针刺推拿+心理疏导+康复训练联合西药治疗多发性末梢周围神经炎随机平行对照研究

Acupuncture and Massage and Psychological Counseling and Rehabilitation Training combined with Western Medicine in the Treatment of Multiple Peripheral Neuritis,Randomized Controlled Study

[目的]观察针刺推拿+心理疏导+康复训练联合西药治疗多发性末梢周围神经炎疗效。[方法]使用随机平行对照方法,将80例住院患者按病志号抽签简单随机分为两组。对照组40例泼尼松龙100ug/次,口服;维生素B12100ug/次,口服;维生素B1100mg+0.9%生理盐水150m L,静滴,1次/d;川芎嗪注射液60mg+5%葡萄糖溶液200m L,静滴,1次/d;面神经炎巯丁二钠270μg、氯化亚锡-680μg、二巯丁二钠0.5g+0.9%生理盐水200m L,静滴,1次/d;根据神经炎范围和部位半导体激光物理调节适合的剂量模式,20min/次,1次/d。治疗组40例针刺印堂、四白、牵正、风池、合谷、下关、太冲、颊车、翳风、曲池、承浆、迎香等,合谷、风池、太冲),泻法,徐进疾出;下关、颊车、迎香平刺,平补平泻;其他面部腧穴,补法,轻轻抽动面部穴位,留针20min,1次/d,疼痛严重穴位注射普鲁卡因;按摩太阳、阳白、颧髎、颊车、地仓、合谷、三阴交、曲池、足三里、阿是穴等;轮刮上、下眼睑各30次,再按揉眼皮30次,10min/d,局部腧穴得气为度;心理疏导:与患者交流沟通,讲解相关知识和注意事项,帮助患者树立治疗信心;康复训练:引导患者进行正确的按摩、运动面部肌肉、肢体训练,如闭眼、皱眉、鼓腮等,远端麻木肢体辅助运动;西药治疗同对照组。连续治15d为1疗程。观测临床症状、神经功能、不良反应。连续治疗1疗程,判定疗效。[结果]治疗组痊愈19例,显效13例,有效7例,无效1例,总有效率97.50%;对照组痊愈10例,显效14例,有效8例,无效8例,总有效率80.00%;治疗组疗效优于对照组(P<0.05)。[结论]针刺推拿+心理疏导+康复训练联合西药治疗多发性末梢周围神经炎,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the acupuncture massage＋psychological counseling muhiple peripheral neuritis and rehabilitation training combined with western medicine in the treatment of. [Methods] 80 patients were randomly divided into two groups according to random parallel control method. The control group （40 cases） and prednisolone meanwhile, oral; vitamin B12 meanwhile, oral; vitamin B1 100 mg＋0.9% saline 150 mL, static drops, 1 times/d; Ligustrazine Injection 60 rag＋5% glucose 200 mL solution, static drops, 1 times/D; facial neuritis mercapto succinic sodium 270 mug, stannous chloride-680 mu g, dimercapto Ding sodium 0.5 g＋0.9% normal saline 200 ml, intravenous drip, 1 times/D; adjust the suitable dose model according to the neuritis extent and location of semiconductor laser physics, 20 min/time, 1 times daily. The treatment group of 40 cases, four hundred, Qianzheng ophryon acupuncture, Fengchi, Hegu, Shimonoseki, Tai Chong, Jiache, Yifeng, Quchi, Chengjiang, Yingxiang, Fengchi, Hegu, Tai Chong）, Xu Jinji; catharsis, Shimonoseki, Jiache, Ying Xiangping thorn, reinforcing reducing; the other on the face. The reinforcement, gently twitching facial acupuncture needle 20min, 1 times/d, severe pain point injection of Procaine; massage sun, Yang Bai, Quanliao, Dicang, Jiache, Hegu, Quchi, Zusanli, Sanyinjiao, Ashi point; round the upper and lower eyelids 30 times each, then rubbing the eyes 30 times. 10 min/d, local acupoints gas degree; psychological counseling： communication with patients, related knowledge and attention, and help patients to establish confidence in the treatment; rehabilitation training： to guide patients to massage, facial muscle movement, limb training right, such as closing Eye, frown, drum, and so on, the distal numbness of the auxiliary movement; western medicine treatment with the control group. Continuous treatment for 1 courses of 15 d. Observation of clinical symptoms, neurological function, adverse reactions. Continuous treatment for 1 courses of treatment, to determine efficacy. [Results] The treatment group 19 cases were cured, 13 cases were markedly effective, effective in 7 cases, invalid in 1 case, efficiency 97.50%; in the control group, 10 cases were cured, markedly effective in 14 cases, effective 8 cases, ineffective in 8 cases, effectiveness 80.00%; treatment group curative effect is better than that of the control group （P〈0.05）. [Conclusion] Acupuncture and massage and psychological counseling and multiple peripheral neuritis and rehabilitation training combined with western medicine treatment, and the results were satisfactory. No serious adverse reactions, worthy of promotion.