针灸穴位注射结合中药熏蒸治疗顽固性面瘫观察

Observation on Clinical Curative Effect of Acupuncture Acupoint Injection Combined with Traditional Chinese Medicine Fumigation in Treatment of Stubborn Facial Paralysis

目的:探讨针灸穴位注射联合中药熏蒸治疗顽固性面瘫的临床效果。方法:将80例顽固性面瘫患者按随机数字表法分为对照组与观察组每组40例,对照组采用针灸穴位注射治疗,观察组在对照组基础上加用中药熏蒸治疗,评定两组治疗前后症状的变化,比较两组治疗效果,采用面部残疾指数(FDI)及House-Brackmann(H-B)面部神经功能分级法评定患者治疗前后面部残疾及麻痹程度改善情况。结果:①治疗4周,两组口眼歪斜、额纹消失、眼裂增大、鼓腮漏气、眼睑闭合不良等积分均降低,观察组各积分降低幅度高于对照组,比较差异有统计学意义(P<0.05);②观察组治疗总有效率高于对照组,比较差异有统计学意义(P<0.05);③治疗4周,两组面部残疾躯体功能指数(FDIP)积分上升,社会生活功能(FDIS)积分降低(P<0.05),观察组FDIP积分高于对照组,FDIS积分低于对照组(P<0.05);④治疗后,观察组H-B分级Ⅰ级所占比例高于对照组,Ⅳ级所占比例低于对照组,对比差异有统计学意义(P<0.05)。结论:针灸穴位注射结合中药熏蒸治疗顽固性面瘫疗效肯定,可改善患者症候、面部残疾指数及面部神经功能。

Objective:To explore the clinical effect of acupuncture acupoint injection combined with traditional Chinese medicine(TCM) fumigation in the treatment of stubborn facial paralysis.Methods:Eighty patients with stubborn facial paralysis were divided into the control group and the observation group with 40 cases by the random number table method. The control group were treated with acupuncture point injection, while the observation group were treated with acupuncture acupoint injection combined with TCM fumigation. Changes of symptoms in the two groups before and after treatment were assessed, and the curative effect was compared between the two groups. The relief of facial abnormalities and the degree of paralysis was evaluated with the facial disability index(FDI) and House-Brackmann(H-B) before and after treatment. Results①After 4 weeks of treatment, scores of facial paralysis, loss of forehead pattern, increase of palpebral fissure, cheek-bulging leakage and poor eyelids closure in the two groups were decreased, and the decrease in observation group was greater than that in the control group(P<0.05). ②The total response rate of the observation group was higher than that of the control group(P<0.05). ③After 4 weeks of treatment, scores of facial disability physical function index(FDIP) were increased while scores of social life function(FDIS) were decreased in the two groups(P<0.05). The FDIP score in the observation group was higher than that in the control group, and the FDIS score was lower than that in the control group(P<0.05). ④After treatment, the proportion of H-B grade I in the observation group was higher than that in the control group, and the proportion of grade IV was lower than that in the control group(P<0.05). Conclusion:Acupuncture acupoint injection combined with TCM fumigation is effective in the treatment of stubborn facial paralysis. It can relieve patients’ syndrome, improve the facial disability index and facial nerve function.