桂枝加葛根汤加减联合皮内针治疗面神经炎疗效观察

Therapeutic Effect of Guizhi Gegen Decoction Combined with Intradermal Needling on Treating Facial Neuritis

目的:研究桂枝加葛根汤加减联合皮内针治疗面神经炎的临床疗效,旨在为更好的治疗面神经炎提供有效的理论依据。方法:将选本院2017年1月—2018年6月收治的88例面神经炎患者按随机数字表法分成对照组与研究组,每组44例。对照组给予牵正散加减联合电针治疗,研究组给予桂枝加葛根汤加减联合皮内针治疗。观察并比较治疗前后两组患者多伦多面神经功能评分(TFGS)、生活质量评分(QOL)评分、House-Braekmann(H-B)量表、面神经麻痹程度及肌电图相关指标变化,同时记录治疗期间的不良反应。结果:①研究组治疗后总有效率(95.45%)显著高于对照组(81.82%)(P<0.05);②两组治疗前TFGS、QOL评分比较,差异无统计学意义(P>0.05);两组治疗后TFGS评分高于治疗前,QOL评分低于治疗前(P<0.05),且研究组治疗后TFGS评分高于治疗前对照组,QOL评分低于治疗前对照组(P<0.05);③两组治疗前H-B分级比较,差异无统计学意义(P>0.05);两组治疗后H-B分级优于治疗前(P<0.05),且研究组治疗后H-B分级优于对照组(P<0.05);④两组治疗面神经麻痹程度分级比较,差异无统计学意义(P>0.05);两组治疗后面神经麻痹程度分级优于治疗前(P<0.05),且研究组治疗后面神经麻痹程度分级优于对照组(P<0.05);⑤两组治疗前CMAP波幅、RI潜伏期比较,差异无统计学意义(P>0.05);两组治疗后CMAP波幅高于治疗前,RI潜伏期低于治疗前(P<0.05);且研究组治疗后CMAP波幅高于对照组,RI潜伏期低于对照组(P<0.05);⑥研究组不良反应总发生率低于对照组(6.81%vs11.37%),但差异无统计学意义(P>0.05)。结论:桂枝加葛根汤加减联合皮内针治疗面神经炎的临床疗效显著,促进面神经恢复,提高患者的生活质量,且无明显不良反应。

Objective:To investigate the therapeutic effect of Guizhi Gegen Decoction combined with intradermal needling on treating facial neuritis,so as to provide an effective theoretical basis for better treatment of facial neuritis.Methods:88 cases of facial neuritis treated in our hospital from January 2017 to June 2018 were selected and divided into two groups according to the random digital table method,each with 44 cases.The control group received the Qianzheng Powder plus electroacupuncture and the study group received the Guizhi Gegen Decoction.Scores of Toronto facial grading system(TFGS),quality of life(QOL),House-Braekmann(HB)scale,facial nerve paralysis degree,EMG related index and adverse reactions of the two groups were recorded and compared.Results:①The total effective rate in the study group was significantly higher than that in the control group(95.45%vs 81.82%,P<0.05).②TFGS and QOL scores between the two groups before treatment had no difference(P>0.05);After treatment,the TFGS score was increased in both groups,and was higher in the study group than that in the pre-treatment control group(P<0.05),meanwhile,the QOL score was decreased in both groups,and was lower in the study group than that in the pre-treatment control group(P<0.05).③H-B classification had no difference between groups before treatment,which was ameliorated after treatment(P<0.05),and was better in the study group than that in the control group(P<0.05).④The facial nerve paralysis degree had no difference between groups before treatment,which was ameliorated after treatment(P<0.05),and was better in the study group than that in the control group(P<0.05).⑤CMAP amplitude and RI latency between the two groups before treatment had no difference(P>0.05);After treatment,the CMAP amplitude was increased in both groups,and was higher in the study group than that in the control group(P<0.05),meanwhile,the RI latency was decreased in both groups,and was lower in the study group than that in the control group(P<0.05).⑥The incidence of adverse reactions in the study group was lower than that in the control group,with no statistical difference(6.81%vs 11.37%,P>0.05).Conclusion:Guizhi Gegen Decoction combined with intradermal needling can effectively promote the facial nerve recovery and improve the quality of life of facial neuritis patients with no obvious adverse reaction.