基于经筋理论针刺结合水针疗法治疗顽固性面瘫的临床疗效研究

Clinical Study of Meridian Sinew Needling Combined with Hydro-Acupuncture on Intractable Facial Paralysis

目的:探讨基于经筋理论进行针刺与水针疗法结合治疗顽固性面瘫的临床疗效。方法:将所收集的符合条件的50例受试者根据随机原则分为经筋刺法组(在经筋理论指导下针刺)和水针结合组(针刺后采用腺苷钴胺注射液进行穴位注射),每组各25例。观察并对比3个疗程后两组治疗前、后的H-B面神经分级量表、面神经肌力评定、Sunnybrook量表,进行疗效评定,并在治疗结束后第1、2、3月进行回访。结果:治疗后两组间H-B评级、面神经肌力、SuBr量表评分比较,具有显著性差异(P<0.05);两组治疗后与治疗前H-B评级、面神经肌力、SuBr量表比较差异有统计学意义(P<0.05);经筋刺法组的愈显率和总有效率分别为28%和80%,水针结合组显率和有效率分别为72%和96%,水针结合组疗效明显优于经筋刺法组(P<0.05);在随访后发现水针结合组的复发率明显低于经筋刺法组。结论:利用经筋理论针刺结合水针疗法治疗顽固性面瘫具有良好的疗效,简效廉便,可有效改善患者的面神经肌力和麻痹程度,复发率低,值得推广。

Objective:To explore the clinical efficacy of meridian sinew needling combined with hydro-acupuncture in the treatment of intractable facial paralysis.Methods:50 patients met the inclusion criteria were randomly divided into the control group(n=25)and the treatment group(n=25).The control group was treated with meridian sinew acupuncture;on which basis,the treatment group was also treated with hydro-acupuncture(acupoint injection with Cobamamide after needling).The scores of H-B facial nerve grading scale,the scores of facial nerve muscle strength and the scores of Sunnybrook scale were observed and compared before and after three courses of treatment in the two groups.Follow-up was conducted after 1m,2m and 3m of the treatment.Results:There were differences in the scores of H-B facial nerve grading scale,the scores of facial nerve muscle strength and the scores of Sunnybrook scale between the two groups after the treatment(P<0.05);and there were differences in the same group before and after the treatment as well(P<0.05).The curative rate and the total effective rate were 72%and 96%in the treatment group,which were significantly higher than 28%and 80%in the control group(P<0.05).It was found that the recurrence rate of the treatment group was significantly lower than that of the control group.Conclusion:Meridian sinew needling combined with hydro-acupuncture is effective for intractable facial paralysis,which can effectively improve the patient's facial nerve muscle strength and degree of paralysis with low recurrence rate.The therapy is simple and inexpensive,and it is worthy of promotion.