浅刺针法治疗贝尔面瘫急性期的临床研究
发布时间：2019-06-13 14:54
【摘要】：目的:通过随机对照设计,与单纯西药口服治疗作对比研究浅刺针法治疗贝尔面瘫急性期的临床疗效;重点在于规范针灸治疗贝尔面瘫的量化操作,提倡早期干预,轻浅刺激,以激发经气,振奋阳气为度;为贝尔面瘫急性期的治疗提供一份有效的循征证据。方法:收集广西中医药大学第一附属医院,针灸科、康复科、脑病科和广西中医药大学第一附属医院仁爱分院针灸科,广西壮医院针灸科、广西中医药大学附属瑞康医院针灸科诊断为贝尔面瘫急性期患者。把符合贝尔面瘫急性期诊断患者60例,按就诊次序进行患者的编号,根据编号运用计算机软件SPSS22.0按1:1比例进行编号随机分组,分为试验组30例(浅针针法组),和对照组30例(单纯西药组)。分别评价治疗1周和治疗2周后的House-Brachmann(H-B)面神经功能,面部残疾指数FDI,症状体征综合改善情况,不良事件和安全性评价。结果:1.纳入治疗前试验组和对照组的病情、病程、年龄、性别不存在明显的统计学差异,即基线一致;组间具有可比性。2.House-Brachmann面神经分级评价:试验组和对照组治疗1周和治疗2周的House-Brachmann面神经分级疗效和治疗前组内疗效比较存在统计学差异,P0.05,治疗1周后的试验组和对照组的组间House-Brachmann面神经分级疗效比较不存在统计学差异,P0.05,治疗2周后的试验组和对照组的组间House-Brachmann面神经分级疗效比较存在统计学差异,P0.05。3.House-Brachmann面神经评分:治疗1周后唯有对照组组内比较在“味觉障碍”和“听觉过敏”不存在疗效上的统计学差异,P0.05,其他方面和试验组所有指标都存在统计学上的差异,P0.05;治疗1周后的组间比较在“皱眉”、“眼险开合”、“鼻唇沟”、“耸鼻运动”、“示齿歪斜”、“鼓腮”、综合评分上不存在统计学差异,P0.05;但是在“食物滞留”、“味觉障碍”、“听觉过敏”、“流泪不适”、“耳周疼痛”上存在统计学差异,P0.05。治疗2周后试验组和对照组组内比较在所有指标上都存在统计学差异,P0.05,而治疗2周后组间比较仅在“皱眉”、“眼险开合”、“鼻唇沟”、“食物滞留”、“听觉过敏”、和综合评分上存在统计学差异,P0.05。4.残疾指数FDI:在治疗1周后,试验组的躯体FDI和社会FDI组内比较都存在统计学差异,P0.05,而对照组在组内比较躯体FDI上不存在统计学差异,P0.05,治疗1周后组间比较,躯体FDI不存在统计学差异,P0.05,社会FDI存在统计学差异,P0.05。治疗2周后在试验组和对照组的组间、组内比较都存在统计学差异,P0.05。5.症状体征综合改善情况:治疗1周后试验组痊愈2例,显效5例,有效10例,无效13例;对照组痊愈3例,显效6例,有效8例,无效13例;经Wilcoxon秩和检验后,发现Z=-0.291,P=0.771,统计学上不存在明显的差异。治疗2周后试验组痊愈13例,显效10例,有效5例,无效2例;对照组痊愈6例,显效8例,有效6例,无效10例;Wilcoxon秩和检验后,发现试验组和对照组疗效比较,Z=-2.702,P=0.007,存在明显的统计学差异。结论:浅刺针法和单纯西药口服治疗贝尔面瘫急性期都有疗效,从短期疗效、副作用、安全性方面考虑浅刺针法疗效明显优于单纯西药口服治疗。但其确切的疗效仍然需要多中心、高质量、大规模的试验去验证支持。
[Abstract]:Objective: To study the clinical effect of acupuncture in the treatment of the acute phase of Bell's facial paralysis by a randomized controlled design, compared with the traditional western medicine oral therapy. The focus is to regulate the quantitative operation of acupuncture and moxibustion in the treatment of Bell's facial paralysis, and to promote early intervention and light-light stimulation to stimulate the menstrual flow. It is an effective way to follow the treatment of the acute phase of Bell's paresis. Methods: The first Affiliated Hospital of the Chinese University of Traditional Chinese Medicine, the Acupuncture and Moxibustion Section, the Medical College, the Encephalopathy Section and the First Affiliated Hospital of the Chinese Medicine University in Guangxi, the Acupuncture and Moxibustion Section of the First Affiliated Hospital of Guangxi University of Traditional Medicine, the Acupuncture and Moxibustion Section of the Zhuang Hospital of Guangxi, and the Department of Acupuncture and Moxibustion of the Affiliated Ruikang Hospital of Guangxi University of Traditional Chinese Medicine were diagnosed as the patients with the acute phase of Bell facial paralysis. 60 patients who were in the acute phase of Bell's facial paralysis were given the number of the patients according to the order of treatment. The number of the patients was randomly divided according to the number using the computer software SPSS10.0 according to the ratio of 1:1. The number of the patients was divided into three groups (30 cases of superficial acupuncture) and 30 cases of the control group (simple western medicine group). House-Brachmann (H-B) facial nerve function, facial disability index, comprehensive improvement of symptoms and signs, adverse events and safety evaluations were evaluated for 1 week and 2 weeks after treatment, respectively. Results:1. There was no significant statistical difference in the condition, course, age, and sex of the pre-treatment and control groups, that is, the baseline was consistent; the groups were comparable.2. House-Brachmann's facial nerve grading evaluation: There was a statistically significant difference in the curative effect of the two-week and 2-week-old House-Brachmann facial nerve in the test group and the control group, P0.05). There was no statistical difference between the two groups of House-Brachmann's facial nerve in the test group and the control group after 1 week of treatment. There was a statistically significant difference in the efficacy of House-Brachmann's facial nerve in the test group and the control group after 2 weeks of treatment. The results showed that there was no statistically significant difference in the therapeutic effect of the "gustatory disorder" and the "auditory allergy" in the control group after 1 week of treatment, P0.05, There was a statistically significant difference in all other aspects and in the test group, P0.05; there was no statistical difference between the groups in the "frowning", "opening and closing of eyes", "nasolabial", "nasal movement", "tooth skew", "a drum" and comprehensive scores after 1 week of treatment, but in the "food retention", the "gustatory disorder", There was a statistical difference in "auditory allergy", "lacrimation" and "ear-to-ear pain", P0.05. There was a statistical difference between the test group and the control group after 2 weeks of treatment, but the difference between the groups was only in the "frowning", the "opening and closing of eyes", the "nasolabial", the "food retention", the "auditory allergy", and the comprehensive score after 2 weeks of treatment. The results showed that there was no statistical difference between the body FDI and the social FDI group in the test group after 1 week of treatment, but there was no statistical difference in the body FDI in the control group, P0.05, compared with that of the control group after 1 week of treatment, there was no statistical difference between the body and the body, P0.05, There was a statistical difference in the social FDI, P0.05. There was a statistically significant difference between the groups in the test group and the control group after 2 weeks of treatment, P 0.05. The comprehensive improvement of symptoms and signs:2 cases were cured after 1 week of treatment,5 cases were effective,10 cases were effective,13 cases were not valid,3 cases were cured in the control group,6 cases were markedly effective,8 cases were effective and 13 cases were not valid; after Wilcoxon rank and test, Z =-0.291, P = 0.771, and there was no significant difference in statistics. After 2 weeks of treatment,13 cases were cured,10 cases were effective,5 cases were effective,2 cases were not valid,6 cases were cured in the control group,8 cases were markedly effective,6 cases were effective and 10 cases were not valid; after Wilcoxon rank and test, the results of the test group and the control group were found to be comparable, and Z =-2.702, P = 0.007, and there was a significant statistical difference. Conclusion: It is effective to treat the acute phase of Bell's facial paralysis by the method of superficial needling and simple western medicine, and the effect of the acupuncture on the short-term effect, side effect and safety is better than that of the traditional western medicine. But its exact efficacy still requires a multi-center, high-quality, large-scale trial to validate support.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6
本文编号：2498598
[Abstract]:Objective: To study the clinical effect of acupuncture in the treatment of the acute phase of Bell's facial paralysis by a randomized controlled design, compared with the traditional western medicine oral therapy. The focus is to regulate the quantitative operation of acupuncture and moxibustion in the treatment of Bell's facial paralysis, and to promote early intervention and light-light stimulation to stimulate the menstrual flow. It is an effective way to follow the treatment of the acute phase of Bell's paresis. Methods: The first Affiliated Hospital of the Chinese University of Traditional Chinese Medicine, the Acupuncture and Moxibustion Section, the Medical College, the Encephalopathy Section and the First Affiliated Hospital of the Chinese Medicine University in Guangxi, the Acupuncture and Moxibustion Section of the First Affiliated Hospital of Guangxi University of Traditional Medicine, the Acupuncture and Moxibustion Section of the Zhuang Hospital of Guangxi, and the Department of Acupuncture and Moxibustion of the Affiliated Ruikang Hospital of Guangxi University of Traditional Chinese Medicine were diagnosed as the patients with the acute phase of Bell facial paralysis. 60 patients who were in the acute phase of Bell's facial paralysis were given the number of the patients according to the order of treatment. The number of the patients was randomly divided according to the number using the computer software SPSS10.0 according to the ratio of 1:1. The number of the patients was divided into three groups (30 cases of superficial acupuncture) and 30 cases of the control group (simple western medicine group). House-Brachmann (H-B) facial nerve function, facial disability index, comprehensive improvement of symptoms and signs, adverse events and safety evaluations were evaluated for 1 week and 2 weeks after treatment, respectively. Results:1. There was no significant statistical difference in the condition, course, age, and sex of the pre-treatment and control groups, that is, the baseline was consistent; the groups were comparable.2. House-Brachmann's facial nerve grading evaluation: There was a statistically significant difference in the curative effect of the two-week and 2-week-old House-Brachmann facial nerve in the test group and the control group, P0.05). There was no statistical difference between the two groups of House-Brachmann's facial nerve in the test group and the control group after 1 week of treatment. There was a statistically significant difference in the efficacy of House-Brachmann's facial nerve in the test group and the control group after 2 weeks of treatment. The results showed that there was no statistically significant difference in the therapeutic effect of the "gustatory disorder" and the "auditory allergy" in the control group after 1 week of treatment, P0.05, There was a statistically significant difference in all other aspects and in the test group, P0.05; there was no statistical difference between the groups in the "frowning", "opening and closing of eyes", "nasolabial", "nasal movement", "tooth skew", "a drum" and comprehensive scores after 1 week of treatment, but in the "food retention", the "gustatory disorder", There was a statistical difference in "auditory allergy", "lacrimation" and "ear-to-ear pain", P0.05. There was a statistical difference between the test group and the control group after 2 weeks of treatment, but the difference between the groups was only in the "frowning", the "opening and closing of eyes", the "nasolabial", the "food retention", the "auditory allergy", and the comprehensive score after 2 weeks of treatment. The results showed that there was no statistical difference between the body FDI and the social FDI group in the test group after 1 week of treatment, but there was no statistical difference in the body FDI in the control group, P0.05, compared with that of the control group after 1 week of treatment, there was no statistical difference between the body and the body, P0.05, There was a statistical difference in the social FDI, P0.05. There was a statistically significant difference between the groups in the test group and the control group after 2 weeks of treatment, P 0.05. The comprehensive improvement of symptoms and signs:2 cases were cured after 1 week of treatment,5 cases were effective,10 cases were effective,13 cases were not valid,3 cases were cured in the control group,6 cases were markedly effective,8 cases were effective and 13 cases were not valid; after Wilcoxon rank and test, Z =-0.291, P = 0.771, and there was no significant difference in statistics. After 2 weeks of treatment,13 cases were cured,10 cases were effective,5 cases were effective,2 cases were not valid,6 cases were cured in the control group,8 cases were markedly effective,6 cases were effective and 10 cases were not valid; after Wilcoxon rank and test, the results of the test group and the control group were found to be comparable, and Z =-2.702, P = 0.007, and there was a significant statistical difference. Conclusion: It is effective to treat the acute phase of Bell's facial paralysis by the method of superficial needling and simple western medicine, and the effect of the acupuncture on the short-term effect, side effect and safety is better than that of the traditional western medicine. But its exact efficacy still requires a multi-center, high-quality, large-scale trial to validate support.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6
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