益气清热针药并用法治疗急性期风热中络型面瘫伴耳后疼痛临床研究

Clinical Study of Yiqi Qingre Decoction and Acupuncture Treatment on the Wind and Heat in Collaterals Type of Facial Paralysis with Ear Pain in the Acute Stage

目的观察益气清热针药并用法治疗急性期风热中络型面瘫伴耳后疼痛临床研究。方法将90例急性面瘫伴有耳后疼痛患者随机分为普通针刺组、益气清热针刺组及益气清热针药并用组即治疗组3组,每组各30例。普通针刺组采用常规针刺治疗,针刺选患侧阳白、太阳、丝竹空、四白、颧髎、地仓、颊车、牵正、承浆、双侧合谷及风池;益气清热针刺组在普通针刺组基础上加取双侧足三里、百会、外关、大椎等穴位;治疗组在益气清热针刺组基础上配伍玉屏风散加减(黄芪、白术、防风、炒山栀、金银花、僵蚕、地龙)。3组治疗均以3周为1个疗程。观察3组治疗前后耳后疼痛评分、急性期耳后疼痛持续时间、多伦多面神经功能评分及总体疗效。结果 3组患者在治疗后耳后疼痛持续天数组间比较皆具有统计学差异,而治疗组明显少于其他两组(P<0.01)。3组患者面神经评分比较,治疗前3组组间比较无统计学意义(P>0.05);治疗后3组组间比较具有显著统计学意义(P<0.01),而治疗组明显高于其他2组;3组治疗前后组内比较皆具有显著差异(P<0.01);3组面瘫患者疗效比较皆具有显著差异(P<0.01),但治疗组优于其他2组。结论益气清热针药并用法对于改善急性期风热中络型面瘫伴耳后疼痛具有确切疗效。

Objective To observe the effect of Yiqi Qingre decoction and acupuncture treatment on the wind and heat in collaterals type of facial paralysis with ear pain in the acute stage. Methods 90 cases of acute facial paralysis with ear pain were randomly divided into common acupuncture group, acupuncture group of nourishing qi and clearing heat （Qingre Yiqi acupuncture group）, and Qingre Yiqi acupuncture group with medicine, each group of 30 cases. Common acupuncture group was treated with conventional acupuncture treatment, acupuncture selected from the affected side Yangbai, Sun, Sizhukong, Sibai, Quanliao, Warehouses, Buccal car, Pull, Bearing slurry, bilateral Hegu and Fengchi; Qingre Yiqi acupuncture group was treated with bilateral Zusanli, Baihui, Waiguan, Dazhui points on the basis of common acupuncture group;treatment group was treated with Yuping Feng pulvis （Huangqi, Baizhu, Fangfeng, fried Gardenia, Jin yinhua, Jiangcan, Dilong） based on Qingre Yiqi acupuncture group. The three groups were treated with 21d for 1 courses, 1 courses of treatment. Ear pain score, duration of acute pain, Toronto of neurological function score and the total efficacy before and after treatment in three groups were observed. Results There were significant differences on duration of ear pain in three groups after the treatment, and the treatment group was significantly less than those of the other two groups（P〈0.01 ）. There were no significant differences on facial nerve score in three groups before the treatment （P〉0.05）; there were significant differences on facial nerve score in three groups after the treatment, and the treatment group was significantly higher than that in the other two groups （P〈0.01）. There were significant differences on the total efficacy in three groups after the treatment, and the treatment group was better than that in the other two groups（P〈0.01 ）. Conclusion Yiqi Qingre decoction and acupuncture treatment have obvious effect on improving the wind and heat in collaterals type of facial paralysis with ear pain in the acute stage.