神经心理因素与贝尔麻痹针刺治疗疗效关系观察

Relationship between Neuro-psychological Factors and Effect of Acupuncture in Treating Bell's Palsy

目的研究神经心理因素对贝尔麻痹针刺治疗和总体预后的影响。方法选择贝尔麻痹患者50例,分为手法组和非手法组进行针刺治疗,采用针灸疗效主观感受量表、卡特尔人格因素测试、汉密尔顿焦虑量表(HAMA)进行评分,采用House-Brackmann分级标准评定治疗效果。结果通过House Brackmann评分,针刺治疗总有效率78.0%(39/50);且手法组疗效[89.2%(25/28)]优于非手法组[63.6%(14/22)],差异有统计学意义(P<0.01);针刺得气感受进行视觉模拟评分结果显示,与非手法组比较,手法组患者得气分值及医者得气分值高于非手法组(P<0.01);通过卡特尔人格因素测试(16PF)测试,乐群性、聪慧性、兴奋性、敢为性、独立性人群较为容易得气,且人格因素与疗效有明显相关性;通过HAMA评分,焦虑者占92.0%(46/50),且焦虑程度与疗效呈负相关(r=-0.9491,P<0.05)。结论神经心理因素在贝尔麻痹的治疗中发挥着重要作用,应采取药物、针灸、心理干预及康复治疗等多种手段结合以改善预后。

Objective To study the influence of neuro-psychological factors on the effect of acupuncture in the treatment of Bell＇s palsy and the overall prognosis in patients.Methods Fifty patients with Bell＇s palsy were randomized into the treatment group and the control group,and they were treated with manipulated and non-manipulated acupuncture,respectively.Scorings by subjective perceptive scale of acupuncture,Cartel personality test,and Hamilton Anxiety Scale were performed and the curative effect was assessed according House-Brackmann grading standards.Results The total effective rate of acupuncture was 78.0%（39/50）,and that of manipulated acupuncture was better than that of non-manipulated acupuncture [89.2%（25/28）vs.63.6%（14/22）,P0.01].Visual analogue scoring for perception of ＂Deqi＂,evaluated either by patients or by doctors,showed that the scores was higher in the treatment group than in the control group（P0.01）.Cartel personality test（16PF）found that patients with personality factors of sociability,intellectuality,excitability,braveness,and independence were capable of getting ＂Deqi＂ more easily,there existed a significant correlation between personality factors and curative effect.By Hamilton Anxiety Scale scoring,92.0%（46/50）of the patients were found being in an anxiety state,and the efficacy of treatment was negatively correlated with the degree of anxiety（r=-0.9491,P0.05）.Conclusion Neuro-psychological factors put great influence on the efficacy of treatment for Bell＇s palsy,multiple measures,such as drug-therapy,acupuncture,psychological intervention,rehabilitation therapy,etc.,should be taken in combination for improving patients＇ prognosis.