针药结合治疗急性周围性面瘫的临床观察

发布时间：2018-02-11 23:20

本文关键词： 急性周围性面瘫地塞米松针刺疗法科摩罗传统按摩法　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：通过观察西药加针刺治疗急性周围性面瘫和西药加科摩罗传统按摩法治疗急性周围性面瘫的临床疗效,对两种治疗方案的疗效进行比较,探讨西药加针刺治疗周围性面瘫的优势,为周围性面瘫的针刺治疗在科摩罗的推广应用提供临床依据。方法：60例急性周围性面瘫均为科摩罗国立医院门诊病人,按就诊顺序先后,分为对照组(单号,西药加科摩罗传统按摩方法)和治疗组(双号,西药加针刺)各30例。对照组采用方案为肾上腺皮质激素(地塞米松)40mmg/天,口服每次20mg,2次/天,连续用药七天(这是科摩罗国立医院治疗急性周围性面瘫的常规用药)。治疗组在与对照组用相同的肾上腺皮质激素(地塞米松)的基础上,加针刺阳白、攒竹、丝竹空、地仓、颊车、牵正、翳风、合谷。配穴：鼻唇沟平坦加迎香,人中沟偏歪加水沟,味觉减退或舌麻加廉泉。针刺方法：患者采取仰卧位,采用苏州华佗厂生产的“华佗牌”25-40mm长的一次性无菌米针进行针刺。穴位常规消毒后,阳白透鱼腰,攒竹向鱼腰或睛明方向针刺,地仓透颊车,迎香向鼻根部斜刺,水沟向上斜刺,廉泉向舌根方向针刺,其余穴常规针刺。面部穴采用平补平泻法,合谷用泻法。留针30min,每天治疗一次,每周治疗5天。二组均观察5周。观察指标：面部表情、眼裂闭合程度、鼻唇沟变浅程度、口角歪斜程度、额纹消失程度等主要症状。二组均于治疗前、后记录患者的病情并分析、比较其临床疗效。结果：1、主症、症状比较：治疗组治疗前、后主症、症状积分比较,有统计学意义(P0.05)。对照组治疗前、后积分比较,虽然也有好转,但无统计学意义(P0.05)。治疗组治疗后的主症、症状积分和对照组同期比较,有统计学意义(P0.05),肾上腺皮质激素加针刺治疗急性周围性面瘫的疗效明显好于肾上腺皮质激素加科摩罗传统按法。2、总有效率比较：治疗组30例治疗后痊愈8例,显效16例,愈显率为80%,有效6例,无效0例。总有效率100%；对照组治疗后没有痊愈的,显效只有1例,愈显率为3.33%,有效29例,无效0例总有效率100%。两组总有效率虽相似,但治疗组的愈显率明显高于对照组。说明肾上腺皮质激素加针刺治疗周围性面瘫的总有效率优于肾上腺皮质激素加科摩罗传统按摩法,尤其是愈显率更为突出。3、在5周的针刺治疗过程中,没有发生任何不良反应。结论：1、肾上腺皮质激素加针刺与肾上腺皮质激素加科摩罗传统按摩法均是治疗急性周围性面瘫的有效方法。2、肾上腺皮质激素加针刺治疗急性周围性面瘫的疗效优于肾上腺皮质激素加科摩罗传统按摩法,具有痊愈率高、疗程短等优势。3、针刺疗法是治疗急性周围性面瘫安全、有效的方法。
[Abstract]:Objective: to observe the clinical effects of western medicine combined with acupuncture in treating acute peripheral facial paralysis and western medicine plus Comorian traditional massage in the treatment of acute peripheral facial paralysis. To explore the advantages of western medicine plus acupuncture in the treatment of peripheral facial paralysis, and to provide a clinical basis for the popularization and application of acupuncture treatment of peripheral facial paralysis in Comoros. Methods 60 cases of acute peripheral facial paralysis were all outpatients of Comorian National Hospital. According to the order of visit, they were divided into control group (single number, western medicine plus Comorian traditional massage method) and treatment group (double number, western medicine and acupuncture). The control group was treated with adrenocortical hormone (dexamethasone 40mmg / day). The treatment group was treated with the same adrenocortical hormone (dexamethasone) and acupuncture on the basis of the same adrenocortical hormone (dexamethasone) as the control group. Zanzhu, Silk Bamboo empty, ground Cang, buccal car, pull Zheng, Yi Feng, Hegu. Matching points: nasolabial groove flat plus incense, human middle groove inclined to add water ditch, taste loss or tongue Ma Jia Lian Quan. Acupuncture method: the patient takes supine position, A single sterile rice needle of 25-40 mm in length produced by Huatuo Factory in Suzhou was used for acupuncture. After routine disinfection of acupoints, Yang white penetrated the fish waist, and the bamboo was needled toward the fish waist or clear direction, and the barnyard was punctured to the root of the nose, and the incense was skewed to the root of the nose. Shuigou upward oblique prick, Lianquan to the root of tongue acupuncture, the rest point routine acupuncture. Facial acupoints with flat tonifying and reducing method, Hegu method. Retention of acupuncture 30 minutes, treatment once a day, treatment 5 days a week. Both groups were observed for 5 weeks. Observation index: facial expression, The degree of closure of eye fissure, the degree of shallow nasolabial sulcus, the degree of obliquity of mouth angle, the degree of disappearance of frontal stripe, etc. Before and after treatment, the patients in both groups were recorded and analyzed, and their clinical effects were compared. Symptom comparison: before and after treatment, the scores of main symptoms and symptoms in the treatment group were significantly higher than those in the control group (P 0.05). Although the scores before and after treatment in the control group were also improved, there was no significant difference between the treatment group and the treatment group. Symptom score was compared with control group in the same period. The effect of adrenocortical hormone plus acupuncture on acute peripheral facial paralysis was better than that of adrenocortical hormone combined with Comorian traditional method .2.The total effective rate was compared: 8 cases were cured and 16 cases had remarkable effect after treatment in the treatment group. The effective rate was 80%, the effective rate was 6 cases, and the ineffective rate was 0 cases. The total effective rate was 100 cases. In the control group, there were only 1 case with remarkable effect, only 1 case with remarkable effect after treatment. The effective rate was 3.33%, the effective rate was 29 cases, and the total effective rate was 100 cases. The total effective rate of the two groups was similar, But the effective rate of the treatment group was significantly higher than that of the control group. It showed that the total effective rate of adrenocortical hormone plus acupuncture in treating peripheral facial paralysis was better than that of adrenal corticosteroid plus Comorian traditional massage. In particular, the recovery rate is more prominent. 3. During the 5 weeks of acupuncture treatment, Conclusion 1, adrenocortical hormone plus acupuncture and adrenocortical hormone plus Comorian traditional massage are effective methods for the treatment of acute peripheral facial paralysis, and adrenocortical hormone plus acupuncture are effective methods for treatment of acute peripheral facial paralysis. The curative effect of acute peripheral facial paralysis is better than that of adrenal corticosteroid plus Comorian traditional massage. Acupuncture therapy is a safe and effective method for the treatment of acute peripheral facial paralysis.
【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】：2016
【分类号】：R246.6

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