“半刺疗法”对早期周围性面瘫的临床观察
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摘要
目的：基于中医基础理论及现代腧穴研究,观察比较半刺疗法与普通针刺方法治疗早期周围性面瘫临床的疗效。
方法：选择2009年4月至2010年1月江苏省中医院针灸科,针刺疗法对早期周围性面瘫观察患者62例：随机分为治疗组和对照组.治疗组为半刺疗法31例,对照组为普通针刺治疗31例。观察治疗前后自身对照10天,20天,30天,终止后,对每一病例进行分析对House-Brackmann面神经平级刺度,作为面部神经功能恢复的评价标准使用。用统计学方法分析评定结果,比较两组间的疗效。
结果：1.10天后治疗组有效21例,总有效率为67.74%；对照组有效12例,总有效率为38.71%。2.20天后治疗组痊愈率25.81%和有效率为74.19%,总有效率100%；对照组有效23例,总有效率为74.19%。3.30天后治疗组痊愈22例,痊愈率70.97%；对照组痊愈4例,痊愈率12.90%。4.为疗程与疗效的关系：痊愈病例中分析,治疗组1个疗程之内痊愈0例,2个疗程之内痊愈8例(21.85%),3个疗程之内痊愈22例(70.97%)。对照组3个疗程后之内治痊愈4例(12.9%),经统计学处理P＜0.05.结论：1.两组有显著性差异,提示“半刺疗法”能明显缩短疗程。2.早期治疗时避免脸部过强过量的刺激；采用浅刺,轻刺,不提不插,不捻转,不透穴。3.表明在急性期适当的针灸治疗。有助于改善面神经病变和急性期恢复,针灸治疗周围性面神经麻痹时间是越早越好。
OBJECTIVE:To compare the effect between electro-acupuncture with semi barbed therapy (kind of superficial needling)on peripheral facial paralysis at early stage according to the Traditional Chinese Medicine and Modern Acupuncture point Theory.
METHODS:Totally 62 cases including 35 males and 27 females with peripheral facial paralysis at early stage were selected from the out patient service of Acupuncture department of Jiansu Province Chinese Traditional Medicine Hospital in Nanjing between April 2009 and January 2010. The patients were divided into two groups, one treated with electro-acupuncture and the second treated with semi barbed therapy (kind of superficial needling) according to the principle in Traditional Chinese Medicine of determination of treatment based on the differentiation of symptoms and signs.10±2 points were treated every time in semi barbed therapy on the affected side,filiform needle were punctured into the local area shallowly (0.1-0.2 inch) with gentle stimulation, do not lift and thrust the needle, and not insert the needle deeply.8±2 points were treated every time in electro-acupuncture.All the cases were treated once a day with the needles retaining for 30 minutes,10 times of treatment constitute one course. The patients were observed one month before and after self-comparison. Therapeutic effect were evaluated every 10 days (every course of treatment) and after finish treatment,using the House-Brackman Facial nerve grading system as a facial nerve function recovery evaluation.
RESULTS:1. After 10 days of treatment for the semi barbed therapy group among 31 cases,21 cases were effective;the rate of total effectiveness was 76.74%. The electro-acupuncture group among 31 cases,12 cases were effective; the rate of totaleffectiveness was 38.71%.2. After 20 days of treatment for the semi barbed therapy group among 31 cases,8 cases were recovery,23 cases were effective, the rate of total effectiveness was 100%. The electro-acupuncture group among 31 cases,23 cases were effective; the rate of totaleffectiveness was 74.19%.3. After 30 days of treatmentertainment for the semi barbed therapy group among 31 cases,22 cases were recovery, the rate of total cure was 70.97%.The electro-acupuncture group among 31 cases,4 cases were recovery, the rate of total cure was 12.90%4. The relation between the treatment and the recovery shows:after 1 course of treatment the total rate of recovery for the two groups was 0%; after 2 courses of treatment the rate of total recovery for the semi barbed therapy was 21.85%, for the electro-acupuncture therapy was 0%; after 3 courses of treatment the rate of total recovery for semibarbed theraphy was 70.97% and for electro-acupuncture therapy was 12.9%.(P<0.05).
CONCLUSION:Through clinical observation, it is found that for semi barbed group therapy at the acute stage the curative rate 70.97% is much better than that of electro-acupuncture group therapy 12.9%. It is fully indicated that appropriate acupuncture treatment at the acute stage will not cause aggravation of the condition, but can improve the recovery of facial nerve and acute stage is the right time for acupuncture treatment for peripheral facial paralysis. The earlier, the better.
方法：选择2009年4月至2010年1月江苏省中医院针灸科,针刺疗法对早期周围性面瘫观察患者62例：随机分为治疗组和对照组.治疗组为半刺疗法31例,对照组为普通针刺治疗31例。观察治疗前后自身对照10天,20天,30天,终止后,对每一病例进行分析对House-Brackmann面神经平级刺度,作为面部神经功能恢复的评价标准使用。用统计学方法分析评定结果,比较两组间的疗效。
结果：1.10天后治疗组有效21例,总有效率为67.74%；对照组有效12例,总有效率为38.71%。2.20天后治疗组痊愈率25.81%和有效率为74.19%,总有效率100%；对照组有效23例,总有效率为74.19%。3.30天后治疗组痊愈22例,痊愈率70.97%；对照组痊愈4例,痊愈率12.90%。4.为疗程与疗效的关系：痊愈病例中分析,治疗组1个疗程之内痊愈0例,2个疗程之内痊愈8例(21.85%),3个疗程之内痊愈22例(70.97%)。对照组3个疗程后之内治痊愈4例(12.9%),经统计学处理P＜0.05.结论：1.两组有显著性差异,提示“半刺疗法”能明显缩短疗程。2.早期治疗时避免脸部过强过量的刺激；采用浅刺,轻刺,不提不插,不捻转,不透穴。3.表明在急性期适当的针灸治疗。有助于改善面神经病变和急性期恢复,针灸治疗周围性面神经麻痹时间是越早越好。
OBJECTIVE:To compare the effect between electro-acupuncture with semi barbed therapy (kind of superficial needling)on peripheral facial paralysis at early stage according to the Traditional Chinese Medicine and Modern Acupuncture point Theory.
METHODS:Totally 62 cases including 35 males and 27 females with peripheral facial paralysis at early stage were selected from the out patient service of Acupuncture department of Jiansu Province Chinese Traditional Medicine Hospital in Nanjing between April 2009 and January 2010. The patients were divided into two groups, one treated with electro-acupuncture and the second treated with semi barbed therapy (kind of superficial needling) according to the principle in Traditional Chinese Medicine of determination of treatment based on the differentiation of symptoms and signs.10±2 points were treated every time in semi barbed therapy on the affected side,filiform needle were punctured into the local area shallowly (0.1-0.2 inch) with gentle stimulation, do not lift and thrust the needle, and not insert the needle deeply.8±2 points were treated every time in electro-acupuncture.All the cases were treated once a day with the needles retaining for 30 minutes,10 times of treatment constitute one course. The patients were observed one month before and after self-comparison. Therapeutic effect were evaluated every 10 days (every course of treatment) and after finish treatment,using the House-Brackman Facial nerve grading system as a facial nerve function recovery evaluation.
RESULTS:1. After 10 days of treatment for the semi barbed therapy group among 31 cases,21 cases were effective;the rate of total effectiveness was 76.74%. The electro-acupuncture group among 31 cases,12 cases were effective; the rate of totaleffectiveness was 38.71%.2. After 20 days of treatment for the semi barbed therapy group among 31 cases,8 cases were recovery,23 cases were effective, the rate of total effectiveness was 100%. The electro-acupuncture group among 31 cases,23 cases were effective; the rate of totaleffectiveness was 74.19%.3. After 30 days of treatmentertainment for the semi barbed therapy group among 31 cases,22 cases were recovery, the rate of total cure was 70.97%.The electro-acupuncture group among 31 cases,4 cases were recovery, the rate of total cure was 12.90%4. The relation between the treatment and the recovery shows:after 1 course of treatment the total rate of recovery for the two groups was 0%; after 2 courses of treatment the rate of total recovery for the semi barbed therapy was 21.85%, for the electro-acupuncture therapy was 0%; after 3 courses of treatment the rate of total recovery for semibarbed theraphy was 70.97% and for electro-acupuncture therapy was 12.9%.(P<0.05).
CONCLUSION:Through clinical observation, it is found that for semi barbed group therapy at the acute stage the curative rate 70.97% is much better than that of electro-acupuncture group therapy 12.9%. It is fully indicated that appropriate acupuncture treatment at the acute stage will not cause aggravation of the condition, but can improve the recovery of facial nerve and acute stage is the right time for acupuncture treatment for peripheral facial paralysis. The earlier, the better.
引文
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