Li Ying, Li Yan, Liu Li-an, Zhao Ling, Hu Ka-ming, Wu Xi, Chen Xiao-qin, Li Gui-ping, Mang Ling-ling, Qi Qi-hua
Chengdu University of TCM, Chengdu 610075, Sichuan Province, China.
Zhongguo Zhen Jiu. 2011 Apr;31(4):289-93.
To explore the best intervention time of acupuncture and moxibustion for peripheral facial palsy (Bell's palsy) and the clinical advantage program of selective treatment with acupuncture and moxibustion.
Multi-central large-sample randomized controlled trial was carried out. Nine hundreds cases of Bell's palsy were randomized into 5 treatment groups, named selective filiform needle group (group A), selective acupuncture + moxibustion group (group B), selective acupuncture + electroacupuncture (group C), selective acupuncture + line-up needling on muscle region of meridian group (group D) and non-selective filiform needle group (group E). Four sessions of treatment were required in each group. Separately, during the enrollment, after 4 sessions of treatment, in 1 month and 3 months of follow-up after treatment, House-Brackmann Scale, Facial Disability Index Scale and Degree of Facial Nerve Paralysis (NFNP) were adopted for efficacy assessment. And the efficacy systematic analysis was provided in view of the intervention time and nerve localization of disease separately.
The curative rates of intervention in acute stage and resting stage were 50.1% (223/445) and 52.1% (162/311), which were superior to recovery stage (25.9%, 35/135) separately. There were no statistical significant differences in efficacy in comparison among 5 treatment programs at the same stage (all P > 0.05). The efficacy of intervention of group A and group E in acute stage was superior to that in recovery stage (both P < 0.01). The difference was significant statistically between the efficacy on the localization above chorda tympani nerve and that on the localization below the nerve in group D (P < 0.01). The efficacy on the localization below chorda tympani nerve was superior to the localization above the nerve.
The best intervention time for the treatment of Bell's palsy is in acute stage and resting stage, meaning 1 to 3 weeks after occurrence. All of the 5 treatment programs are advantageous to Bell's palsy. In the condition of the limited medical sources, the simple filiform needle therapy is recommended in acute stage. For the patients with the disorder above chorda tympani nerve, the line-up needling on muscle region of meridian is not recommended.
探讨针刺艾灸治疗周围性面瘫（贝尔面瘫）的最佳干预时机以及针刺艾灸选择性治疗的临床优势方案。
进行多中心大样本随机对照试验。将900例贝尔面瘫患者随机分为5个治疗组，分别为选择性毫针组（A组）、选择性针刺+艾灸组（B组）、选择性针刺+电针组（C组）、选择性针刺+经筋肌肉排刺组（D组）和非选择性毫针组（E组）。每组均需治疗4个疗程。分别在入组时、治疗4个疗程后、治疗后1个月及3个月随访时，采用House-Brackmann量表、面部残疾指数量表及面神经麻痹程度（NFNP）进行疗效评估。并分别从干预时间和疾病神经定位角度进行疗效系统分析。
急性期和静止期干预的治愈率分别为50.1%（223/445）和52.1%（162/311），均分别优于恢复期（25.9%，35/135）。同一阶段5种治疗方案疗效比较差异均无统计学意义（均P>0.05）。A组和E组急性期干预疗效优于恢复期（均P<0.01）。D组鼓索神经以上定位与鼓索神经以下定位疗效差异有统计学意义（P<0.01），鼓索神经以下定位疗效优于鼓索神经以上定位。
贝尔面瘫治疗的最佳干预时机为急性期和静止期，即发病后1至3周。5种治疗方案对贝尔面瘫均有优势。在医疗资源有限的情况下，急性期推荐单纯毫针疗法。对于鼓索神经以上病变的患者，不推荐经筋肌肉排刺。
