患侧“反应点”针刺对急性期周围性面瘫的影响

[Effect of acupuncture at "reflection points" of the affected side on the peripheral facial paralysis in acute phase].

作者信息

Wang Jing-Hua, Cui Yao-Hui, Li Ying, Hou Yun-Xia, Han Qiong, Cheng Kun, Zhang Jian-Bin, Jin Guan-Yuan

机构信息

Department of TCM, Affiliated Peace Hospital of Changzhi Medical College, Changzhi 046000, Shanxi Province, China.

Department of Physiotherapy, Affiliated Peace Hospital of Changzhi Medical College, Changzhi 046000, Shanxi Province, China.

出版信息

Zhongguo Zhen Jiu. 2019 Jun 12;39(6):588-92. doi: 10.13703/j.0255-2930.2019.06.005.

Abstract

OBJECTIVE

To explore the effect of acupuncture at the "reflection points" of affected side on the peripheral facial paralysis in acute phase.

METHODS

Ninety patients with peripheral facial paralysis in acute phase were randomly divided into a reflection group (group A), a conventional acupuncture group (group B) and a physiotherapy group (group C), 30 cases in each group. The same basic medication were given in all three groups. In the group A, acupuncture at "reflection points" of the affected side and local acupoints in acute phase, such as Dicang (ST 4), Jiache (ST 6), Quanliao (SI 18), Xiaguan (ST 7), Yangbai (GB 14), Taiyang (EX-HN 5), etc. were applied. The electroacupuncture was added in the stationary phase, and Zusanli (ST 36) was added in the recovery phase. In the group B, acupuncture at Yifeng (TE 17) of the affected side in acute phase and local acupoints, such as Dicang (ST 4), Jiache (ST 6), Quanliao (SI 18), Xiaguan (ST 7), Yangbai (GB 14), Taiyang (EX-HN 5), etc. were applied. The electroacupuncture was added in the stationary phase, and Zusanli (ST 36) was added in the recovery phase. In the group C, ultrashort wave on Yifeng (TE 17) of the affected side in acute phase was applied, and the treatment in the stationary phase and the recovery phase was the same as the group B. The treatment was given once every day, 5 times as one course for 4 courses. The House-Brackmann (H-B) grading scale, facial disability index scale, the symptom and physical score integral scale were used to score before and after treatment, and the clinical effects of the three groups were compared.

RESULTS

After treatment, the functional grade of H-B facial nerve was better than that before treatment in the three groups (<0.01). There was no significant difference among the three groups after treatment (>0.05). After treatment, the course of treatment required to reflect the healing in the group A was shorter than that in the group B and the group C (<0.01); the body function scores and social function scores in the three groups were better than those before treatment (<0.01), there was no significant difference among the three groups after treatment (>0.05). The scores of symptoms and signs in the three groups were lower than those before treatment (<0.01), there was no significant difference among the three groups after treatment (>0.05). H-B facial nerve function grading scale and facial disability index (FDI) scale were used as the evaluation criteria, the curative rate was 66.7% (20/30) in the group A, 50.0% (15/30) in the group B and 46.7% (14/30) in the group C, the curative rate in the group A was better than the other two groups (<0.05). The curative and markedly effective rate in the group A was 83.3% (25/30), 70.0% (21/30) in the group B and 63.3% (19/30) in the group C, the curative and markedly effective rate in the group A was better than the other two groups (<0.05). The scores of symptoms and signs were used as the evaluation criteria, the curative rate was 66.7% (20/30) in the group A, 50.0% (15/30) in the group B, and 46.7% (14/30) in the group C. The curative rate in the group A was better than the other two groups (<0.05).

CONCLUSION

Compared with general acupuncture and physiotherapy, acupuncture at the "reflection points" of the affected side on the peripheral facial paralysis in acute phase could shorten the course of treatment and improve the curative effect.

摘要

目的

探讨针刺患侧“反应点”对急性期周围性面瘫的影响。

方法

将90例急性期周围性面瘫患者随机分为反应点组(A组)、传统针刺组(B组)和物理治疗组(C组),每组30例。三组均给予相同的基础用药。A组在急性期针刺患侧“反应点”及局部穴位,如地仓(ST4)、颊车(ST6)、颧髎(SI18)、下关(ST7)、阳白(GB14)、太阳(EX-HN5)等;静止期加用电针,恢复期加用足三里(ST36)。B组在急性期针刺患侧翳风(TE17)及局部穴位,如地仓(ST4)、颊车(ST6)、颧髎(SI18)、下关(ST7)、阳白(GB14)、太阳(EX-HN5)等;静止期加用电针,恢复期加用足三里(ST36)。C组在急性期采用患侧翳风(TE17)超短波治疗,静止期和恢复期治疗同B组。每天治疗1次,5次为1个疗程,共治疗4个疗程。采用House-Brackmann(H-B)分级量表、面部残疾指数量表、症状体征积分量表在治疗前后进行评分,比较三组的临床疗效。

结果

治疗后,三组H-B面神经功能分级均优于治疗前(P<0.01);治疗后三组间比较差异无统计学意义(P>0.05)。治疗后,A组面神经恢复所需疗程短于B组和C组(P<0.01);三组躯体功能评分和社会功能评分均优于治疗前(P<0.01),治疗后三组间比较差异无统计学意义(P>0.05)。三组症状体征评分均低于治疗前(P<0.01),治疗后三组间比较差异无统计学意义(P>0.05)。以H-B面神经功能分级量表和面部残疾指数(FDI)量表为评价标准,A组治愈率为66.7%(20/30),B组为50.0%(15/30),C组为46.7%(14/30),A组治愈率优于其他两组(P<0.05)。A组治愈显效率为83.3%(25/30),B组为70.0%(21/30),C组为63.3%(19/30),A组治愈显效率优于其他两组(P<0.05)。以症状体征评分为评价标准,A组治愈率为66.7%(20/30),B组为50.0%(15/30),C组为46.7%(14/30),A组治愈率优于其他两组(P<0.05)。

结论

与普通针刺和物理治疗相比,针刺患侧“反应点”治疗急性期周围性面瘫可缩短疗程,提高疗效。

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