM,IgA,and IgG response to pneumococcal vaccine in children with transient hypogammaglobulinemia of infancy[J]. Journal of Allergy&Clinical Immunology,2016,137(2):617-619.
[18]王春红,刘立安,戚其华.周围性面瘫急性期中医治疗方法研究进展[J].按摩与康复医学,2015,6(9):9-11.
[19]张加英,徐炳国,戴丽娟,等.周围性面瘫急性期针灸治疗的临床观察[J].中国中医急症,2014,23(2):347-348.
[20]张峻峰,王健雄.针刺治疗急性期周围性面瘫随机对照研究[J].针灸临床杂志,2014,30(4):9-11.
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