针刺治疗急性面神经炎介入时机的临床观察
|
摘要
目的:观察不同针刺介入时机对急性面神经炎症状改善情况和痊愈时间长短的影响,寻找急性面神经炎的最佳治疗时机。方法:将120例急性面神经炎患者(均为单侧发病)随机分为4组,即A组、B组、C组、D组,每组30例。A组患者发病3天内即开始施行针刺;B组患者发病前3天仅口服甲钴胺分散片、复合维生素B片,自第4天开始施行针刺;C组患者发病前5天仅口服甲钴胺分散片、复合维生素B片,自第6天开始施行针刺;D组患者发病前7天仅口服甲钴胺分散片、复合维生素B片,自第8天开始施行针刺。针刺以透刺为主,配合面颊部红外线照射,每日治疗1次,每周治疗6 d,治疗3周。比较各组治疗前与发病第7、14、28天症状体征评分(Portmann评分),比较各组病情好转的时间,并比较各组临床疗效。结果:发病第7、14、28天,4组Portmann评分均高于治疗前(均P<0.05);发病第7、14、28天,A组Portmann评分高于其余3组(均P<0.05),B组、C组和D组两两比较差异均有统计学意义(均P<0.05)。A组总有效率为96.7%(29/30),高于其余3组[93.3%(28/30)、86.7%(26/30)、83.3%(25/30),均P<0.05]。4组病情开始好转时间、显著好转时间及临床痊愈时间比较,差异有统计学意义(均P<0.05),其中A组最优。结论:急性面神经炎及早介入针刺,可以适当减缓面神经损伤的进展,提高疗效,缩短临床痊愈时间。
Objective To observe the effect of different acupuncture intervention time on the improvement of the symptoms of acute facial neuritis and the length of recovery time, and to find the best interventional opportunity for acute facial neuritis. Methods A total of 120 patients with acute facial neuritis(all unilateral onset) were randomly divided into4 groups, namely group A, group B, group C and group D, 30 cases in each group. Acupuncture performed within 3 days after onset in the group A; oral mecobalamin dispersible tablets and multivitamin B tablets were received within 3 days after onset, and acupuncture was started from the 4 th day in the group B; oral mecobalamin dispersible tablets and multivitamin B tablets were given within 5 days after onset, and acupuncture was administered from the 6 th day in the group C; oral mecobalamin dispersible tablets and multivitamin B tablets were given within 7 days after onset, and acupuncture was applied from the 8 th day in the group D. Penetration needling was the main acupuncture treatment, with infrared radiation on the cheeks, once a day, 6 days a week and 3 weeks were given. After treatment, the symptom scores(Portmann scores) of the 7 th, 14 th and 28 th day after onset were compared. The time of improvement and the clinical effect of each group were compared. Results On the 7 th, 14 th and 28 th day after onset, the Portmann scores of the4 groups were higher than those before treatment(all P<0.05). On the 7 th, 14 th and 28 th day after onset, the Portmann scores in the group A were higher than those in the other 3 groups(all P<0.05). There was significant difference between both pairs of group B, group C and group D(all P<0.05). The total effective rate in the group A was 96.7%(29/30), which was higher than 93.3%(28/30), 86.7%(26/30) and 83.3%(25/30) in the other 3 groups(all P<0.05). The difference between the 4 groups in the beginning of improvement, significant improvement time and clinical recovery time was statistically significant(all P<0.05), and the group A was optimal. Conclusion Early intervention of acupuncture with acute facial neuritis can appropriately slow the progression of facial nerve injury, improve the therapeutic effect, and shorten the clinical recovery time.
Objective To observe the effect of different acupuncture intervention time on the improvement of the symptoms of acute facial neuritis and the length of recovery time, and to find the best interventional opportunity for acute facial neuritis. Methods A total of 120 patients with acute facial neuritis(all unilateral onset) were randomly divided into4 groups, namely group A, group B, group C and group D, 30 cases in each group. Acupuncture performed within 3 days after onset in the group A; oral mecobalamin dispersible tablets and multivitamin B tablets were received within 3 days after onset, and acupuncture was started from the 4 th day in the group B; oral mecobalamin dispersible tablets and multivitamin B tablets were given within 5 days after onset, and acupuncture was administered from the 6 th day in the group C; oral mecobalamin dispersible tablets and multivitamin B tablets were given within 7 days after onset, and acupuncture was applied from the 8 th day in the group D. Penetration needling was the main acupuncture treatment, with infrared radiation on the cheeks, once a day, 6 days a week and 3 weeks were given. After treatment, the symptom scores(Portmann scores) of the 7 th, 14 th and 28 th day after onset were compared. The time of improvement and the clinical effect of each group were compared. Results On the 7 th, 14 th and 28 th day after onset, the Portmann scores of the4 groups were higher than those before treatment(all P<0.05). On the 7 th, 14 th and 28 th day after onset, the Portmann scores in the group A were higher than those in the other 3 groups(all P<0.05). There was significant difference between both pairs of group B, group C and group D(all P<0.05). The total effective rate in the group A was 96.7%(29/30), which was higher than 93.3%(28/30), 86.7%(26/30) and 83.3%(25/30) in the other 3 groups(all P<0.05). The difference between the 4 groups in the beginning of improvement, significant improvement time and clinical recovery time was statistically significant(all P<0.05), and the group A was optimal. Conclusion Early intervention of acupuncture with acute facial neuritis can appropriately slow the progression of facial nerve injury, improve the therapeutic effect, and shorten the clinical recovery time.
引文
[1]唐宏图,王华,徐海波,等.电针周围性面瘫患者左侧合谷穴的fMRI研究[J].中华中医药学刊, 2010, 28(5):964-966.
[2]王舒,王敏,张杰,等.“经筋刺法”治疗周围性面神经麻痹50例疗效观察[J].中国针灸, 2001, 21(3):27-29.
[3]刘锦.浅析针灸治疗的取穴和治疗时机[J].针灸临床杂志,2006, 22(10):3-4.
[4]王启才.针灸治疗学[M].北京:中国中医药出版社,2007:332.
[5]孔炳耀,李俊.中西医结合神经病治疗学[M].北京:人民卫生出版社, 2005:267-273.
[6]王恺,徐丽蓉,校.Bell’s麻痹:电生理研究及现状[J].国外医学:耳鼻咽喉科学分册, 1997, 21:137-140.
[7]国家药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社, 2002:383.
[8]吴华,户玫琳.针灸治疗周围性面瘫的近况[J].中医外治杂志, 2010, 19(2):54-56.
[9]韩宝杰.分期针药并用治疗周围性面瘫的临床观察[J].辽宁中医杂志, 2006, 33(2):212-213.
[10]杨连松,王京善,杨莎莎.分期针刺加TDP中频电治疗周围性面瘫282例[J].山东中医杂志, 2006, 25(9):611-612.
[11]闵志,张辉.重灸患侧翳风穴加多针浅治疗顽固性面瘫29例[J].江西中医药, 2014, 45(12):51.
[12]万春晓,王旻晨.针刺治疗中枢性面瘫疗效分析(附120例报告)[J].苏州大学学报(医学版), 2007, 27(6):1022-1024.
[13]李瑛,李妍,刘立安,等.针灸择期治疗周围性面瘫多中心大样本随机对照试验[J].中国针灸, 2011, 31(4):298.
[2]王舒,王敏,张杰,等.“经筋刺法”治疗周围性面神经麻痹50例疗效观察[J].中国针灸, 2001, 21(3):27-29.
[3]刘锦.浅析针灸治疗的取穴和治疗时机[J].针灸临床杂志,2006, 22(10):3-4.
[4]王启才.针灸治疗学[M].北京:中国中医药出版社,2007:332.
[5]孔炳耀,李俊.中西医结合神经病治疗学[M].北京:人民卫生出版社, 2005:267-273.
[6]王恺,徐丽蓉,校.Bell’s麻痹:电生理研究及现状[J].国外医学:耳鼻咽喉科学分册, 1997, 21:137-140.
[7]国家药品监督管理局.中药新药临床研究指导原则[M].北京:中国医药科技出版社, 2002:383.
[8]吴华,户玫琳.针灸治疗周围性面瘫的近况[J].中医外治杂志, 2010, 19(2):54-56.
[9]韩宝杰.分期针药并用治疗周围性面瘫的临床观察[J].辽宁中医杂志, 2006, 33(2):212-213.
[10]杨连松,王京善,杨莎莎.分期针刺加TDP中频电治疗周围性面瘫282例[J].山东中医杂志, 2006, 25(9):611-612.
[11]闵志,张辉.重灸患侧翳风穴加多针浅治疗顽固性面瘫29例[J].江西中医药, 2014, 45(12):51.
[12]万春晓,王旻晨.针刺治疗中枢性面瘫疗效分析(附120例报告)[J].苏州大学学报(医学版), 2007, 27(6):1022-1024.
[13]李瑛,李妍,刘立安,等.针灸择期治疗周围性面瘫多中心大样本随机对照试验[J].中国针灸, 2011, 31(4):298.