针刺时机、针法、刺激量对针刺治疗面神经炎疗效的影响

Influence of acupuncture occasion, acupuncture manipulation and stimulation volume on the curative effects of acupuncture for facial neuritis

目的:通过观察针刺前后临床症状的改变,探讨针刺时机,针法,刺激量三因素对针刺治疗面神经炎在获得临床疗效方面的影响。方法:选择武装警察部队总医院2004-05/2005-05门诊和住院面神经炎患者72例,病程在1～3个月内。选穴:体穴选合谷、太冲,并随症加减;面部选穴:阳白、太阳、四白、颧廖、地仓、颊车、下关、翳风等穴位,并且采用透刺法。以评分方式来评定治疗前后的语言、面部运动功能和综合功能的恢复程度(痊愈:积分增加达24分以上者;显效:积分增加超过10分者;有效:积分增加超过4分以上者;无效:积分增加不足4分者)。考察针刺治疗面神经炎的针刺时机(A:1～7d,B:8￣21d,C:22d～3个月),刺激量(轻、中、重),针法(健患侧同时刺、患侧刺、健侧刺)3个因素及3个水平在获得临床疗效的主次地位和优劣作用,最后确定其最优化作用。结果:72例患者全部进入结果分析。①针刺后语言功能、面部运动功能、综合功能评分均高于针刺前[(3.25±0.72),(2.58±0.54)分;(15.24±1.25),(12.17±1.06)分;(4.76±0.20),(2.72±0.26)分,t=4.12￣5.72,P<0.01]。②针法以健患侧同时刺效果最好,但与健侧刺、患侧刺二针法比较,差异不显著。③刺激量以轻刺激效果最好,优于重刺激量与中刺激量;针刺时机以发病7d内针刺效果最好。结论:以针刺时机7d内、健患侧同时刺、轻刺激量的组合治疗效果最佳,说明多因素在不同水平上的优化组合,是提高针刺疗效的关键。

Abstract AIM：Tu explore the influences of acupuneture occasion,acupuncture manipulation anti stimulation volumc on the clinical effect of acupuncture for treatment of facial neuritis by means of observing the changes of clinical symptoms before and after acupuncture. METHODS： Seventy-twu patients with facial neuritis, who were treated in the out-patient clinic or hospitalized in the General Hospital of Chinese People＇s Armed Police Force from May 2004 to May 2005,were selected within 1-3 months after onset.Selecting point：The Hegu（LI 4） and Taichong （LR 3） of body point were selected, and change with the symptoms. Facial point： The Yangbai （GB 14）.Taiyang （Extra）, Sibai （ST 2）, Quanliao （SI 18）, Dicang （ST 4）, Jianche （ST 6）, Xiaguan（ST 7） and Yifeng （SJ 17） etc. were selected,and the penetrating puncture method was used.The recovery degrees of language, facial motor function and comprehensive function were assessed with score （Healing：the patients with over 24 increased points; Significant effect：those with over 10 increased points; Efficiency： those with over 4 increased points;lnefficiecy：thnse with less than 4 increased points）. The acupuncture occasion （A： 1-7 days. B： 8-21 days, C： 22 days-3 months）, stimulation volume （mild, moderate, severe）, and acupuncture manipulation （puncturing at uninjured and injured sides at one time,at injured side or at uninjured side） of acupuncture for treatment of facial neuritis were observed.The primary and secondary status and good and bad effects on the clinical effects in the three different levels were inspected. The optimal effect was defined at last. RESULTS：Totally 72 patients were involved in the result analysis. ① The scores of language function,facial motor function and comprehensive function after acupuncture were higher than those before acupuncture [（3.25±0.72）, （2.58±0.54）points ; （ 15.24± 1.25）,（12.17± 1.06）poims ; （4.76±0.20）,（2.72±0.26） points,t=4.12-5.72,P 〈 0.011. ② The acupuncture at uninjured and injured sides at the same time had the best effect, but there was insignificant difference between the uninjured side acupuncture and injured side acupuncture. ③ The mild stimulation had the best effect, which was better than the severe and moderate stimulation.The acupuncture effect was the best within 7 days after episode. CONCLUSION：Therapeutic efficacy of mild acupuncture at uninjured and injured sides simultaneously within 7 days after onset is the best in treatment of facial neuritis, which indicates that the optimal combination of multiple factors in different level is the key to the improvement of the acupuncture effect.