三才调平贴治疗贝尔氏面瘫效果观察

Effect of Sancai Tiaoping Tie in the treatment of Bell's facial paralysis

目的观察三才调平贴治疗贝尔氏面瘫的临床效果。方法选取2019年1月至2023年1月河南省中西医结合医院脑病科收治的201例贝尔氏面瘫患者作为研究对象,按随机数表法分为西医组、中医内治组和中医外治组,每组67例。西医组患者给予西医常规治疗,中医内治组在西医常规治疗基础上采用口服中药治疗,中医外治组在西医常规治疗基础上采用三才调平贴治疗,均治疗4周。治疗4周后,比较三组患者的治疗效果,以及治疗前、治疗4周后的中医证候积分(面部表情、口角歪斜、鼻唇沟变浅、舌前味觉消失、额纹消失、眼裂闭合)和面神经功能[House-Brackmann面部神经功能分级法(HBGS)、sunnybrook面神经评分(SFGS)],同时比较三组患者治疗期间的不良反应发生情况。结果中医外治组患者的治疗总有效率为97.01%,明显高于中医内治组的85.07%和西医组的70.15%,中医内治组也明显高于西医组,差异均有统计学意义(P<0.05);治疗4周后,中医外治组患者的面部表情、口角歪斜、鼻唇沟变浅、舌前味觉消失、额纹消失、眼裂闭合积分明显低于中医内治组和西医组,中医内治组也明显低于西医组,差异均有统计学意义(P<0.05);治疗4周后,中医外治组患者的HBGS评分为(1.91±0.14)分,明显低于中医内治组的(2.34±0.22)分和西医组的(2.68±0.25)分,中医内治组明显低于西医组,SFGS评分为(56.82±4.08)分,明显高于中医内治组的(50.31±3.49)分和西医组的(46.66±4.17)分,中医内治组明显高于西医组,差异均有统计学意义(P<0.05);治疗期间中医外治组患者的不良反应发生率为2.99%,明显低于中医内治组的14.93%和西医组的17.91%,差异有统计学意义(P<0.05)。结论三才调平贴治疗贝尔氏面瘫能显著提高疗效,促进症状消退,改善面神经功能,且不良反应较少。

Objective To observe the clinical effect of Sancai Tiaoping Tie in the treatment of Bell's facial paralysis.Methods A total of 201 patients with Bell's facial paralysis admitted to Department of Encephalopathy,Henan Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2019 to January 2023 were selected and randomly divided into western medicine group,traditional Chinese medicine internal treatment group,and traditional Chinese medicine external treatment group,with 67 patients in each group.Patients in the western medicine group were given conventional western medicine treatment,patients in the traditional Chinese medicine internal treatment group were treated with oral Chinese medicine on the basis of conventional western medicine treatment,and patients in the traditional Chinese medicine external treatment group were treated with Sancai Tiaoping Tie on the basis of conventional western medicine treatment,all for 4 weeks.After 4 weeks of treatment,the therapeutic effects of the three groups were compared,as well as the TCM syndrome scores(facial expression,mouth angle deviation,nasolabial groove shallowing,loss of prelingual taste,loss of forehead wrinkles,eye closure)and facial nerve function[House-Brackmann Grading System(HBGS),Sunnybrook Facial Grading System(SFGS)]before and after 4 weeks of treatment.At the same time,the incidence of adverse reactions during the treatment was compared among the three groups.Results The total effective rate of treatment in the traditional Chinese medicine external treatment group was 97.01%,which was significantly higher than 85.07%in the traditional Chinese medicine internal treatment group and 70.15%in the western medicine group,and the rate in the traditional Chinese medicine internal treatment group was also significantly higher than that in western medicine group,with statistically significant differences(P<0.05).After 4 weeks of treatment,the scores of facial expression,mouth angle deviation,nasolabial groove shallowing,loss of prelingual taste,loss of forehead wrinkles,and eye closure in the traditional Chinese medicine external treatment group were significantly lower than those in the traditional Chinese medicine internal treatment group and western medicine group,and the score in the traditional Chinese medicine internal treatment group were also significantly lower than those in western medicine group,with statistically significant differences(P<0.05).After 4 weeks of treatment,the HBGS score in the traditional chinese medicine external treatment group was(1.91±0.14)points,which was significantly lower than(2.34±0.22)points in the traditional Chinese medicine internal treatment group and(2.68±0.25)points in the western medicine group,and the score in the traditional Chinese medicine internal treatment group was significantly lower than that in the western medicine group;the SFGS score was(56.82±4.08)points,significantly higher than(50.31±3.49)points in the traditional Chinese medicine internal treatment group and(46.66±4.17)points in the western medicine group,and the score in the traditional Chinese medicine internal treatment group was higher than that in the western medicine group;the differences were statistically significant(P<0.05).During the treatment,the incidence of adverse reactions in the traditional Chinese medicine external treatment group was 2.99%,which was significantly lower than 14.93%in the traditional Chinese medicine internal treatment group and 17.91%in the western medicine group,and the differences were statistically significant(P<0.05).Conclusion Sancai Tiaoping Tie in the treatment of Bell's facial paralysis can significantly improve the curative effect,promote the disappearance of symptoms,improve facial nerve function,with slight adverse reactions.