分析中医针灸、推拿联合中药治疗面瘫的临床疗效

Analysis of the clinical efficacy of acupuncture and massage combined with traditional Chinese medicine in the treatment of facial paralysis

目的研究中医针灸、推拿联合中药对于面瘫患者的治疗效果。方法36例面瘫患者,随机分为对照组及研究组,每组18例。对照组患者实施中医针灸、推拿治疗,研究组患者在中医针灸、推拿基础上应用中药治疗。对比两组治疗效果,治疗前后的血清炎症因子指标[C反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、免疫功能指标(CD3^(+)、CD4^(+)/CD8^(+))、症状评分、舒适度评分、睡眠质量评分、生活质量评分。结果研究组患者的总有效率100.00%高于对照组的77.78%,差异具有统计学意义(P<0.05)。治疗后,两组患者的CRP、PCT、IL-6、TNF-α水平均低于本组治疗前,且研究组患者的CRP(5.89±1.06)mg/L、PCT(0.46±0.15)ng/ml、IL-6(87.64±19.32)pg/ml、TNF-α(10.83±2.07)mg/L均低于对照组的(7.02±1.27)mg/L、(0.69±0.23)ng/ml、(114.50±25.87)pg/ml、(13.49±2.46)mg/L,差异具有统计学意义(P<0.05)。治疗后,两组患者的CD3^(+)、CD4^(+)/CD8^(+)水平均高于本组治疗前,且研究组患者的CD3^(+)(45.28±2.91)%、CD4^(+)/CD8^(+)(2.14±0.55)均高于对照组的(41.59±2.25)%、(1.50±0.42),差异具有统计学意义(P<0.05)。治疗后,两组患者的口角歪斜、眼睑开阖、鼓腮漏气评分均低于本组治疗前,且研究组患者的口角歪斜评分(1.17±0.39)分、眼睑开阖评分(1.06±0.31)分、鼓腮漏气评分(1.16±0.40)分均低于对照组的(1.58±0.43)、(1.52±0.48)、(1.61±0.45)分,差异具有统计学意义(P<0.05)。治疗后,两组患者的舒适度评分高于本组治疗前,睡眠质量评分低于本组治疗前,且研究组患者的舒适度评分(102.80±6.57)分高于对照组的(93.25±6.30)分,睡眠质量评分(10.49±1.31)分低于对照组的(12.36±1.58)分,差异具有统计学意义(P<0.05)。治疗后,两组患者的生理、心理、环境、社会关系评分均高于本组治疗前,且研究组患者的生理、心理、环境、社会关系评分分别为(89.75±6.48)、(89.07±6.02)、(90.14±6.15)、(89.96±6.27)分,均高于对照组的(82.93±6.85)、(82.40±6.13)、(83.27±6.30)、(83.14±6.54)分,差异具有统计学意义(P<0.05)。结论对于面瘫患者,联合应用中医针灸、推拿及中药治疗,可提高患者的治疗效果,减轻炎症反应,缓解症状,调节免疫功能,有利于增加躯体舒适度,改善患者睡眠和生活质量。

Objective To study the therapeutic effect of acupuncture and massage combined with traditional Chinese medicine in the treatment of facial paralysis.Methods A total of 36 patients with facial paralysis were randomly divided into control group and study group,with 18 cases in each group.The control group was treated with acupuncture and massage,and the study group was treated with traditional Chinese medicine on the basis of the control group.Both groups were compared in terms of therapeutic effect,serum inflammatory factor indexes[C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],immune function indexes(CD3^(+),CD4^(+)/CD8^(+)),symptom score,comfort score,sleep quality score,quality of life score before and after treatment.Results The total effective rate of 100.00%in the study group was higher than that of 77.78%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of CRP,PCT,IL-6 and TNF-αin both groups were lower than those before treatment in this group;the study group had CRP of(5.89±1.06)mg/L,PCT of(0.46±0.15)ng/ml,IL-6 of(87.64±19.32)pg/ml and TNF-αof(10.83±2.07)mg/L,which were lower than those of(7.02±1.27)mg/L,(0.69±0.23)ng/ml,(114.50±25.87)pg/ml and(13.49±2.46)mg/L in the control group;the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+)and CD4^(+)/CD8^(+)in both groups were higher than those before+treatment in this group;CD3 of(45.28±2.91)%and CD4^(+)/CD8^(+)of(2.14±0.55)in the study group were higher than those of(41.59±2.25)%and(1.50±0.42)in the control group;the differences were statistically significant(P<0.05).After treatment,the scores of deflection of angle of mouth,eyelid opening and closing and air leakage from cheek blowing in both groups were lower than those before treatment in this group;the scores of deflection of angle of mouth,eyelid opening and closing and air leakage from cheek blowing were(1.17±0.39),(1.06±0.31)and(1.16±0.40)points in the study group,which were lower than those of(1.58±0.43),(1.52±0.48)and(1.61±0.45)points in the control group;the differences were statistically significant(P<0.05).After treatment,the comfort score of the two groups was higher than that of this group before treatment,and the sleep quality score was lower than that before treatment in this group;the comfort score of(102.80±6.57)points of the study group was higher than that of(93.25±6.30)points of the control group;the sleep quality score of(10.49±1.31)points of the study group was lower than that of(12.36±1.58)points of the control group;the differences were statistically significant(P<0.05).After treatment,the scores of physical,psychological,environmental and social relationship in both groups were higher than those before treatment in this group;the scores of physical,psychological,environmental and social relationship were(89.75±6.48),(89.07±6.02),(90.14±6.15)and(89.96±6.27)points in the study group,which were higher than those of(82.93±6.85),(82.40±6.13),(83.27±6.30)and(83.14±6.54)points in the control group;the differences were statistically significant(P<0.05).Conclusion For patients with facial paralysis,the combined application of acupuncture,massage and traditional Chinese medicine treatment can improve the therapeutic effect of patients,reduce inflammation,relieve symptoms,regulate immune function,increase physical comfort,and improve patients'sleep quality and quality of life.