不同波形电针治疗周围性面神经麻痹疗效对比研究
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摘要
目的比较不同波形电针治疗周围性面神经麻痹的临床疗效。方法将120例周围性面神经麻痹患者随机分为A组、B组、C组和D组,每组30例。4组均取相同穴位进行电针治疗,其中A组采用疏波,B组采用密波,C组采用疏密波,D组采用断续波。4组均每日治疗1次,12次为1个疗程。治疗2个疗程后观察4组患者治疗前后House-Brackmann(H-B)量表评分变化情况,并比较各组临床疗效。结果 A组总有效率为60.0%,B组为66.7%,C组63.3%,D组为86.7%。D组临床疗效与其他3组比较,差异均具有统计学意义(P<0.05)。4组治疗1、2个疗程后H-B评分与同组治疗前比较,差异具有统计学意义(P<0.01)。D组治疗1、2个疗程后H-B评分与其他3组比较,差异具有统计学意义(P<0.05,P<0.01)。D组病程≤7 d的患者痊愈率为81.3%,病程>7 d的患者痊愈率为42.9%。两者临床疗效比较,差异具有统计学意义(P<0.05)。结论电针是一种治疗周围性面神经麻痹的有效方法 ,其中断续波的治疗效果优于其他波形。
Objective To compare the clinical efficacies of electroacupuncture with different waves in treating peripheral facial paralysis. Method A total of 120 patients with peripheral facial paralysis were randomized into group A, B, C and D, 30 cases in each group. Same acupoints were selected in the four groups for electroacupuncture treatment, but with sparse wave in group A, dense wave in group B, sparse-dense wave in group C and discontinuous wave in group D. For the four groups, the treatment was given once a day, 12 sessions as a treatment course. After 2 treatment courses, House-Brackmann(H-B) facial nerve grading system was observed to see the changes in the four groups, and the clinical efficacies were compared.Result The total effective rate was 60.0% in group A, 66.7% in group B, 63.3% in group C and 86.7% in group D. The clinical efficacy of group D was significantly different from that of the other three groups(P<0.05). Respectively after 1 and 2 treatment courses, the H-B scores were significantly changed compared with that before treatment in the four groups(P<0.01). Respectively after 1 and 2 treatment courses, the H-B scores in group D were significantly different from those in the other three groups(P<0.05,P<0.01). In group D, the recovery rate was 81.3% in the patients with a disease duration ≤7 d and was 42.9% in those with a disease duration >7 d, and the difference was statistically significant(P<0.05). Conclusion Electroacupuncture is an effective method in treating peripheral facial paralysis, and the treatment result of discontinuous wave is better than that of other waves.
Objective To compare the clinical efficacies of electroacupuncture with different waves in treating peripheral facial paralysis. Method A total of 120 patients with peripheral facial paralysis were randomized into group A, B, C and D, 30 cases in each group. Same acupoints were selected in the four groups for electroacupuncture treatment, but with sparse wave in group A, dense wave in group B, sparse-dense wave in group C and discontinuous wave in group D. For the four groups, the treatment was given once a day, 12 sessions as a treatment course. After 2 treatment courses, House-Brackmann(H-B) facial nerve grading system was observed to see the changes in the four groups, and the clinical efficacies were compared.Result The total effective rate was 60.0% in group A, 66.7% in group B, 63.3% in group C and 86.7% in group D. The clinical efficacy of group D was significantly different from that of the other three groups(P<0.05). Respectively after 1 and 2 treatment courses, the H-B scores were significantly changed compared with that before treatment in the four groups(P<0.01). Respectively after 1 and 2 treatment courses, the H-B scores in group D were significantly different from those in the other three groups(P<0.05,P<0.01). In group D, the recovery rate was 81.3% in the patients with a disease duration ≤7 d and was 42.9% in those with a disease duration >7 d, and the difference was statistically significant(P<0.05). Conclusion Electroacupuncture is an effective method in treating peripheral facial paralysis, and the treatment result of discontinuous wave is better than that of other waves.
引文
[1]叶春华,黄静.中西医结合治疗周围性面神经麻痹疗效观察[J].上海针灸杂志,2010,29(1):14-16.
[2]赵清燕.电针预测周围性面瘫的预后[J].浙江中医药大学学报,2007,31(1):111,113.
[3]王启才.针灸治疗学[M].第2版,北京:中国中医药出版社,2007:69.
[4]吴江.神经病学[M].北京:人民卫生出版社,2005:121.
[5]House JW.Brackmann DE.Facial nervegradingsystem[J].Otolaryngol Head Neck Surg,1985,93(2):146-147.
[6]Leonetti JP,Marzo SJ,Anderson DA,et al.Neoplastic causes of nonacute facial paralysis:A review of 221cases[J].Ear Nose Throat J,2016,95(9):390-404.
[7]Vivera MJ,Gomersall JS.The effectiveness of ayurvedic oil-based nasal instillation(Nasya)medicines in the treatment of facial paralysis(Ardita):a systematic review[J].JBI Database System Rev Implement Rep,2016,14(4):198-228.
[8]Codari M,Pucciarelli V,Stangoni F,et al.Facial thirds-based evaluation of facial asymmetry using stereophotogrammetric devices:Application to facial palsy subjects[J].J Craniomaxillofac Surg,2017,45(1):76-81.
[9]Dziedzic TA,Kunert P,Marchel A.Results of hemihypoglossal-facial nerve anastomosis in the treatment of facial nerve paralysis after failed stereotactic radiosurgery for vestibular schwannoma[J].J Neurosurg Sci,2017,61(2):207-212.
[10]周丽云.针刺循经筋阿是穴治疗周围性面瘫的临床研究[J].航空航天医学杂志,2015,26(12):1538-1539.
[11]程爱军.近十年针刺治疗周围性面瘫的研究进展[J].世界中医药,2015,10(1):794.
[12]郭秀冰,王宁宁,张少群,等.棍针配合针刺治疗周围性面瘫临床观察[J].上海针灸杂志,2012,31(8):574-576.
[13]邢丹,倪姗姗,高旭超,等.针灸择期治疗周围性面瘫疗效观察[J].上海针灸杂志,2010,29(5):289-291.
[14]常雪利.电针配合TDP治疗周围性面瘫疗效观察[J].中医临床研究,2011,3(13):65-66.
[15]毛林焕,李妍,李桂平.电针治疗周围性面瘫介入时机和波形选择的临床研究进展[J].江苏中医药,2009,41(7):85-86.
[16]桑久华,孙丽艳.电针浅刺治疗急性期周围性面瘫疗效观察[J].上海针灸杂志,2013,32(9):715-716.
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[18]吴曦,晋松,陈敏,等.电针为主治疗腰椎间盘突出所致坐骨神经痛:多中心随机对照试验[J].成都中医药大学学报,2015,38(2):43-47.
[19]孙晶,王超,陈利芳,等.电针分期治疗面神经炎之优势参数探讨[J].上海针灸杂志,2016,35(1):101-104.
[20]蒯乐,杨华元,刘堂义,等.不同脉冲波形电针对佐剂性关节炎大鼠的影响[J].中国针灸,2005,25(1):68-71.
[21]牙祖蒙,王建华,李忠禹,等.穴位电针刺激对面神经再生过程中表情肌组织神经生长因子m RNA表达的影响[J].中华物理医学与康复杂志,2000,22(3):157-159.
[22]牙祖蒙,王建华,李忠禹,等.穴位电针刺激对面神经再生过程中神经营养因子-3m RNA表达的影响[J].中华理疗杂志,2000,23(2):99-101.
[23]Wallace MC,Tator CH,Piper I.Recovery of spinal cord function induced by direct current stimulation of the injured rat spinal cord[J].Neurosurgery,1987,20(6):878-884.
[24]李庆雯,石田寅夫,郭义,等.不同频率电针对大鼠坐骨神经损伤后神经与骨骼肌组织形态学的影响[J].天津体育学院学报,2005,20(1):41-45.
[2]赵清燕.电针预测周围性面瘫的预后[J].浙江中医药大学学报,2007,31(1):111,113.
[3]王启才.针灸治疗学[M].第2版,北京:中国中医药出版社,2007:69.
[4]吴江.神经病学[M].北京:人民卫生出版社,2005:121.
[5]House JW.Brackmann DE.Facial nervegradingsystem[J].Otolaryngol Head Neck Surg,1985,93(2):146-147.
[6]Leonetti JP,Marzo SJ,Anderson DA,et al.Neoplastic causes of nonacute facial paralysis:A review of 221cases[J].Ear Nose Throat J,2016,95(9):390-404.
[7]Vivera MJ,Gomersall JS.The effectiveness of ayurvedic oil-based nasal instillation(Nasya)medicines in the treatment of facial paralysis(Ardita):a systematic review[J].JBI Database System Rev Implement Rep,2016,14(4):198-228.
[8]Codari M,Pucciarelli V,Stangoni F,et al.Facial thirds-based evaluation of facial asymmetry using stereophotogrammetric devices:Application to facial palsy subjects[J].J Craniomaxillofac Surg,2017,45(1):76-81.
[9]Dziedzic TA,Kunert P,Marchel A.Results of hemihypoglossal-facial nerve anastomosis in the treatment of facial nerve paralysis after failed stereotactic radiosurgery for vestibular schwannoma[J].J Neurosurg Sci,2017,61(2):207-212.
[10]周丽云.针刺循经筋阿是穴治疗周围性面瘫的临床研究[J].航空航天医学杂志,2015,26(12):1538-1539.
[11]程爱军.近十年针刺治疗周围性面瘫的研究进展[J].世界中医药,2015,10(1):794.
[12]郭秀冰,王宁宁,张少群,等.棍针配合针刺治疗周围性面瘫临床观察[J].上海针灸杂志,2012,31(8):574-576.
[13]邢丹,倪姗姗,高旭超,等.针灸择期治疗周围性面瘫疗效观察[J].上海针灸杂志,2010,29(5):289-291.
[14]常雪利.电针配合TDP治疗周围性面瘫疗效观察[J].中医临床研究,2011,3(13):65-66.
[15]毛林焕,李妍,李桂平.电针治疗周围性面瘫介入时机和波形选择的临床研究进展[J].江苏中医药,2009,41(7):85-86.
[16]桑久华,孙丽艳.电针浅刺治疗急性期周围性面瘫疗效观察[J].上海针灸杂志,2013,32(9):715-716.
[17]肖红梅.电针结合肌内效贴治疗难治性周围性面瘫疗效观察[J].实用中医药杂志,2015,31(8):752-753.
[18]吴曦,晋松,陈敏,等.电针为主治疗腰椎间盘突出所致坐骨神经痛:多中心随机对照试验[J].成都中医药大学学报,2015,38(2):43-47.
[19]孙晶,王超,陈利芳,等.电针分期治疗面神经炎之优势参数探讨[J].上海针灸杂志,2016,35(1):101-104.
[20]蒯乐,杨华元,刘堂义,等.不同脉冲波形电针对佐剂性关节炎大鼠的影响[J].中国针灸,2005,25(1):68-71.
[21]牙祖蒙,王建华,李忠禹,等.穴位电针刺激对面神经再生过程中表情肌组织神经生长因子m RNA表达的影响[J].中华物理医学与康复杂志,2000,22(3):157-159.
[22]牙祖蒙,王建华,李忠禹,等.穴位电针刺激对面神经再生过程中神经营养因子-3m RNA表达的影响[J].中华理疗杂志,2000,23(2):99-101.
[23]Wallace MC,Tator CH,Piper I.Recovery of spinal cord function induced by direct current stimulation of the injured rat spinal cord[J].Neurosurgery,1987,20(6):878-884.
[24]李庆雯,石田寅夫,郭义,等.不同频率电针对大鼠坐骨神经损伤后神经与骨骼肌组织形态学的影响[J].天津体育学院学报,2005,20(1):41-45.