针灸分期治疗贝尔氏面瘫临床观察

Clinical observation on treatment of acupuncture for different stages of Bell's palsy

目的:观察针灸治疗贝尔氏面瘫不同病期的疗效差异,探讨针灸治疗面瘫的最佳介入时期。方法:40例贝尔氏面瘫患者随就诊发病时间长短分为发展期组、静止期组与恢复期组。治疗前均以Sunnybrook(多伦多)面神经评定系统和面部残疾指数调查问卷(FDI)作为量化指标评定积分。3组均予针灸治疗,主穴取患侧风池、地仓、颊车、牵正、四白、阳白,健侧合谷;配穴:大椎、承浆、水沟,患侧攒竹、鱼腰、翳风、听会、颧髎、下关、迎香。操作:风池、合谷、大椎针用泻法,其他穴位均采用平补平泻法,于临床痊愈或治疗20次后再次评分判定疗效。结果:(1)针灸对贝尔氏面瘫发展期、静止期、恢复期均有治疗效果,有效率均为100%;(2)针灸治疗贝尔氏面瘫发展期组愈显率明显优于静止期和恢复期组(均P<0.01);(3)静止期组与恢复期组间比较愈显率差异无统计学意义(P>0.05)。结论:针灸治疗贝尔氏面瘫有良好的效果,且发展期介入治疗其疗效最为明显。

Objective To observe the therapeutic effects of acupuncture for treatment of different stages of BelPs palsy, and explore the best intervention period. Methods Forty cases of Bell＇s palsy patients were divided into three groups according to their onset time： an active stage group, a resting stage group and a recovery stage group. The scores were evaluated with Sunnybrook Facial Nerve Evaluation System and Facial Disability Index Question- naire （FDI）. All three groups were treated with acupuncture. Fengchi （GB 20）, Dicang （ST 4）, Jiache （ST 6）, Qianzheng （Extra）, Sihai （ST 2）, Yangbai （GB 14） on the affected side and Hegu （LI 4） on the healthy side were selected as main points. Dazhui （GV 14）, Chengjiang （CV 24）, Shuigou （GV 26） and Cuanzhu （BL 2）, Yuyao （EX-HN 4）, Yifeng （TE 17）, Tinghui （GB 2）, Quanliao （SI 18）, Xiaguan （ST 7）, Yingxiang （LI 20） on the af- fected side were selected as adjuvant points. Operation.. reducing was performed at Fengchi （GB 20）, Hegu （LI 4） and Dazhui （GV 14）, while mild tonification and mild purgation was performed at other points. The therapeutic effect was evaluated again by scoring after the clinical recovery or treatment of 20 times. Results （1） Acupuncture was effective for the Bell＇s palsy in active stage, resting stage and recovery stage （all P〈0.01） ;（2）The obvious effective rate of acupuncture for treatment of Bell＇s palsy in the active stage group was obviously superior to those of resting stage group and recovery stage （both P〈0. 01）. （3） There was no significant difference of the obvious effective rate between the resting stage group and the recovery stage group （P〈0.05）. Conclusion Acupuncture has a good therapeutic effect for treatment of Bell＇s palsy, and the therapeutic effect is most obvious with intervention of treatment in the active stage.