辨证分型针刺治疗急性周围性面神经炎(风寒、风热)随机平行对照研究

Acupuncture Treatment of Acute Peripheral Facial Neuritis(Fenghan,Fengre) Randomized Parallel Control Study

[目的]观察辨证分型针刺治疗急性周围性面神经炎(风寒、风热)疗效。[方法]使用随机平行对照方法,将48例住院患者按病志号抽签方法随机分为两组。对照组24例常规针灸:患侧阳白、攒竹、迎香、颧髂、牵正、翳风、风池、地仓、颊车、外关、双侧合谷;平补平泻,匀速进针,提插捻转,得气后留针30min,每10min行针1次,10~15s/次,2次/d。治疗组24例辨证分型针刺,风寒:患侧列缺、风池、外关,轻刺迎香、阳白、颧髂,7d后,患侧阳白透临泣、地仓透颊车、牵正、迎香、颧髂、攒竹透鱼腰、夹承浆、外关、风池、双侧合谷,中等刺激;风热:患侧阳白、地仓、颧髂、颊车、迎香,轻度刺激,患侧外关、风池、足临泣;平补平泻,匀速进针,提插捻转,得气后留针30min,每10min行针1次,10~15s/次,2次/d。连续治疗5d为1疗程,间隔2d继续下一疗程。观测临床表现、面部神经功能评分、中医症状积分、不良反应。连续治疗4疗程(28d),判定疗效。[结果]治疗组显效13例,有效10例,无效1例,总有效率95.83%;对照组显效6例,有效12例,无效6例,总有效率75.00%;治疗组疗效优于对照组(P<0.05)。面部神经功能评分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。额纹、眼裂闭合、面部表情、口角歪斜两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]辨证分型针刺治疗急性周围性面神经炎(风寒、风热),疗效满意,无严重不良反应,值得推广。

[Objective] To observe the therapeutic effect of acupuncture with syndrome differentiation on acute peripheral facial neuritis（Fenghan,Fengre）. [Methods] using random parallel control method, 48 inpatients were randomly divided into two groups according to coin tossing method. In the control group, 24 cases were treated with routine acupuncture and moxibustion： Yangbai, Cuanzhu, Yingxiang, Quanqia, Qianzheng, Yifeng, Fengchi, Dicang,Jiache, Waiguan, bilateral Hegu; Regular tonic and diarrhea, uniform speed of needling, lifting and inserting and twisting, retaining needles for 30 minutes every 10 minutes, 10-15 s/time, 2 times a day. Twenty-four patients in the treatment group were treated with acupuncture according to syndrome differentiation and typing. Fenghan： the affected side was Lieque, Fengchi, Waiguan, slightly punctured Yingxiang, Yangbai, Quanqia, 7 days later, the affected side was white and crying, cheek-piercing car, pulling, Yingxiang, Quanqia, bamboo-piercing fish waist, sandwich pulp, Waiguan, Fengchi, bilateral valley, moderate stimulation. Quanqia,Jiache, Yingxiang, mild stimulation, the affected side Waiguan, Fengchi, foot cries; flat tonic and diarrhea, uniform speed needle insertion, lifting and twisting, retain needle 30 minutes, every 10 minutes, 10-15 s/time, twice a day. Continuous treatment of 5 d for 1 courses, interval 2 d to continue the next course of treatment. Clinical manifestations, facial nerve function scores, symptom scores and adverse reactions were observed. Continuous treatment of 4 courses（28 d）, determine the curative effect. [Results] The total effective rate was 95.83% in the treatment group and 75.00% in the control group. The curative effect of the treatment group was better than that of the control group（P〈0.05）. Facial nervefunction score improved in the two groups（P〈0.01）, and the improvement in the treatment group was better than that in the control group（P〈0.01）. The frontal veins, cleft eyes, facial expression and angle of mouth were improved in both groups（P〈0.01）. The improvement in the treatment group was better than that in the control group（P〈0.01）. [Conclusion] Acupuncture based on syndrome differentiation and classification has a satisfactory therapeutic effect on acute peripheral facial neuritis（Fenghan,Fengre）. It has no serious adverse reactions and is worth popularizing.