周围性面瘫针刺时机临床循证分析

Analysis of evidence-based clinical practices on timing factor in acupuncture treatment for facial paralysis

目的:采用循证医学方法分析周围性面瘫最佳针刺时机的选择,为临床提供参考依据。方法:应用计算机在中国医院数字图书馆检索中国知网(CNKI)全文数据库文献,以周围性面瘫、针刺、治疗时机/针刺时机为检索词,时间在1994年1月-2009年8月间的相关文献。按照Cochrane标准,对纳入研究进行循证分析,采用SPSS 13.0软件进行统计分析。结果:133篇符合纳入标准的研究,其中急性期观察组进行针刺/电针治疗、对照组采用常规药物治疗的有11篇,经Mann-WhitneyU检验,疗效差异有统计学意义(P<0.001)。结论:急性期针刺早期介入治疗有利于提高疗效,促进患者神经功能的恢复。而且在急性期,多项动物实验与临床观察证据支持并使用电针、传统针刺等疗法。

Objective By using the evidence based medicine approach to analyze the optimum timing in acupunc ture treatment for facial paralysis, to provide the scientific evidence for acupuncture clinical practices. Methods Computer searches were conducted in the CNKI literature database from January 1994 to August 2009, using the keywords ＂facial paralysis＂, ＂acupuncture＂ and ＂acupuncture timing/ treatment timing＂. According to the standard of Cochrane, the literatures were retrieved and conducted with evidence based analysis. The SPSS 13.0 Software was used for the statistical analysis. Results Among the 133 retrieved literatures which met the inclusion criteria of the study, there were 11 literatures on the effect of acupuncture or electroacupuncture treatment in acute phase observation group and conventional medical treatment group. Using Mann Whitney U test, the difference of treatment effect is statistically significant （P〈0. 001）. Conclusion Early intervention in acupuncture treatment for facial paralysis in acute phase can improve the efficacy and promote neurological recovery. In the acute phase, animal experi ments and clinical observations provide evidence to support the application of electric needle and traditional acupunc ture treatments.