针刺对贝尔麻痹急性期干预效果的临床观察

Clinical Observation of Acupuncture in Intervening Bell's Palsy in Acute Stage

目的观察贝尔麻痹急性期针刺干预对临床疗效及预后有何影响。方法将发病3 d内的62例贝尔麻痹患者随机分为两组,即针刺干预组(观察组)32例和西药对照组(对照组)30例。在常规药物治疗的基础上,对观察组患者就诊当天即行针刺干预治疗,而对照组患者在发病7 d(急性期)后再行针刺干预。观察两组患者治疗前及治疗第7天、第14天、第28天症状体征积分、神经电图ENo G值和House-Brackmann(H-B)分级,并比较临床疗效。结果两组治疗均能改善临床症状体征以及促进面神经功能恢复,且观察组症状体征积分在治疗第14天和第28天与对照组比较差异有统计学意义(P<0.05),H-B分级和ENo G值在第28天相比有显著性差异(P<0.05);观察组总有效率为90.6%,明显高于对照组(70.0%),临床疗效比较差异有统计学意义(P<0.05)。结论贝尔麻痹急性期针刺的介入,并不加重发病7 d(急性期)后的病情;相同病变时期内针刺介入越早,对提高临床疗效越有优势。

Objective To discuss the clinical efficacy of acupuncture in intervening Bell＇s palsy in acute stage and its effect on the prognosis. Method Sixty-two Bell＇s palsy patients with an onset in 3 d were randomized into two groups： an acupuncture group（observation group） of 32 cases and a Western medication group（control group） of 30 cases. In addition to the conventional medications, patients in the observation group started to receive acupuncture on the day of visiting, while patients in the control group started to receive acupuncture 7 d after the onset（after the acute stage）. The symptom sign score, electroneurogram（ENo G）, and House-Brackmann（H-B） score were evaluated before intervention, at treatment day 7, treatment day 14, and treatment day 28, and the clinical efficacies were also compared. Result The symptom sign score and facial nerve function were improved in both groups; there were significant differences in comparing symptom sign score at treatment day 14 and 28 between the two groups（P〈0.05）; there were significant differences in comparing H-B score and ENo G value at treatment day 28 between the two groups（P〈0.05）. The total effective rate was 90.6% in the observation group, significantly higher than 70.0% in the control group, suggesting that there was a significant difference in comparing the clinical efficacy between the two groups（P〈0.05）. Conclusion Intervention of acupuncture in acute stage wont aggravate the disease condition of Bell＇s palsy 7 d after the onset; with the same onset time, the early intervention of acupuncture benefits the enhancement of clinical efficacy.