针刺联合补阳还五汤治疗脑梗死恢复期中枢性面瘫的临床疗效及对面神经功能、面瘫程度、患者自理能力的影响

Clinical effects of acupnncture combined with Buyang-Huanwu decoction on central facial paralysis during cerebral infarction convalescence and its influence on facial nerve function,degree of facial paralysis and selfcare ability of patients

目的观察针刺联合补阳还五汤治疗脑梗死恢复期中枢性面瘫的临床疗效及对面神经功能、面瘫程度、患者自理能力的影响。方法将120例脑梗死恢复期中枢性面瘫患者随机分为3组。针药组40例予针刺联合补阳还五汤口服治疗;针刺组40例予针刺治疗;中药组40例予补阳还五汤口服治疗。3组均治疗4周,观察临床疗效,比较3组治疗前后H-B面神经功能分级量表评分、面部残疾指数(FDI)量表评分、改良Barthel指数评分。结果针药组愈显率55.0%,高于针刺组(27.5%)及中药组(32.5%)(P<0.05)。3组治疗后H-B面神经功能分级量表功能值均较本组治疗前升高(P<0.05);治疗后针药组H-B面神经功能分级量表改善值均高于针刺组、中药组(P<0.05)。针药组治疗后FDI量表躯体功能评分较本组治疗前明显升高(P<0.05);治疗后针药组FDI躯体功能评分及改善值均高于针刺组、中药组(P<0.05)。3组治疗前后FDI量表社会生活功能评分及改善值比较差异无统计学意义(P>0.05)。3组治疗后改良Barthel指数评分较本组治疗前均升高(P<0.05);治疗后针药组改良Barthel指数评分及改善值均高于针刺组、中药组(P<0.05)。结论针刺联合补阳还五汤治疗脑梗死恢复期中枢性面瘫有较好疗效,能有效改善患者面神经功能、临床症状及日常生活能力,针药合用较单一疗法效果更加显著。

Objective To observe the clinical effects of acupuncture combined with Buyang-Huanwu decoction on central facial paralysis during cerebral infarction convalescence and its influence on facial nerve function,degree of facial paralysis and self-care ability of patients. Methods 120 patients with central facial paralysis during cerebral infarction convalescence were randomly divided into three groups. 40 cases in acupuncture-drug group were treated by acupuncture plus Buyang-Huanwu decoction. 40 cases in acupuncture group were treated by acupuncture. 40 cases in Chinese medicine group were treated by Buyang Huanwu decoction for oral administration. All3 groups were treated for 4 weeks. The H-B facial nerve functional grading scale score,facial disability index number（ FDI） score,and modified Barthel index score were compared before and after treatment in the three groups. Results The effective rate of the acupuncture-drug group was 55. 0 %,higher than that of the acupuncture group（ 27. 5 %） and the Chinese medicine group（ 32. 5 %）（ P〈0. 05）. The H-B function values of the three groups after treatment were higher than that before treatment（ P〈0. 05）. After treatment,the H-B improvement value of the acupuncture-drug group was higher than that of the acupuncture group and the Chinese medicine group（ P〈0. 05）. The physical function score of FDI in acupuncture-drug group was significantly higher than that before treatment（ P〈0. 05）. The physical function score and improvement value of FDI in acupuncture-drug group were higher than those in acupuncture group and Chinese medicine group（ P〈0. 05）. There was no significant difference in FDI social function scores and improvement values between the three groups before and after treatment（ P〈0. 05）. The modified Barthel index scores after treatment in all three groups were higher than those before treatment（ P〈0. 05）.The improved Barthel index scores and improvement values of acupuncture-drug group after treatment were higher than those of the acupuncture group and the Chinese medicine group（ P〈0. 05）. Conclusion Acupuncture combined with Buyang-Huanwu decoction has a good curative effect on central facial paralysis during cerebral infarction convalescence. The combination of acupuncture and Chinese medicine was more effective than single therapy.