基于特发性面神经麻痹患者病期分型的穴位热敏化规律及热敏灸的临床疗效

Regulation of thermal sensitization of acupoints and clinical efficacy of heat-sensitive moxibustion based on stage classification of patients with bell palsy

目的基于特发性面神经麻痹(BP)患者病期分型探讨穴位热敏化规律及热敏灸的临床疗效。方法选取2022年4月至2023年9月江西中医药大学附属医院收治的96例BP患者作为研究对象,按照不同病期分为急性期组(34例)、亚急性期组(31例)、恢复期组(31例),均使用热敏灸艾条行热敏探穴与灸疗,记录热敏穴位出现频次并评估Sunnybrook评分,比较三组患者临床总有效率。结果96例BP患者共探查518个热敏穴位,高频分布穴区在翳风、天枢、阳白、下关、合谷、承泣、阴陵泉、牵正、三阴交及太冲,急性期高发穴区为翳风、下关和阳白,亚急性期为翳风、牵正和天枢,恢复期为天枢、阴陵泉和阳白。三组治疗前组间Sunnybrook评分比较,差异无统计学意义(P>0.05);三组治疗后Sunnybrook评分均高于本组治疗前,差异有统计学意义(P<0.05);急性期组患者治疗后Sunnybrook评分高于亚急性期组及恢复期组,差异有统计学意义(P<0.05);三组总有效率比较,差异有统计学意义(P<0.05);但组间两两比较,差异无统计学意义(P>0.017)。结论BP患者热敏探穴在不同病期有不同的分布规律,高频分布在翳风、天枢、阳白、下关、合谷、承泣、阴陵泉、牵正、三阴交及太冲,热敏灸技术在急性期介入有利于改善患者面部功能状态,为BP的针灸治疗提供新的临床思路和选穴指导。

Objective To investigate the regulation of thermal sensitization of acupoints and clinical efficacy of heat-sensi-tive moxibustion based on the stage classification of patients with bell palsy(BP).Methods Ninety-six BP patients admitted to Affiliated Hospital of Jiangxi University of Chinese Medicine from April 2022 to September 2023 were selected as the study objects.According to different disease stages,they were divided into acute stage group(34 cases),subacute stage group(31 cases)and recovery stage group(31 cases).All of them were treated with heat-sensitive moxibustion sticks for heat-sen-sitive acupoint exploration and moxibustion.The occurrence frequency of heat-sensitive acupoints was recorded and Sunny-brook score was evaluated,and the total clinical effective rate of the three groups was compared.Results A total of 518 heat sensitive acupoints were investigated in 96 BP patients.The high frequency distribution points were Yifeng,Tianshu,Yang-bai,Xiaguan,Hegu,Chengli,Yinlingquan,Qianzheng,Sanyinjiao and Taichong.Yifeng,Xiaguan and Yangbai were the high occurrence points in acute stage,Yifeng,Qianhe and Tianshu were in the subacute stage,and Tianshu,Yinlingquan and Yangbai were in the recovery stage.There was no significant difference in Sunnybrook score among the three groups before treatment(P>0.05).Sunnybrook scores of three group after treatment were higher than those before treatment,and the dif-ferences were statistically significant(P<0.05).After treatment,Sunnybrook score in acute stage group was higher than those in subacute stage group and recovery stage group,and the differences were statistically significant(P<0.05).The total effective rate of the three groups was compared,and the difference was statistically significant(P<0.05).However,there was no significant difference in pairwise comparison between the two groups(P>0.017).Conclusion The heat-sensitive probing points in BP patients have different distribution rules in different stages,and the high frequencies are distributed in Yifang,Tianshu,Yangbai,Xiaguan,Hegu,Chengqi,Yinlingquan,Qianzheng,Sanyinjiao and Taichong.Heat-sensitive moxibustion technology in the acute stage is beneficial to improve the facial function of patients,and provides new clinical ideas and guidance for acupuncture treatment of BP.