针药为主治疗气血不足型面瘫疗效观察

发布时间：2018-01-19 13:33

本文关键词： 面瘫气血不足针药合治心理辅导面肌功能锻炼临床疗效　出处：《湖北中医药大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的气血不足型面瘫严重影响患者身体和心理健康，本研究观察临床采用针刺配合中药内服为主、心理辅导与面部肌肉锻炼为辅综合治疗该疾病的疗效，并进行对比研究，探索较佳治疗方法，提高康复率，为针药综合治疗此型面瘫提供全面可靠的依据。方法将符合气血不足证型的64例周围性面瘫患者分为针刺综合治疗组（针刺组）和针药综合治疗组（针药组）两组，针刺组32例采用针刺治疗为主，心理辅导与面部肌肉锻炼为辅治疗。针刺取穴在一般面瘫常规所取穴位的基础上加上补益气血，活血调气的穴位，隔日一次，2周为一疗程。配合适当的措辞和方法适时适度引导患者进行心理调节，树立正确疾病观、康复观；指导患者自行进行面部肌肉锻炼，适当把握锻炼的方法、强度和时限。以上治疗方法均在治疗两个疗程后评定疗效。针药组32例除采用上述针刺及辅助治疗外，再予牵正散合八珍汤随症加减方口服，日一付，2周为一疗程。在研究开始和完成一定疗程后据病情变化记录面神经功能评分，完成面部残疾指数问卷，记录躯体功能指数FDIP,社会功能指数FDIS，统计分析其变化的显著性意义，并进行安全性评价，由此评定两组的临床疗效。结果 1.两组临床疗效比较：针刺组治愈率为32.3%，愈显率为80.7%，总有效率为93.5%；针药组治愈率为19.4%，愈显率为51.7%，总有效率为77.4%。针药组总有效例数、总有效率、治愈率、愈显率均高于针刺组，经统计学处理，差异有统计学意义（P0.05）。 2.两组面神经功能评分比较：治疗前两组间面神经功能评分比较，无显著差异（P0.05）。治疗后两组面神经功能评分均增高(P0.05)，与针刺组比较，针药组增高更明显，且差异有统计学意义（P0.05）。 3.两组FDI评分比较：治疗前两组间FDIP、FDIS比较，无显著差异（P0.05）。治疗后两组FDIP、FDIS均增高(P0.05)，与针刺组比较，针药组增高更明显，且差异有统计学意义（P0.05）。 4.两种疗法治疗气血不足型面瘫均未出现针刺不良反应，针药组口服中药后未出现不良反应。结论 1.两组临床疗效比较表明针药组的治愈率和愈显率优于针刺组，提示针药综合治疗气血不足面瘫有更确切的临床疗效，有助于提高此型面瘫的康复率。 2.两组治疗方法都有助于改善患者面神经功能，针药组改善更明显。 3.两组治疗方法都可提高患者的躯体功能指数和社会功能指数，针药组提高更明显。 4.两组疗法治疗气血不足型面瘫均安全有效。
[Abstract]:Purpose Deficiency of qi and blood type facial paralysis seriously affected the patients' physical and mental health. This study observed the clinical efficacy of acupuncture combined with traditional Chinese medicine, psychological counseling and facial muscle exercise for the comprehensive treatment of the disease. A comparative study was carried out to explore a better treatment method and to improve the recovery rate, and to provide a comprehensive and reliable basis for the comprehensive treatment of this type of facial paralysis with acupuncture and medicine. Method Sixty-four patients with peripheral facial paralysis were divided into two groups: acupuncture group (acupuncture group) and acupuncture medicine group (acupuncture group). 32 cases in acupuncture group were treated mainly with acupuncture. Psychological counseling and facial muscle training as a supplementary treatment. Acupuncture points in the general facial paralysis on the basis of the routine points to add tonifying Qi and blood, blood points, Qi-regulating points, once every other day. 2 weeks as a course of treatment. With appropriate words and methods to guide the patients to conduct psychological adjustment, to establish a correct view of disease, rehabilitation view; Guide patients to exercise their own facial muscles, and properly grasp the methods of exercise. Strength and time limit. All the above treatment methods were evaluated after two courses of treatment. In addition to the above acupuncture and auxiliary treatment, 32 cases in the acupuncture and medicine group were given oral administration of Daozheng San and Bazhen decoction with syndrome plus or minus. Two weeks as a course of treatment. After the beginning of the study and the completion of a course of treatment according to the disease changes recorded facial nerve function score, complete the facial disability index questionnaire, recorded the body function index, social function index (FDIS). Statistical analysis of the significance of its changes, and safety evaluation, so as to evaluate the clinical efficacy of the two groups. Results 1. Comparison of clinical efficacy between the two groups: the cure rate of acupuncture group was 32.3g, the effective rate was 80.7 and the total effective rate was 93.5; The cure rate of acupuncture and medicine group was 19.4, the effective rate was 51.7 and the total effective rate was 77.4. The total effective cases, total effective rate, cure rate and effective rate of acupuncture group were higher than those of acupuncture group. The difference was statistically significant (P 0.05). 2. Comparison of facial nerve function score between the two groups before treatment, there was no significant difference in facial nerve function score between the two groups before treatment (P 0.05). After treatment, the score of facial nerve function in both groups increased significantly (P 0.05). Compared with the acupuncture group, the acupuncture and medicine group increased more obviously, and the difference was statistically significant (P 0.05). 3. Comparison of FDI scores between the two groups: before treatment, there was no significant difference between the two groups (P 0.05). After treatment, the FDI scores of the two groups were higher than that of the control group (P 0.05). Compared with the acupuncture group, the acupuncture and medicine group increased more obviously, and the difference was statistically significant (P 0.05). 4. There were no side effects of acupuncture in the treatment of facial paralysis with deficiency of qi and blood, but no adverse reactions in the group of acupuncture and medicine after oral administration of traditional Chinese medicine. Conclusion 1. The comparison of clinical curative effect between the two groups shows that the cure rate and curative effect of acupuncture and medicine group are better than that of acupuncture group, which indicates that the comprehensive treatment of acupuncture and medicine has more accurate clinical effect on facial paralysis due to deficiency of qi and blood, which is helpful to improve the rehabilitation rate of this type of facial paralysis. 2. Both treatment methods can improve the facial nerve function of the patients, especially in the acupuncture and medicine groups. 3. Both treatment methods can improve the body function index and social function index of the patients, especially in the acupuncture and medicine group. 4. Both groups were safe and effective in the treatment of deficiency of qi and blood.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R246.6

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