井穴放血联合星状神经节阻滞治疗急性期Bell面瘫的临床效果观察
发布时间：2018-09-19 21:16
【摘要】：目的:本研究选用随机对照法,经过将井穴放血联合星状神经节阻滞(stellate ganglion block,SGB)治疗急性期Bell面瘫的临床效果与常规的针刺治疗进行对比,目的在于探究井穴放血联合星状神经节阻滞(stellate ganglion block,SGB)对急性期Bell面瘫的疗效是否优于普通的针刺治疗。方法:本研究选取2014年9月至2016年10月于河北北方学院附属第二医院神经内科门诊就诊及住院治疗经临床确诊的急性期Bell面瘫患者92例。按照随机数表法,将其分为研究组与对照组,每组46例。两组患者的基础治疗均给予强的松、泛昔洛韦、甲钴胺胶囊以及维生素B1,研究组急性期给予井穴放血及星状神经节阻滞(stellate ganglion block,SGB),急性期过后给予常规针刺治疗;对照组急性期只给予上述基础药物治疗,急性期过后给予常规针刺治疗。观察两组患者的年龄、病程、性别以及病因,两组患者治疗前面瘫的程度分级及患病侧,两组患者治疗前后的眼裂情况、额纹深浅、鼻前庭活动情况、闭眼情况、示齿时嘴角歪斜情况、鼻唇沟深浅情况、舌前三分之二的味觉、吹口哨及鼓腮状况、耳后疼痛情况以及听觉情况的十项评分,两组患者治疗前后的H-B总评分、FDI评分以及两组患者的疗效。结果:两组患者年龄、性别、病程方面比较,差异无统计学意义(P0.05)。两组每种病因的患者例数相比较,差异无统计学意义(P0.05)。治疗前研究组轻中度面瘫患者21例、中重度面瘫患者25例与对照组轻中度面瘫患者23例、中重度面瘫患者23例,患者患病侧研究组右侧22例、左侧24例与对照组右侧24例、左侧22例,差异无统计学意义(P0.05)。治疗前研究组眼裂大小评分、额纹深浅评分、鼻前庭活动情况评分、闭眼情况评分、示齿时嘴角歪斜情况评分、鼻唇沟深浅情况评分、舌前三分之二的味觉评分、吹口哨及鼓腮状况评分、耳后疼痛情况评分、听觉评分与对照组评分相比,差异无统计学意义(P0.05)。治疗后研究组眼裂大小评分、额纹深浅评分、鼻前庭活动情况评分、闭眼情况评分、示齿时嘴角歪斜情况评分、鼻唇沟深浅情况评分、舌前三分之二的味觉评分、吹口哨及鼓腮状况评分、耳后疼痛情况评分、听觉评分明显小于对照组各项评分,差异有统计学意义(P0.05)。研究组治疗前H-B总评分、社会功能评分及躯体功能评分与对照组的各项评分相比较,差异无统计学意义(P0.05)。研究组治疗后H-B总评分明显小于对照组治疗后H-B总评分,差异有统计学意义(P0.05)。研究组总有效率97.83%明显大于对照组84.78%,显效及治愈的人数均分别多于对照组,差异有统计学意义(P0.05)。研究组治疗后社会功能评分明显小于对照组,研究组治疗后躯体功能评分明显大于对照组,差异有统计学意义(P0.05)。结论:井穴放血联合星状神经节阻滞(stellate ganglion block,SGB)疗法的临床疗效要明显优于普通的针刺治疗,井穴放血联合星状神经节阻滞(stellate ganglion block,SGB)疗法值得在临床上进行推广。
[Abstract]:Objective: To compare the clinical effect of well point bleeding combined with stellate ganglion block (SGB) in the treatment of acute Bell facial paralysis with that of conventional acupuncture, and to explore the effect of well point bleeding combined with stellate ganglion block (SGB) in the treatment of acute Bell facial paralysis. Methods: From September 2014 to October 2016, 92 patients with Bell facial paralysis were selected from the Department of Neurology, the Second Affiliated Hospital of Hebei North University. According to the method of random number table, they were divided into study group and control group, with 46 patients in each group. All the patients were given prednisone, famciclovir, Mecobalamin capsule and vitamin B1 as the basic treatment. The study group was given well point bloodletting and stellate ganglion block (SGB) in the acute phase and routine acupuncture treatment after the acute phase. The age, course of disease, sex and etiology of the two groups were observed. The degree of facial paralysis and the side of the disease were graded before and after treatment. The ocular fissure, frontal lines, nasal vestibular activity, eye closure, angle of mouth when showing teeth, depth of nasolabial groove, two-thirds of the sense of taste before the tongue, whistling and drum were observed before and after treatment. Results: There was no significant difference in age, sex and course of disease between the two groups (P 0.05). There was no significant difference in the number of patients with each cause between the two groups (P 0.05). Before treatment, 21 patients with mild to moderate facial paralysis, 25 patients with moderate to severe facial paralysis and 23 patients with mild to moderate facial paralysis, 23 patients with moderate to severe facial paralysis, 22 patients with right side of the study group, 24 patients with left side of the control group and 24 patients with right side, 22 patients with left side of the control group, the difference was not statistically significant (P 0.05). There was no significant difference between the study group and the control group in terms of shallow score, nasal vestibular activity score, eye closure score, mouth angle deviation score, nasolabial groove depth score, two-thirds of the taste score before the tongue, whistle and gill status score, postaural pain score, and auditory score (P 0.05). The scores of fissure size, frontal vein depth, nasal vestibular activity, eye closure, mouth angle deviation, nasolabial groove depth, two-thirds of the tongue, whistling and gills, post-aural pain, and auditory scores were significantly lower than those of the control group. Significance (P 0.05). There was no significant difference in the total H-B score, social function score and somatic function score between the study group and the control group before treatment (P 0.05). The total H-B score in the study group was significantly lower than that in the control group after treatment (P 0.05). The total effective rate in the study group was 97.83% higher than that in the control group (P 0.05). The score of social function in the study group was significantly lower than that in the control group, and the score of somatic function in the study group was significantly higher than that in the control group (P 0.05). The clinical effect of e-ganglion block (SGB) therapy is obviously better than that of ordinary acupuncture therapy. The combination of well point bleeding and stellate ganglion block (SGB) therapy is worthy of clinical promotion.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R745.12
本文编号：2251359
[Abstract]:Objective: To compare the clinical effect of well point bleeding combined with stellate ganglion block (SGB) in the treatment of acute Bell facial paralysis with that of conventional acupuncture, and to explore the effect of well point bleeding combined with stellate ganglion block (SGB) in the treatment of acute Bell facial paralysis. Methods: From September 2014 to October 2016, 92 patients with Bell facial paralysis were selected from the Department of Neurology, the Second Affiliated Hospital of Hebei North University. According to the method of random number table, they were divided into study group and control group, with 46 patients in each group. All the patients were given prednisone, famciclovir, Mecobalamin capsule and vitamin B1 as the basic treatment. The study group was given well point bloodletting and stellate ganglion block (SGB) in the acute phase and routine acupuncture treatment after the acute phase. The age, course of disease, sex and etiology of the two groups were observed. The degree of facial paralysis and the side of the disease were graded before and after treatment. The ocular fissure, frontal lines, nasal vestibular activity, eye closure, angle of mouth when showing teeth, depth of nasolabial groove, two-thirds of the sense of taste before the tongue, whistling and drum were observed before and after treatment. Results: There was no significant difference in age, sex and course of disease between the two groups (P 0.05). There was no significant difference in the number of patients with each cause between the two groups (P 0.05). Before treatment, 21 patients with mild to moderate facial paralysis, 25 patients with moderate to severe facial paralysis and 23 patients with mild to moderate facial paralysis, 23 patients with moderate to severe facial paralysis, 22 patients with right side of the study group, 24 patients with left side of the control group and 24 patients with right side, 22 patients with left side of the control group, the difference was not statistically significant (P 0.05). There was no significant difference between the study group and the control group in terms of shallow score, nasal vestibular activity score, eye closure score, mouth angle deviation score, nasolabial groove depth score, two-thirds of the taste score before the tongue, whistle and gill status score, postaural pain score, and auditory score (P 0.05). The scores of fissure size, frontal vein depth, nasal vestibular activity, eye closure, mouth angle deviation, nasolabial groove depth, two-thirds of the tongue, whistling and gills, post-aural pain, and auditory scores were significantly lower than those of the control group. Significance (P 0.05). There was no significant difference in the total H-B score, social function score and somatic function score between the study group and the control group before treatment (P 0.05). The total H-B score in the study group was significantly lower than that in the control group after treatment (P 0.05). The total effective rate in the study group was 97.83% higher than that in the control group (P 0.05). The score of social function in the study group was significantly lower than that in the control group, and the score of somatic function in the study group was significantly higher than that in the control group (P 0.05). The clinical effect of e-ganglion block (SGB) therapy is obviously better than that of ordinary acupuncture therapy. The combination of well point bleeding and stellate ganglion block (SGB) therapy is worthy of clinical promotion.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R745.12
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