温针灸治疗急性期周围性面瘫的临床观察

Clinical Observation of Needle-Warming Moxibustion on Acute PFP

目的:探讨温针灸结合电针治疗急性期周围性面瘫的临床疗效,同时为电针在急性期介入治疗本病提供证据支持。方法:将80例周围性面瘫患者随机分为电针组与电温针组各40例,两组患者均予激素及神经营养剂口服,共治疗15次后,对比两组患者治疗前后H-B面神经功能分级、Sunnybrook(多伦多)面神经评分系统(SBGS)及面部残疾指数中社会功能(FDIS)评分差异,并评价其临床疗效。结果:(1)电温针组总有效率为94.74%(36/38),相比电针组87.18%(34/39),有显著性差异(P<0.05);(2)治疗后两组H-B分型较治疗前明显改善(P<0.05),且电温针组比电针组改善情况更佳,差异有统计学意义(P<0.05);(3)治疗后两组SBGS得分比治疗前显著增加(P<0.05),且电温针组改善情况明显胜于电针组,有显著性差异(P<0.05);(4)治疗后两组FDIS评分显著低于治疗前(P<0.05),且电温针组比电针组改善更优(P<0.05)。结论:温针灸联合电针疗法不仅有效缓解急性期周围性面瘫症状,对该类人群的社会功能及心理调适亦有积极作用,疗效胜过单纯电针;同时表明面瘫急性期于患侧给予合理的电针干预不会加重面神经炎症反应,可认为是临床安全有效的治疗手段。

Objective: To explore the clinical efficacy of needle-warming moxibustion combined with electro-acupuncture(EA) in treating acute peripheral facial paralysis(PFP), and to provide evidence for EA in intervention of the disease during acute stage. Methods: 80 patients with acute PFP were randomly divided into the observation group and the control group, with 40 cases in each group. Both groups were basically given hormone and neurotrophic agent. The control group was treated with EA, and the observation group was treated with needle-warming moxibustion combined with EA. After 15 times of treatment, the scores of H-B grading system(HBGS), Sunnybrook grading system(SBGS) and facial disability index about social function(FDIS) were compared between before and after the treatment in the two groups. The clinical efficacy was also compared between the two groups after the treatment. Results: The total clinical efficacy was 94.74% in the observation group, which was significantly higher than 87.18% in the control group(P<0.05). H-B classification was significantly improved after the treatment compared with that before the treatment in the two groups(P<0.05), and the improvement in the observation group was more significant than that in the observation group(P<0.05). SBGS score was significantly increased after the treatment compared with that before the treatment in the two groups(P<0.05), and the increase in the observation group was more obvious than that in the control group(P<0.05). FDIS score was significantly lower after the treatment than that before the treatment(P<0.05), and the improvement of the observation group was superior to that of the control group(P<0.05). Conclusion: Needle-warming moxibustion combined with EA can not only effectively improve the physical symptoms of acute PFP, but also had a positive effect on social function and psychological adjustment of the patients;the effect of needle-warming moxibution combined with EA is better than that of simple EA. Besides, the experiment shows that the suitable EA intervention for acute PFP will not aggravate the inflammatory reactions of facial nerve, which can be used as a safe and effective clinical treatment.