周围性面瘫发病季节与针灸疗效的关系

Observation on relations between onset seasons of peripheral facial paralysis and therapeutic courses and effect of acupuncture

目的:观察季节因素对针灸治疗周围性面瘫疗程、疗效的影响。方法:将400例面瘫患者按季节分为春、夏、秋、冬4组,每组100例,均进行常规针刺治疗,穴取患侧风池、翳风、牵正、颊车、地仓等,每日1次,共观察2个月,以面部症状、体征及功能活动为疗效观察指标,比较各组临床疗效及治疗所需平均疗程。结果:春季组有效率为78.0%(78/100),夏季组为82.0%(82/100),秋季组为89.0%(89/100),冬季组为92.0%(92/100),秋季组和冬季组优于春季组和夏季组(均P<0.05);春夏秋冬4组平均疗程分别为(47.6±22.3)天、(43.7±18.4)天、(31.5±11.3)天、(22.6±9.2)天,除春季组与夏季组平均疗程无差异以外,其他各组间差异均有统计学意义(均P<0.01);风寒袭络型愈显率为80.1%(161/201),风热郁结型为53.5%(61/114),湿热疫毒型为36.5%(31/85),风寒袭络组优于风热郁结型和湿热疫毒型(P<0.001,P<0.05)。结论:不同季节周围性面瘫证型分布与疗程疗效不一,故临床也需考虑"年之所加,病之所起"而采取因时因证而异的治疗。

Objective To observe the influences of seasonal factors on peripheral facial paralysis by acupuncture. Methods Four hundred cases of facial paralysis were divided into spring, summer, autumn and winter groups, 100 cases in each group. All these cases were treated by routine puncture. Fengchi （GB 20）, Yifeng （TE 17）, Qianzheng （Extra）, Jiache （ST 6）, and Dicang （ST 4）, etc. were applied at affect side, once a day. 2 months observation was carried on to compare the clinical therapeutic effects and average courses. The facial symptoms, physical sign and functional activities were taken as observation indexes of therapeutic effect. Results The effect rate was 78. 0% （78/100） in spring group, 82. 0% （82/100） in summer group, 89. 0% （89/100） in autumn group and 92.0% （92/100） in winter group; the effect rate in summer or autumn group was superior to those in spring group and in summer group （all P〈0. 05） the average course was （47.6i 22. 3） days in spring group, （43.7±18.4） days in summer group, （31.5 ± 11.3） days in autumn group and （22.6±9.2） days in winter group, indicating the significant differences between groups except that between spring and summer group （all P〈0.01）. The cured and markedly effective rate was 80. 1% （161/201） for wind cold type, 53.5% （61/114） for wind heat type, and 36.5% （31/85） for damp heat type, indicating that it of wind cold type was superior to that of wind heat type or damp heat type （P〈0. 001, P〈0.05）. Conclusion The syndrome distribution and courses of peripheral facial paralysis are different in different seasons, hence, the diseases should be treated according to attack time and syndromes.