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悬灸早期治疗贝尔面瘫急性期的疗效观察

[Early treatment of suspension moxibustion for Bell's palsy in acute stage].

作者信息

Li De-Hua, Li Ji, Ye Xiao-Qi, Peng Qian

机构信息

Department of Acupuncture-Moxibustion and Rehabilitation, Affiliated Hospital of Chengdu University of TCM, Chengdu 610072, Sichuan Province, China.

出版信息

Zhongguo Zhen Jiu. 2020 Feb 12;40(2):123-8. doi: 10.13703/j.0255-2930.20190101-k00014.

DOI:10.13703/j.0255-2930.20190101-k00014
PMID:32100495
Abstract

OBJECTIVE

To observe the efficacy of early treatment of suspension moxibustion for Bell's palsy and its influence on the prognosis, and to explore whether the early treatment of suspension moxibustion has non-inferiority effect to hormone treatment and whether suspension moxibustion combined with hormone treatment has the synergistic effect.

METHODS

A total of 132 patients with acute-stage Bell's palsy were divided into a hormone group (94 cases) and a moxibustion group (38 cases) by non-random method, and the hormone group was further randomly divided into a hormone with moxibustion group (48 cases) and a hormone without moxibustion group (46 cases). The acupuncture and oral administration of mecobalamin capsule were used as basic treatment. Acupuncture was applied at Yangbai (GB 14), Sibai (ST 2), Quanliao (SI 18), Dicang (ST 4), Jiache (ST 6), Yifeng (TE 17), etc., with the needles retained for 30 min, once a day, 5 consecutive days per week; there was an interval of 2 days between two weeks, and a total of 4-week treatment was given. The oral administration of mecobalamin capsule was given 0.5 mg each time, 3 times a day for 4 weeks. The patients in the moxibustion group, on the basis of basic treatment, were treated with the suspension moxibustion at Yangbai (GB 14), Sibai (ST 2), Dicang (ST 4), Jiache (ST 6), Wangu (GB 12), Yifeng (TE 17) of affected side, 5 min per acupoint, once a day, 5 consecutive days per week; there was an interval of 2 days between two weeks, and a total of 4-week treatment was given. The patients in the hormone without moxibustion group, on the basis of basic treatment, were treated with prednisone acetate tablets. The patients in the hormone with moxibustion group, on the basis of basic treatment, were treated with suspension moxibustion and prednisone acetate tablets. All the treatment was given for 4 weeks. The House-Brcackmann facial nerve grading (H-B) global score and facial disability index (FDI) scale were used to evaluate the curative effect in the three groups before treatment, 2 weeks and 4 weeks into treatment and 4 weeks after treatment; the efficacy was compared among the three groups.

RESULTS

Compared before treatment, the H-B grading and FDI scores were significantly improved 2 weeks and 4 weeks into treatment and 4 weeks after treatment (<0.05). The various indexs of each group 2 weeks into treatment were not statistically significant in the three groups (>0.05); the H-B grading and FDI scores in the hormone with moxibustion group were superior to those in the moxibustion group and the hormone without moxibustion group 4 weeks into treatment and 4 weeks after treatment (<0.05), while there was no significant difference between the moxibustion group and the hormone without moxibustion group (>0.05). At the end of follow-up, the cured rate in the hormone with moxibustion group was 81.3% (39/48), which was superior to 68.4% (26/38) in the moxibustion group and 60.9% (28/46) in the hormone without moxibustion group (<0.05). However, there was no significant difference between the moxibustion group and the hormone without moxibustion group (>0.05).

CONCLUSION

The three treatment methods are all safe and effective for acute-stage Bell's palsy. The suspension moxibustion combined with hormone therapy are superior to suspension moxibustion or hormone therapy alone. Early treatment of suspension moxibustion is safe and effective for Bell's palsy, and has obvious synergistic effect with hormone. For the patients who cannot use hormone, suspension moxibustion could replace hormone, which is non-inferior to hormone.

摘要

目的

观察早期悬灸治疗贝尔面瘫的疗效及其对预后的影响,探讨早期悬灸治疗对激素治疗是否具有非劣效性,以及悬灸联合激素治疗是否具有协同效应。

方法

将132例急性期贝尔面瘫患者采用非随机法分为激素组(94例)和艾灸组(38例),激素组再随机分为激素加艾灸组(48例)和单纯激素组(46例)。针刺及口服甲钴胺胶囊作为基础治疗。针刺选取阳白(GB 14)、四白(ST 2)、颧髎(SI 18)、地仓(ST 4)、颊车(ST 6)、翳风(TE 17)等穴,留针30分钟,每日1次,每周连续治疗5天;两周之间间隔2天,共给予4周治疗。口服甲钴胺胶囊每次0.5mg,每日3次,共4周。艾灸组在基础治疗的基础上,对患侧阳白(GB 14)、四白(ST 2)、地仓(ST 4)、颊车(ST 6)、完骨(GB 12)、翳风(TE 17)进行悬灸,每穴5分钟,每日1次,每周连续治疗5天;两周之间间隔2天,共给予4周治疗。单纯激素组在基础治疗基础上,给予醋酸泼尼松片治疗。激素加艾灸组在基础治疗基础上,给予悬灸及醋酸泼尼松片治疗。所有治疗均持续4周。采用House-Brcackmann面神经分级(H-B)整体评分及面部残疾指数(FDI)量表对三组患者治疗前、治疗2周、4周及治疗后4周进行疗效评估;比较三组疗效。

结果

与治疗前比较,治疗2周、4周及治疗后4周时H-B分级及FDI评分均显著改善(<0.05)。治疗2周时三组各指标比较差异无统计学意义(>0.05);治疗4周及治疗后4周时激素加艾灸组H-B分级及FDI评分优于艾灸组及单纯激素组(<0.05),而艾灸组与单纯激素组比较差异无统计学意义(>0.05)。随访结束时,激素加艾灸组治愈率为81.3%(39/48),优于艾灸组的68.4%(26/38)及单纯激素组的60.9%(28/46)(<0.05)。但艾灸组与单纯激素组比较差异无统计学意义(>0.05)。

结论

三种治疗方法对急性期贝尔面瘫均安全有效。悬灸联合激素治疗优于单纯悬灸或单纯激素治疗。早期悬灸治疗贝尔面瘫安全有效,且与激素具有明显协同效应。对于不能使用激素的患者,悬灸可替代激素,且非劣于激素。

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