Dong Zhen-Ying, Zhang Bao-Qiu, Guo Xi-Quan
Clinical Medical College of Acupuncture-moxibustion and Rehabilitation，Guangzhou University of Chinese Medicine, Guangzhou 510400, China; Department of Acupuncture and Moxibustion, Foshan City Hospital of Chinese Medicine, Foshan 528000, Guangdong Province.
Department of Acupuncture and Moxibustion, Foshan City Hospital of Chinese Medicine, Foshan 528000, Guangdong Province.
Zhen Ci Yan Jiu. 2019 Feb 25;44(2):131-5. doi: 10.13702/j.1000-0607.180304.
To observe the clinical effect of acupuncture combined with herbal-cake (Qianzhengsan) partitioned moxibustion at Xiaguan (ST7), Qianzheng (EX-HN), etc. for patients with peripheral facial paralysis.
Seventy-eight patients with peripheral facial paralysis (within 7 days) were divided into acupuncture plus moxibustion (Acu-Moxi) group and routine acupuncture (control) group (＝38 cases in each). Patients of the control group were treated by routine acupuncture of unilateral or bilateral Yangbai (GB14), Sibai (ST2), Taiyang (EX-HN5), Quanliao (SI18), Jiache (ST6), Dicang (ST4), Yifeng (SJ17), Hegu (LI4) and Zusanli (ST36), and those of the Acu-Moxi group were treated by routine acupuncture of the above-mentioned acupoints in combination with herbal-cake-partitioned moxibustion at ST7 and EX-HN. The treatment was conducted once daily for 20 days. The House-Brackmann facial grading scale (H-B FGS) was used to assess the degree of facial nerve palsy (Ⅰ－Ⅵ grades), the modified Portmann scale used to assess the severity of facial paralysis including the situations of movement of eyebrow raising, eye closing, cheek bulging, pouting, teeth showing and nostril widening, and symmetry during resting state (20 points in total) and the facial disability index (FDI) used to rate the physical function (FDIP) and social life function (FDIS) (5－30 points in total). The clinical efficacy of each group was evaluated after the treatment.
After the treatment, the number of patients with H-B FGS grade IV and V and FDIS scores were significantly decreased, and patients' number of H-B FGS grade I and II , Portmann scale and FDIP scores were significantly increased in both control and Acu-Moxi groups in comparison with their own pre-treatment (<0.01), suggesting an improvement of facial nerve function after treatment. The patients' number of H-B FGS grade I and II and Portmann scores of the Acu-Moxi group was significantly higher than those of the control group (<0.05, <0.01), but no significant differences were found between two groups in the FDIP and FDIS scores (>0.05). Of the two 38 patients in the control group and Acu-Moxi group, 8 (21.05%) and 15 (39.47%) were cured, 7 (18.42%) and 8 (21.05%) experienced marked improvement, 14 (36.84%) and 13 (34.21%) were effective, and 9 (23.68%) and 2 (5.26%) invalid, with the effective rates being 76.32% and 94.74%, respectively. The therapeutic effect of the Acu-Moxi group was evidently superior to that of the control group (<0.05).
The acupuncture combined with Qianzhengsan-partitioned moxibustion is considerably superior to routine acupuncture in improving clinical symptoms and signs of peripheral facial paralysis patients.
观察针刺联合牵正散药饼隔物灸下关（ST7）、牵正（EX-HN）等穴治疗周围性面瘫患者的临床疗效。
将78例周围性面瘫（病程7天内）患者分为针药灸组和常规针刺（对照）组，每组38例。对照组采用常规针刺单侧或双侧阳白（GB14）、四白（ST2）、太阳（EX-HN5）、颧髎（SI18）、颊车（ST6）、地仓（ST4）、翳风（SJ17）、合谷（LI4）和足三里（ST36），针药灸组在上述穴位常规针刺基础上联合牵正散药饼隔物灸下关穴和牵正穴。每日治疗1次，共20天。采用House-Brackmann面神经功能分级量表（H-B FGS）评估面神经麻痹程度（Ⅰ～Ⅵ级），改良Portmann量表评估面瘫严重程度（包括抬眉、闭眼、鼓腮、撅嘴、露齿、鼻孔开大情况及静息状态下的对称性，满分20分），面部残疾指数（FDI）评估生理功能（FDIP）和社会生活功能（FDIS）（满分5～30分）。治疗后评价两组临床疗效。
治疗后，两组患者H-B FGSⅣ、Ⅴ级人数及FDIS评分均显著降低，H-B FGSⅠ、Ⅱ级人数及Portmann量表评分、FDIP评分均显著高于治疗前（P<0.01），提示治疗后面神经功能改善。针药灸组患者H-B FGSⅠ、Ⅱ级人数及Portmann量表评分显著高于对照组（P<0.05，P<0.01），但两组FDIP评分及FDIS评分比较差异无统计学意义（P>0.05）。对照组38例患者中，治愈8例（21.05%）、显效7例（18.42%）、有效14例（36.84%）、无效9例（23.68%）；针药灸组38例患者中，治愈15例（39.47%）、显效8例（21.05%）、有效13例（34.21%）、无效2例（5.26%），有效率分别为76.32%、～4.74%。针药灸组疗效明显优于对照组（P<0.05）。
针刺联合牵正散隔物灸在改善周围性面瘫患者临床症状和体征方面明显优于常规针刺。
