针灸联合牵正散治疗面神经炎随机平行对照研究

Qianzheng powder combined Acupuncture Treatment of Facial Paralysis Randomized Controlled Study

[目的]观察针灸联合牵正散治疗面神经炎疗效。[方法]使用随机平行对照方法,将86例门诊及住院患者按就诊顺序号法简单随机分为两组。对照组43例泼尼松,30mg/次,早起晨服,持续一周后减量为20mg;甲钴胺,0.5mg/次,3次/d;阿昔洛韦,200mg/次,5次/d;地巴唑,3次/d,10mg/次;面部照射红外线,配合相应的面部肌肉康复训练比如皱眉,鼓腮等,20min/次,1次/d。治疗组43例牵正散（白附子、白僵蚕、全蝎各10g,风寒加荆芥、防风、羌活各10g,桂枝6g;风热加柴胡、葛根各10g;气滞血瘀加当归、丹参、川芎、红花各10g;痰瘀阻络加胆南星、竹沥各10g;气血亏虚加黄芪、熟地各15g;肝阳上亢加夏枯草10g,石决明15g,勾藤10g）,1剂/d,水煎200m L,早晚饭后30min口服。针刺,卧位,面颊局部、足阳明经腧穴为主,阳白、下关、迎香、翳风、合谷、曲池,颊车透地仓,阳白透鱼腰、四白透迎香;风寒加风池、外关;风热加风池、曲池;抬眉困难加攒竹;体虚加足三里、三阴交;鼻唇沟变浅加迎香;人中沟歪斜加水沟;颏唇沟歪斜加承浆;30号1-1.5寸毫针,面部腧穴均行平补平泻法,面部穴位多取透穴刺法,初期面部穴位多轻刺浅刺;恢复期可加灸;阳白与鱼腰穴沿皮肤刺入0.4寸,地仓则向颊车刺0.5寸,其他穴位直刺,之后加电针,持续通电30min,以患者耐受为度;5次/周。连续治疗10d为1疗程。观测临床症状、症状评分、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组痊愈21例,有效20例,无效2例,总有效率95.35%。对照组痊愈18例,有效10例,无效15例,总有效率65.12%。治疗组疗效优于对照组（P〈0.01）。[结论]针灸联合牵正散治疗面神经炎疗效满意,无严重不良反应,值得推广。

[Objective]To observe Qianzheng Powder combined with acupuncture treatment of facial neuritis.[Methods]Randomized parallel controlled method,86 cases of outpatient and inpatient treatment order number method is simple and randomly divided into two groups.The control group of 43 patients with prednisone,30mg/times,early morning service,a week after the reduction to 20 mg.Mecobalamin,0.5mg/time,3 times/d;acyclovir,200mg/day,5 times/d;methimazole,3 times/d,10mg/times;face infrared rays,with the corresponding facial muscles rehabilitation such as frowning,drum gills,etc.,20min/times,1 times/d.Treatmentgroup of 43 patients Qianzheng powder（Baifuzi,Baijiangcan,Quanxie 10 g,cold plus Jingjie,Fangfeng,Qianghuo 10 g,Guizhi 6g;wind-heat plus Chaihu,Gegen 10g;stasis plus Danggui,Danshen,Chuanxiong,Honghua each 10g;phlegm network plus Dannanxing,Xianzhuli each 10g;blood deficiency plus Huangqi,Shudi 15g;hyperactivity plus Xiakucao 10 g,Shijueming 15 g,Gouteng 10g）,a/d,decoction 200 m L,morning and evening meal 30 min oral.Acupuncture,supine,cheeks topical,Meridian acupoints based,Yang Bai,Shimonoseki,Ying Hong,Yifeng,gu,music pool,buccal car through warehouses,Yang Bai through fish back,four white through greet incense;cold plus the wind pool,foreign relations;wind-heat plus the wind pool,music pool;brow lift plus Cuanzhu difficult;physically weak plus the full three years,Sanyinjiao;shallow nasolabial fold increase yingxiang;people ditch skew plus ditch;mentolabial ditch skew plus bearing slurry;on the 30 th of 1 to 1.5 inch needle,facial acupoints underwent reinforcing-reducing method,facial points to take on more transparent Needling initial facial points more light stab shallow stab;recovery can moxibustion;male white with fish back points along the skin piercing 0.4 inch,to warehouse the car to the cheek spines 0.5 inch,piercing the other points,after adding EA,continuous power 30 min,patient tolerance for the degree;5 times/week.10 d for a course of continuous treatment.Observation of clinical symptoms,symptom scores,adverse reactions.Continuous treatment of 3 courses,to determine efficacy.[Results]The cure 21 cases,effective in 20 cases,2 cases,the total efficiency of 95.35%.The control group cured 18 cases,10 cases,15 cases ineffective,the total efficiency of 65.12%.Treatment group than the control group（P〈0.01）.[Conclusion]Qianzheng powder combined acupuncture treatment of facial neuritis results were satisfactory,no side effects,worthy of promotion.