不同灸量治疗周围性面瘫伴耳周疼痛临床研究

Clinical Study of Different Moxibustion Doses for Treatment of Peripheral Facial Paralysis with Periauricular Pain

目的观察温针灸不同灸量治疗周围性面瘫伴耳周疼痛的疗效,优化周围性面瘫的温针灸治疗方案。方法将入选的60例周围性面瘫患者随机分成温针灸Ⅰ组、温针灸Ⅱ组与普通针刺组,每组20例,分别采用温针灸3壮、温针灸5壮与单纯针刺治疗。各组患者在治疗前及疗程结束后进行FDI评分量表测定,比较各组的临床疗效,同时在治疗过程中进行疼痛视觉模拟评分(VAS)测定,比较耳周疼痛缓解程度,并记录耳周疼痛消失天数。结果普通针刺组总有效率为75.0%,温针灸Ⅰ组为95.0%,温针灸Ⅱ组达100%,各组疗效比较差异有统计学意义(P<0.05),温针灸Ⅰ组、温针灸Ⅱ组分别与普通针刺组比较差异有统计学意义(P<0.01),温针灸Ⅱ组与温针灸Ⅰ组比较差异有统计学意义(P<0.01)。结论温针灸与普通针刺治疗周围性面瘫伴耳周疼痛均取得较好疗效,均能有效缓解耳部疼痛;温针灸疗效与普通针刺相比较更显著;温针灸疗效与灸量具有相关性,温针灸5壮与3壮相比疗效更佳。

Objective To investigate the efficacies of different doses of warming needling moxibustion in treating peripheral facial paralysis with periauricular pain and optimize the protocol for warming needling moxibustion to treat peripheral facial paralysis. Method Sixty patients with peripheral facial paralysis were randomized to warming needling moxibustion group Ⅰ, warming needling moxibustion group Ⅱ and conventional acupuncture group, 20 cases each. They received warming needling moxibustion with 3 moxa cones, warming needling moxibustion with 5 moxa cones and acupuncture alone, respectively. The FDI score was recorded in every group of patients before and after treatment. The clinical therapeutic effects were compared between the groups. Meanwhile, the Visual Analogue Scale （VAS） score was recorded to compare the degrees of periauricular pain relief. The number of days needed for periauricular pain disappearance was also recorded. Result The total efficacy rate was 75.0% in the conventional acupuncture group, 95.0% in the warming needling moxibustion group Ⅰ and 100% in the warming needling moxibustion group Ⅱ. There was a statistically significant difference in the therapeutic effect among the three groups （P〈0.05）, between the warming needling moxibustion group Ⅰ or Ⅱ and the conventional acupuncture group （P〈0.01）, and between the warming needling moxibustion groups Ⅰ and Ⅱ （P〈0.01）. Conclusion Both warming needling moxibustion and conventional acupuncture have a better therapeutic effect on this disease and can effectively relieve auricular pain. Warming needling moxibustion is more effective than conventional acupuncture in treating this disease. The therapeutic effect of warming needling moxibustion on this disease correlates with the dose of moxibustion.Warming needling moxibustion is more effective with 5 moxa cones than with 3 moxa cones.