颈穴配合局部温针灸治疗面肌痉挛的临床疗效观察

发布时间：2018-06-06 02:38

本文选题：面肌痉挛 + 针刺　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的通过观察针刺颈穴配合局部温针灸治疗面肌痉挛的临床疗效及对椎基底动脉、患侧小脑后下动脉平均血流速度的影响,同时设立常规针刺作为对照组进行比较,客观评价两种针刺治疗的疗效差异,为临床治疗面肌痉挛方案的优化提供参考。方法将符合标准的66例面肌痉挛患者,采用随机数字表法分组法分为治疗组和对照组,每组各33例。治疗组采用针刺颈穴配合局部温针灸治疗,对照组采用常规针刺治疗。两组均每日治疗1次,10次为1个疗程,每个疗程间隔2天,共3个疗程。分别对治疗前、疗程结束后两组面肌痉挛患者面肌痉挛强度(Cohen分级)、频度(Penn分级)、椎基底动脉及患侧小脑后下动脉经颅多普勒检测值的变化进行记录,最后对两组患者总有效率进行临床疗效评定。结果(1)治疗后两组患者根据面肌痉挛Cohen强度分级及Penn频率分级评定标准显示:治疗3个疗程后,两组患者的面肌痉挛Cohen强度及Penn频率评定较治疗前均有明显下降(P0.05),说明两组患者治疗3个疗程后较治疗前均有明显的疗效。(2)对本次临床观察总有效率进行分析,治疗组总有效率为96.77%,对照组的总有效率83.33%,治疗组的总有效率明显高于对照组(P0.05),说明治疗组的疗效明显优于对照组。(3)TCD检测指标比较:治疗前两组患者双侧VA、BA及患侧PICA平均血流速度组间比较,均P0.05,无显著差异,具有可比性;3个疗程结束后:治疗组双侧VA、BA及患侧PICA平均血流速度组内比较,均P0.05,差异有统计学意义;对照组双侧VA、BA及患侧PICA平均血流速度组内比较,P0.05,差异有统计学意义;两组双侧VA、BA及患侧PICA平均血流速度组间比较,P0.05,差异有统计学差异。结论(1)两种针刺疗法均能有效治疗面肌痉挛,但颈穴配合局部温针灸治疗方案治愈率及总有效率明显优于常规针刺疗法。(2)两种针刺疗法均能改善面肌痉挛患者的症状,但颈穴配合局部温针灸疗法改善患者面肌痉挛的强度、频率明显优于常规针刺疗法。(3)两种针刺疗法均能有效调节面肌痉挛患者的椎基底、小脑后下动脉血流速度,但颈穴配合局部温针灸疗法改善更显著。随着面肌痉挛症状的好转,椎基底、小脑后下动脉血流速度也有不同程度的改善,面肌痉挛与颈部相应的动脉血流速度可能存在一定相关的关系。
[Abstract]:Objective to observe the clinical effect of acupuncture on cervical points combined with local warming acupuncture in the treatment of hemifacial spasm and its effect on the average blood flow velocity of vertebrobasilar artery and the affected posterior inferior cerebellar artery. Objective to evaluate the difference of therapeutic effect between the two kinds of acupuncture therapy, and to provide reference for the optimization of clinical treatment of hemifacial spasm. Methods 66 patients with hemifacial spasm were divided into treatment group (n = 33) and control group (n = 33). The treatment group was treated with acupuncture of neck points combined with local warming acupuncture, while the control group was treated with routine acupuncture. The two groups were treated once a day 10 times as a course of treatment, each course of treatment interval 2 days, a total of 3 courses of treatment. The intensity and frequency of hemifacial spasm were recorded before and after treatment in two groups. The changes of transcranial Doppler (TCD) of vertebrobasilar artery and affected posterior inferior cerebellar artery were recorded. Finally, the total effective rate of the two groups was evaluated. Results 1) according to Cohen's strength grade and Penn frequency grade, the two groups showed that: after 3 courses of treatment, Cohen's intensity and Penn frequency of hemifacial spasm in both groups were significantly decreased compared with those before treatment, indicating that the two groups had obvious curative effect after 3 courses of treatment compared with those before treatment.) the total effective rate of this clinical observation was analyzed. The total effective rate of the treatment group was 96.777.The total effective rate of the control group was 83.33. The total effective rate of the treatment group was significantly higher than that of the control group (P 0.05), which indicated that the curative effect of the treatment group was obviously better than that of the control group. PICA mean blood flow velocity was compared among groups, After three courses of treatment, the mean blood flow velocity of both sides of VABA and PICA in the treatment group was significantly higher than that in the control group (P 0.05). In the control group, there was significant difference between the two sides of VABA and PICA mean blood flow velocity (P 0.05), and there was a significant difference between the two groups (P 0.05) between the bilateral VABA group and the affected side PICA mean blood flow velocity group (P 0.05). Conclusion (1) both kinds of acupuncture therapy can effectively treat hemifacial spasm, but the cure rate and total effective rate of two kinds of acupuncture therapy combined with local warming acupuncture are obviously better than that of routine acupuncture therapy. 2) both kinds of acupuncture therapy can improve the symptoms of patients with hemifacial spasm. However, the cervical point combined with local warming acupuncture can improve the strength of hemifacial spasm, and the frequency of acupuncture therapy is better than that of routine acupuncture therapy. The two kinds of acupuncture therapy can effectively regulate the blood flow velocity of vertebrobasilar and posterior inferior cerebellar artery in patients with hemifacial spasm. However, the cervical point combined with local warming acupuncture therapy improved more significantly. With the improvement of hemifacial spasm, the blood flow velocity of vertebrobasilar and posterior inferior cerebellar artery also improved to some extent, and the hemifacial spasm may be related to the blood flow velocity of the corresponding artery in the neck.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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