排针平刺治疗特发性面神经麻痹的临床疗效评价

发布时间：2018-01-03 16:44

本文关键词：排针平刺治疗特发性面神经麻痹的临床疗效评价　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：背景:特发性面神经麻痹也称贝尔麻痹(Bell麻痹),是临床常见的疾病之一。本病发病率高,根据流行病学调查,我国每年至少有335万人出现贝尔麻痹,本病每年发病率达26-34/10万[1]。早在1979年贝尔麻痹即被世界卫生组织认定为适宜针灸治疗的疾病之一,当前对于本病的针刺治疗方法多样,但仍有部分贝尔麻痹疗效欠佳。本研究旨在通过对比排针平刺联合基础治疗、常规针刺联合基础治疗以及单纯基础治疗这三种不同的治疗方法在贝尔麻痹治疗中的疗效,为本病的治疗提出新的思路和方法。目的:通过严格的随机、对照试验,观察排针平刺结合基础治疗、常规针刺结合基础治疗以及单纯基础治疗在贝尔麻痹中的疗效,采用House-Brackmann分级量表以及功能积分量表来记录治疗前后面部功能情况,客观评价三种不同治疗方法对于贝尔麻痹的作用。方法:从南京市中医院脑病科门诊、病房、针灸科门诊Bell麻痹患者中筛选出符合标准患者共80例,根据随机对照表,分为排针平刺组(治疗组)40例及传统针刺组(对照组)40例,从南京市第一医院神经科门诊Bell麻痹患者中筛选基础治疗组(单纯口服药物)40例。基础治疗组为强的松及甲钴胺口服;治疗组采用排针平刺加基础治疗,无补泻手法,留针4-6h;对照组以常规针刺加基础治疗,予以平补平泻手法,留针时间30min。口服药物自患者就诊时开始服用;针刺均从发病1周开始,以2周作为1个疗程;每周周一至周五共针刺5次;每周进行一次疗效评估,针刺总疗程1个月。将记录到的数据以SPSS16.0软件进行分析处理。结果:经统计分析,三组病例治疗前的基线资料(性别、年龄、病程、H-B面神经功能计分)具有可比性(p0.05)。1、在临床总疗效方面治疗组(排针平刺组)总有效率90%,对照组(常规针刺组)总有效率85%,基础治疗组总有效率77.5%。总有效率治疗组对照组基础治疗组,经统计学分析三组疗效无统计学差异P=0.183(p0.05),在第3周愈显率方面,治疗组排针平刺组愈显率35%,对照组(常规针刺组)愈显率15%,基础治疗组愈显率12.5%,愈显率治疗组对照组基础治疗组,经统计学分析,三组愈显率存在统计学差异p=0.031(p0.05)。2、在临床症状改善方面(H-B积分量表),治疗前组间比较无统计学差异(p0.05),具有可比性。组内对比治疗组、对照组及基础治疗组治疗前后比较均有统计学差异(p0.05),组间对比,三组治疗前后H-B评分无统计学差异(p=0.9050.05)。结论:1.三种治疗方法对于特发性面神经麻痹的临床症状均有改善,最终疗效相当;2.在特发性面神经麻痹的治疗中排针平刺结合基础治疗较其他两种治疗方法显效更快。
[Abstract]:Background: idiopathic facial paralysis, also known as Bell's palsy of Bell's palsy, is one of the common clinical diseases. The incidence of this disease is high, according to epidemiological investigation. Bell's paralysis occurs in at least 3.35 million people in China every year, with an annual incidence of 26-34 / 100, 000. [As early as 1979 Bell's paralysis was recognized as one of the diseases suitable for acupuncture and moxibustion treatment by the World Health Organization (WHO). At present, there are various methods of acupuncture treatment for this disease. However, some of Bell's palsy still have poor curative effect. The purpose of this study is to combine the basic treatment with peeled acupuncture and flat acupuncture. General acupuncture combined with basic treatment and simple basic treatment in the treatment of Bell paralysis the efficacy of three different methods for the treatment of this disease put forward new ideas and methods. Objective: through strict randomization. In the control experiment, the curative effect of Pai Acupuncture combined with basic treatment, conventional Acupuncture combined with basic Therapy and simple basic treatment in Bell's paralysis was observed. House-Brackmann scale and functional integral scale were used to record the facial function before and after treatment. Objective to evaluate the effect of three different treatment methods on Bell's palsy. Methods: 80 patients with Bell paralysis were selected from the Department of Encephalopathy, Department of Encephalopathy, Department of Acupuncture and moxibustion in Nanjing Hospital of traditional Chinese Medicine. According to the random control table, 40 cases in the treatment group and 40 cases in the traditional acupuncture group were divided into two groups: the control group (n = 40) and the control group (n = 40). The basic treatment group (40 cases) was selected from the outpatient department of the Department of Neurology of the first Hospital of Nanjing. The primary treatment group was prednisone and mecobalamin. In the treatment group, the treatment group was treated with Pai acupuncture and acupuncture plus basic treatment without reinforcing and reducing manipulation, and the acupuncture was kept for 4-6 hours. The control group was treated with routine acupuncture plus basic treatment, and was treated with flat tonifying and reducing manipulation for 30 mins. The oral medicine was taken from the time of the patient's visit. Acupuncture all started from 1 week of onset and took 2 weeks as a course of treatment. Five times a week from Monday to Friday; The data were analyzed by SPSS16.0 software. Results: after statistical analysis, the baseline data (sex) of the three groups before treatment were analyzed. Age, course of disease and score of H-B facial nerve function were comparable. The total effective rate of the treatment group was 90% in the total clinical curative effect. The total effective rate of the control group (routine acupuncture group) was 85g, the total effective rate of the basic treatment group was 77.5%. The total effective rate of the control group was 77.5%. The total effective rate of the control group was the basic treatment group. After statistical analysis, there was no statistical difference among the three groups (P < 0. 183, P 0. 05). In the third week, the effective rate of treatment group was 35%. The obvious rate of the control group (routine acupuncture group) and the basic treatment group were 15%, 12.5% and 12.5%, respectively. There was statistical difference between the three groups in the effective rate of recovery. There was no statistical difference between the three groups in the improvement of clinical symptoms by H-B integral scale (p0.05). Comparison group, control group and basic treatment group were compared before and after treatment, there were significant differences between the two groups. There was no statistical difference in H-B score between the three groups before and after treatment. Conclusion the three treatments have improved the clinical symptoms of idiopathic facial paralysis, and the final curative effect is similar. 2. In the treatment of idiopathic facial paralysis, the combination of acupuncture and acupuncture combined with basic treatment was more effective than the other two methods.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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