桂枝加葛根汤加减联合皮内针治疗面神经炎疗效观察
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摘要
目的:研究桂枝加葛根汤加减联合皮内针治疗面神经炎的临床疗效,旨在为更好的治疗面神经炎提供有效的理论依据。方法:将选本院2017年1月—2018年6月收治的88例面神经炎患者按随机数字表法分成对照组与研究组,每组44例。对照组给予牵正散加减联合电针治疗,研究组给予桂枝加葛根汤加减联合皮内针治疗。观察并比较治疗前后两组患者多伦多面神经功能评分(TFGS)、生活质量评分(QOL)评分、House-Braekmann(H-B)量表、面神经麻痹程度及肌电图相关指标变化,同时记录治疗期间的不良反应。结果:①研究组治疗后总有效率(95.45%)显著高于对照组(81.82%)(P<0.05);②两组治疗前TFGS、QOL评分比较,差异无统计学意义(P>0.05);两组治疗后TFGS评分高于治疗前,QOL评分低于治疗前(P<0.05),且研究组治疗后TFGS评分高于治疗前对照组,QOL评分低于治疗前对照组(P<0.05);③两组治疗前H-B分级比较,差异无统计学意义(P>0.05);两组治疗后H-B分级优于治疗前(P<0.05),且研究组治疗后H-B分级优于对照组(P<0.05);④两组治疗面神经麻痹程度分级比较,差异无统计学意义(P>0.05);两组治疗后面神经麻痹程度分级优于治疗前(P<0.05),且研究组治疗后面神经麻痹程度分级优于对照组(P<0.05);⑤两组治疗前CMAP波幅、RI潜伏期比较,差异无统计学意义(P>0.05);两组治疗后CMAP波幅高于治疗前,RI潜伏期低于治疗前(P<0.05);且研究组治疗后CMAP波幅高于对照组,RI潜伏期低于对照组(P<0.05);⑥研究组不良反应总发生率低于对照组(6.81%vs 11.37%),但差异无统计学意义(P>0.05)。结论:桂枝加葛根汤加减联合皮内针治疗面神经炎的临床疗效显著,促进面神经恢复,提高患者的生活质量,且无明显不良反应。
Objective:To investigate the therapeutic effect of Guizhi Gegen Decoction combined with intradermal needling on treating facial neuritis,so as to provide an effective theoretical basis for better treatment of facial neuritis. Methods:88 cases of facial neuritis treated in our hospital from January 2017 to June 2018 were selected and divided into two groups according to the random digital table method,each with 44 cases. The control group received the Qianzheng Powder plus electroacupuncture and the study group received the Guizhi Gegen Decoction. Scores of Toronto facial grading system(TFGS),quality of life(QOL),House-Braekmann(HB)scale,facial nerve paralysis degree,EMG related index and adverse reactions of the two groups were recorded and compared. Results: ①The total effective rate in the study group was significantly higher than that in the control group(95.45% vs 81.82%,P<0.05). ②TFGS and QOL scores between the two groups before treatment had no difference(P>0.05);After treatment,the TFGS score was increased in both groups,and was higher in the study group than that in the pre-treatment control group(P<0.05),meanwhile,the QOL score was decreased in both groups,and was lower in the study group than that in the pre-treatment control group(P<0.05). ③H-B classification had no difference between groups before treatment,which was ameliorated after treatment(P<0.05),and was better in the study group than that in the control group(P<0.05). ④The facial nerve paralysis degree had no difference between groups before treatment,which was ameliorated after treatment(P<0.05),and was better in the study group than that in the control group(P<0.05). ⑤CMAP amplitude and RI latency between the two groups before treatment had no difference(P>0.05);After treatment,the CMAP amplitude was increased in both groups,and was higher in the study group than that in the control group(P<0.05),meanwhile,the RI latency was decreased in both groups,and was lower in the study group than that in the control group(P<0.05). ⑥The incidence of adverse reactions in the study group was lower than that in the control group,with no statistical difference(6.81% vs 11.37%,P>0.05). Conclusion:Guizhi Gegen Decoction combined with intradermal needling can effectively promote the facial nerve recovery and improve the quality of life of facial neuritis patients with no obvious adverse reaction.
Objective:To investigate the therapeutic effect of Guizhi Gegen Decoction combined with intradermal needling on treating facial neuritis,so as to provide an effective theoretical basis for better treatment of facial neuritis. Methods:88 cases of facial neuritis treated in our hospital from January 2017 to June 2018 were selected and divided into two groups according to the random digital table method,each with 44 cases. The control group received the Qianzheng Powder plus electroacupuncture and the study group received the Guizhi Gegen Decoction. Scores of Toronto facial grading system(TFGS),quality of life(QOL),House-Braekmann(HB)scale,facial nerve paralysis degree,EMG related index and adverse reactions of the two groups were recorded and compared. Results: ①The total effective rate in the study group was significantly higher than that in the control group(95.45% vs 81.82%,P<0.05). ②TFGS and QOL scores between the two groups before treatment had no difference(P>0.05);After treatment,the TFGS score was increased in both groups,and was higher in the study group than that in the pre-treatment control group(P<0.05),meanwhile,the QOL score was decreased in both groups,and was lower in the study group than that in the pre-treatment control group(P<0.05). ③H-B classification had no difference between groups before treatment,which was ameliorated after treatment(P<0.05),and was better in the study group than that in the control group(P<0.05). ④The facial nerve paralysis degree had no difference between groups before treatment,which was ameliorated after treatment(P<0.05),and was better in the study group than that in the control group(P<0.05). ⑤CMAP amplitude and RI latency between the two groups before treatment had no difference(P>0.05);After treatment,the CMAP amplitude was increased in both groups,and was higher in the study group than that in the control group(P<0.05),meanwhile,the RI latency was decreased in both groups,and was lower in the study group than that in the control group(P<0.05). ⑥The incidence of adverse reactions in the study group was lower than that in the control group,with no statistical difference(6.81% vs 11.37%,P>0.05). Conclusion:Guizhi Gegen Decoction combined with intradermal needling can effectively promote the facial nerve recovery and improve the quality of life of facial neuritis patients with no obvious adverse reaction.
引文
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[11]杨万章,吴芳,张敏.周围性面神经麻痹的中西医结合评定及疗效标准(草案)[J].中西医结合心脑血管病杂志,2005,3(9):786-787.
[12]Maeshima S,Tsunoda T,Okamoto S,et al. Alternating Hemiplegia with Ipsilateral Supranuclear Facial Palsy and Abducens Nerve Palsy Caused by Pontine Infarction[J].Internal Medicine,2016,55(15):2073.
[13]梁文章,梁勇,黄经河.复方樟柳碱注射液联合针灸对面神经麻痹的疗效及对免疫球蛋白水平的影响[J].解放军预防医学杂志,2018,26(4):1325-1328.
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[15]李宝珍.牵正汤联合西医治疗周围性面神经麻痹疗效观察[J].现代中西医结合杂志,2017,26(3):267-269.
[16]倪浩斌,王华政.牵正散加味治疗外感型周围性面神经麻痹的临床观察[J].陕西中医,2016,36(3):274-276.
[17]刘金,张柳燕,刘芳,等.牵正散联合温针灸足三里对急性特发性面神经麻痹患者血管内皮祖细胞影响的临床观察[J].上海中医药杂志,2016,62(4):50-52.
[18]徐立军,王娟,田杏红.自拟中药熏蒸联合针刺疗法治疗面神经炎疗效及对肌电图的影响[J].现代中西医结合杂志,2016,25(36):4031-4033.
[19]孙丹,徐纬,陈娜,等.皮内针埋针对脑卒中后吞咽障碍患者的吞咽功能和表面肌电图的影响[J].针刺研究,2018,43(2):118-122.
[20]刘峰,高亚军.中西医结合治疗周围性面神经炎急性期临床观察[J].湖北中医药大学学报,2016,18(5):61-63.
[2]Rath B,Gidudu J F,Anyoti H,et al. Facial nerve palsy including Bell's palsy Case definitions and guidelines for collection analysis and presentation of immunisation safety data[J]. Vaccine,2017,35(15):1972-1983.
[3]张钢花.大秦艽汤加减联合电针及康复训练治疗特发性面神经麻痹疗效观察[J].现代中西医结合杂志,2018,26(15):1285-1287.
[4]谢谢,孙勤国,郭乃燕,等.甘露醇联合糖皮质激素治疗周围性面神经麻痹的疗效观察[J].神经损伤与功能重建,2017,37(6):523-525.
[5]王洁,倪金霞,陈悦,等.电针配合皮内针治疗风寒外袭型面瘫临床观察[J].山东中医药大学学报,2017,41(4):349-351.
[6]史玉泉,周孝达.实用神经病学[M].上海:上海科学技术出版社,2004:76-97.
[7]裘沛然,陈汉平.新编中国针灸学[M].上海:上海科学技术出版社,1992:126-136.
[8]陈明月,蔡慧敏,陈江云,等.密歇根糖尿病神经病变评分和多伦多临床评分系统在糖尿病周围神经病变中的诊断价值研究[J].中国全科医学,2017,20(4):427-431.
[9]屈菲,颜海霞,刘言薇,等.针刺联合肌内效贴治疗周围性面神经炎的疗效观察[J].中国康复医学杂志,2017,32(4):424-427.
[10]Lee HY,Park MS,Byun JY,et al. Agreement between the Facial Nerve Grading System 2.0 and the House-Brackmann Grading System in Patients with Bell Palsy[J]. Clin Exp Otorhinolaryngol,2013,6(3):135-139.
[11]杨万章,吴芳,张敏.周围性面神经麻痹的中西医结合评定及疗效标准(草案)[J].中西医结合心脑血管病杂志,2005,3(9):786-787.
[12]Maeshima S,Tsunoda T,Okamoto S,et al. Alternating Hemiplegia with Ipsilateral Supranuclear Facial Palsy and Abducens Nerve Palsy Caused by Pontine Infarction[J].Internal Medicine,2016,55(15):2073.
[13]梁文章,梁勇,黄经河.复方樟柳碱注射液联合针灸对面神经麻痹的疗效及对免疫球蛋白水平的影响[J].解放军预防医学杂志,2018,26(4):1325-1328.
[14]沈佳.刘渡舟《经方临证指南》治验七则[J].实用中医内科杂志,2013,27(12):7-9.
[15]李宝珍.牵正汤联合西医治疗周围性面神经麻痹疗效观察[J].现代中西医结合杂志,2017,26(3):267-269.
[16]倪浩斌,王华政.牵正散加味治疗外感型周围性面神经麻痹的临床观察[J].陕西中医,2016,36(3):274-276.
[17]刘金,张柳燕,刘芳,等.牵正散联合温针灸足三里对急性特发性面神经麻痹患者血管内皮祖细胞影响的临床观察[J].上海中医药杂志,2016,62(4):50-52.
[18]徐立军,王娟,田杏红.自拟中药熏蒸联合针刺疗法治疗面神经炎疗效及对肌电图的影响[J].现代中西医结合杂志,2016,25(36):4031-4033.
[19]孙丹,徐纬,陈娜,等.皮内针埋针对脑卒中后吞咽障碍患者的吞咽功能和表面肌电图的影响[J].针刺研究,2018,43(2):118-122.
[20]刘峰,高亚军.中西医结合治疗周围性面神经炎急性期临床观察[J].湖北中医药大学学报,2016,18(5):61-63.