针刺与针药结合治疗面神经磁共振检查正常的周围性面瘫患者疗效对照研究

A controlled study on the therapeutic effect of acupuncture and acupuncture combined with drugs on peripheral facial paralysis with normal result of facial nerve magnetic resonance examination

目的:探讨针刺治疗面神经磁共振检查正常的周围性面瘫时,是否需要联合使用药物。方法:将48例面神经磁共振检查正常的周围性面瘫患者随机分为针药组和针刺组,每组24例。针药组采用针刺联合醋酸泼尼松片治疗,针刺组采用单纯针刺治疗,两组针刺治疗的方法相同。针刺主要穴取患侧翳风、颧髎、太阳、四白、颊车、地仓、对侧合谷,每次30 min,隔日1次,急性期后患侧翳风与颧髎、颊车与地仓加用2对电针,直至治愈;口服醋酸泼尼松片每天1次,初始剂量30mg,每3天减量10mg,共用9d,治疗3、8周后用Portmann评分观察疗效。结果:针刺组治疗3、8周后治愈率分别为50.0%(12/24)、83.3%(20/24),均略低于针药组的58.3%(14/24)、87.5%(21/24),但两组间差异均无统计学意义(均P>0.05);针刺组治愈患者疗程为(31.2±17.0)d,略长于针药组的(29.5±12.8)d,但两组间差异无统计学意义(P>0.05)。结论:单纯针刺治疗面神经磁共振检查正常的周围性面瘫,能取得针刺联合药物治疗同等的疗效,避免了药物的相关不良反应。

Objective To explore whether a combination of drugs is needed when acupuncture is used to treat peripheral facial paralysis with normal result of facial nerve magnetic resonance examination. Methods A total of 48 normal facial nerve magnetic resonance examination of peripheral facial paralysis patients were randomly divided into an acupuncture combined with drugs group and an acupuncture group, 24 cases in each group. Acupuncture combined with prednisone were applied in the acupuncture combined with drugs group, and simple acupuncture was given in the acupuncture group. The acupuncture treatment methods were the same. Acupuncture mainly applied at Yifeng(TE 17), Quanliao(SI 18), Taiyang(EX-HN 5), Sibai(ST 2), Jiache(ST 6), Dicang(ST 4) on the affected side, Hegu(LI 4, opposite side) for 30 min a day, once every other day. Electroacupuncture was added at Yifeng(TE 17) and Quanliao(SI 18), Jiache(ST 6) and Dicang(ST 4) on the affected side after the acute phase until it was cured. Prednisone was taken orally once a day, with an initial dose of 30 mg, decrease 10 mg every 3 days for 9 days. After 3 and 8 weeks of treatment, the effect was observed by Portmann score. Results After 3 and 8 weeks of treatment, the cured rates were 50.0%(12/24) and 83.3%(20/24) in the acupuncture group,which were slightly lower than 58.3%(14/24) and 87.5%(21/24) in the acupuncture combined with drugs group,there was no significant difference between the two groups(both P>0.05);the course of treatment in the acupuncture group was(31.2±17.0) d, slightly longer than(29.5±12.8) d in the acupuncture combined with drugs group, but there was no significant difference between the two groups(P>0.05). Conclusion Simple acupuncture treatment on peripheral facial paralysis with normal result of facial nerve magnetic resonance examination can achieve the same effect of acupuncture combined with drugs, and avoid drug-related adverse reactions.