推拿治疗周围面神麻痹

面神经麻痹又称面瘫,中医称面中风或口眼歪斜,因其发病不分季节和年龄,又因其影响容貌美观,所以给患者带来诸多不便,临床常有报道,笔者1993年以来:用我国传统中医推拿方法,治疗此病11例,取得较为满意疗效,现报道如下.

针灸治疗周围性面神经麻痹78例

目的:观察透刺配合电针、理疗、闪罐、按摩治疗周围性面神经麻痹的临床疗效。方法:选取周围性面神经麻痹患者78例,透刺主穴根据患者个体差异配合配穴进行电针、理疗、闪罐、按摩治疗,7天为1个疗程,治疗2个疗程后观察疗效。结果:78例患者痊愈60例,显效15例,有效3例,总有效率100%。结论:透刺配合电针、理疗、闪罐、按摩治疗周围性面神经麻痹临床疗效显著。

加减天麻钩藤饮治疗面肌痉挛46例

以加减天麻钩藤饮治疗面肌痉挛46例,认为本病病因是肝阴亏虚,虚风内动或血虚生风,气血失常。治以熄风止痉,养血滋阴柔肝为法。结果:痊愈32例,显效8例,有效6例。

综合外治法治疗面瘫63例报告

自1994年以来,我们用针刺、按摩、中草药外薰综合治疗面瘫63例,并与单纯针刺治疗的24例对比,结果综合治疗效果明显优于单纯针刺法,现报导如下:1.一般资料综合治疗组63例,其中男42例,女21例;年龄最大者69岁,最小16岁,其中40岁以下25例,40岁以上38例;左侧面瘫28例.右侧面瘫35例;病程1个月以内42例,1个月至3个月15例,3个月以上者6例.诊断标准:①患侧面部表情肌瘫痪,额纹消失,眼不能闭合或闭合不全,流泪.②鼻唇沟变浅,口角向健侧歪斜,流涎,鼓腮时患侧口角漏气,咀嚼咬腮,唇颊沟积食.③发病初期,部分患者伴有耳后、耳下疼痛或颜面部麻木,舌前2/3味觉减退,听力障碍等.

Treatment of Obstinate Diseases by Acupuncture and Cupping

Acupuncture treatment integrated with cupping for enhancing the therapeutic effect is a technique in Yang's school of acupuncture carried forward from generation to generation. The author's grandfather created Yang's shallow puncturing and cupping therapy to enhance the effect of promoting blood flow and removing blood stasis in the light of his clinical experience. In this therapy, the gentle puncturing and heavy tapping are carried out with the seven-star needle until light bleeding occurs, followed by drawing out of pituita or stagnant blood and coagula by cupping, in an attempt to promote tissue regeneration by removing blood stasis for promoting the flow of qi and blood in the meridians. The therapy has been developed by Dr. Yang Yifang (the author's father) in clinical practice over the past six decades. Satisfactory therapeutic results have been obtained in clinical practice, which are introduced with examples below.

CLINICAL AND EXPERIMENTAL STUDIES OF LARGE AMPLITUDE ACTION POTENTIAL OF THE SUFFERED FACIAL MUSCLES IN INTRATEMPORAL FACIAL NERVE PARALYSIS

Objective. To testify the phenomenon that large amplitude action potential appears at the early stage of facial paralysis, and to search for the mechanism through clinical and experimental studies. Patients(animals) and methods. The action potentials of the orbicular ocular and oral muscles were recorded in 34 normal persons by electromyogram instruments. The normal range of amplitude percentage was found out according to the normal distribution. One hundred patients with facial paralysis were also studied. The action potentials of facial muscles were recorded in 17 guinea pigs before and after the facial nerve was compressed and the facial nerve was examined under electromicroscope before and after the compression. Results. The amplitude percentage of the suffered side to the healthy side was more than 153 percent in 6 of the 100 patients. Large amplitude action potential occured in 35 per cent guinea pigs which were performed the experiment of facial nerve compression. Electromicroscopic examination revealed separation of the lammae of the facial nerve’s myelin sheath in the guinea pigs which exhibited large amplitude action potential. Conclusion. The facial nerve exhibited a temporary over excitability at the early stage of facial nerve injury in some patients and guinea pigs. If the injury was limited in the myelin sheath, the prognosis was relatively good.

Clinical Application of Taichong Acupoint

Taichong(LR 3),the Shu and Yuan point of theLiver Meridian of Foot-Jueyin,is located on the dorsumof the foot and in the space between the first and secondmetatarsal bones.Clinically,it can be used to treatdiseases of various kind with rather good therapeuticresults.A report follows.

CHARACTERISTIC OF FACIAL MUSCLE AND EFFERENT NERVE ON PHYSIOLOGY AND ANATOMY

Objective.To study the speciality of orbicularis oculi muscles, nerves and oris muscles, nerves and mechanism of difference of faclal muscular injury in facial paralysis deeply.Methods. The conductive velocity of the efferent nerves of orbicularis oculi and oris muscles of the health human beings and guinea pigs is measured with electromyogram (EMG) apparatus.Results. The conductive velocity of orbicularis oculi nerve is quicker and oris muscles are controlled by facial nerves on both sides. Measuring the threshold of Strength-Duration (S-D) curves of the motor point of orbicularis oculi and oris muscles shows the threshold of the former is lower. Measuring the diameter of orbicularis oculi and oris nerve fibers on the guinea pigs and rabbits shows the diameter of orbicularis oculi nerve fiber is bigger. The area of secondary synapse space of orbicularis oculi motor end plate is larger than that of oris under scanning electromicroscope.Conclusions. Orbicularis oculi muscles,orbicularis oculi nerves and oris muscles,oris nerves all have their own characteristic on physiology and anatomy. It elucidated the mechanism that orbicularis oculi muscle is easy to be injuried.

Analysis of evidence-based clinical practices on timing factor in acupuncture for facial paralysis

Objective By using the evidence-based medicine approach to analyze the optimum timing in acupuncture treatment for facial paralysis, to provide the scientific evidence for acupuncture clinical practices. Methods Computer searches were conducted in the CNKI literature database from January 1994 to August 2009, using the keywords ＂facial paralysis acupuncture＂ and ＂treating opportunity/acupuncture opportunity＂. According to the standard of Cochrane, the literatures were retrieved and conducted with evidence-based analysis. The SPSS 13.0 software was used for the statistical analysis. Results Among the 133 retrieved literatures which met the inclusion criteria of the study, there were 11 literatures on the effect of acupuncture or electroacupuncture treatment in acute stage observation group and conventional medical treatment group. Using Mann-Whitney U test, the difference of treatment effect is statistically significant （P〈0.001）. Conclusion Early intervention in acupuncture treatment for facial paralysis in acute stage can improve the efficacy and promote neurological recovery. In the acute stage, animal experiments and clinical observations provide evidence to support the application of electric needle and traditional acupuncture treatments.

Observation on the therapeutic effect of time-oriented points opening of Linggui Bafa for Bell's palsy

Objective To evaluate the therapeutic effect and safety of time-oriented points opening of Linggui Bafa for Bell＇s palsy and provide a new idea for the clinical treatment of this problem. Methods Fifty-four cases included in the study were randomized into two groups, and the treatment group was treated with the routine acupuncture combined with time-oriented points opening of Linggui Bafa. The control group was treated with the routine acupuncture only, Hegu （合谷 El 4）, Kunlun （昆仑 BL 60）, Jiache （颊车 ST 6）, Dicang （地仓 ST 4）, Xiaguan （下关 ST 7）, Cuanzhu （攒竹 BL 2）, Yangbai （附白 GB 14）, and Quanliao （颧髎 SI 18） were selected as the main points. The manipulation and time of retaining needles were as same as the treatment group. Both groups were treated once a day, 5 days made one session and 4 sessions were required in all. Modified Portmann＇s scale, Horse-Brackmann grading scale （H-B）, FDIP and FDIS were used to assess the therapeutic effect after the treatment. Results The curative and improvement rate in the treatment group was 80.8% （22/26）, and that in the control group was 66.7% （16/24）, with the statistically significant difference （P〈O.05）, the comparison of scores of Portmann＇s scale, H-B, FDIP and FDIS in the same group and between the two groups before and after the treatment also had statistically significant differences （all P〈0.05）. Conclusion The method of time-oriented points opening of Linggui Bafa for Bell＇s palsy is better than the routine acupuncture for Bell＇s palsy.

Optimization of acupuncture treatment programs for facial paralysis

Objective To optimize acupuncture treatment programs for facial paralysis.Methods Sixty-three cases of facial paralysis were randomly grouped according to orthogonal design L9（3）4 table,and treated by different combined programs of 4 factors,A（acupuncture opportunity）,B（combination of points）,C（stimulating quantity）,D（electroacupuncture time） and 3 levels,and changes of the functional score of the facial nerve were observed,and the different combined programs of the 4 factors,A（acupuncture opportunity）,B（combination of point）,C（stimulating quantity）,D（electroacupuncture time） and 3 levels influencing acupuncture therapeutic effect on facial paralysis were optimized.Results B（combination of points） and D（electroacupuncture time） were obvious factors（P0.05）,among them,B（combination of points） was the most main influencing factor;among the 3 levels of B（combination of points） and D（electroacupuncture time）,B3 （alternately needling two groups of acupoints） and D3 （electroacupuncture treatment at sparse-dense wave for 30 min） were the best.Conclusion Electroacupuncture at sparse-dense wave for 30 min,alternately needling two groups of acupoints is the best program for treatment of facial paralysis.

Severe facial paralysis:early clinical manifestations and treatment

The study explained features of severe facial paralysis of early stage from the level and degree of nerve injury,syndromes and clinical manifestations of peripheral facial paralysis.Treating protocols with acupuncture were worked out concerning its characteristics to acquire the law of treatment,especially on the severe case.Severe facial paralysis is not only known as the focus of the study on acupuncture treatment,but also the key point to approve the effectiveness of acupuncture on peripheral facial paralysis.

Comparison of efficacy and the safety evaluation of electroacupuncture with different waveforms for peripheral facial paralysis patients

Objective To use different waveforms of electroacupuncture （EA） to treat peripheral facial paralysis and assess the clinical efficacy of three kinds of EA waveforms （continuous wave, disperse-dense wave and intermittent wave）. Methods One hundred and twenty nine patients of Bell＇s palsy were randomly divided into a continuous wave group （45 cases）, a disperse-dense wave group （40 cases） and an intermittent wave group （44 cases）. The acupoints selected were Dicing （地仓 ST 4）, Jiache （颊车 ST 6）, Taiyang （太阳 EX-HN 5）, Xiaguan （下关 ST 7）, Hegu （合谷 LI 4）, etc. The House-Brackmann （HB） scale was used in assessment on the day of inclusion, after the 1st, 2nd, 3rd and 4th courses of treatment and the 1st and 3rd months after the end of treatment during the follow-up visit respectively. Results The cured rates were 68.9% （31/45）, 60.0% （24/40） and 65.9% （29/44） respectively in the continuous wave group, the disperse-dense wave group and the intermittent wave group. The results of the rank sum test showed that the efficacy comparison among three groups did not show statistically significant difference （P〉0.05）. Conclusion EA achieved the significant clinical efficacy on peripheral facial paralysis and there is no significant difference in the efficacy among different waveforms. It is suggested that the clinical efficacy of EA on the disease had no significant correlation with the waveforms.

Clinical observation of warm needling moxibustion plus flash cupping for remission-stage peripheral facial paralysis due to wind-cold

Objective： To observe the clinical efficacy of warm needling moxibustion plus flash cupping for remission-stage peripheral facial paralysis （FP） due to wind-cold. Methods： Fifty eligible patients were randomized into a warm needling moxibustion group and an acupuncture-cupping group, 25 cases in each group. The warm needling moxibustion group was intervened by acupuncture at Fengchi （GB 20）, Yangbai （GB 14） towards Yuyao （EX-HN 4）, Xiaguan （ST 7）, Dicang （ST 4） towards Jiache （ST 6）, Quanliao （SI 18）, and Hegu （LI 4）, plus warm needling moxibustion at Quanliao （SI 18）; the acupuncture-cupping group received flash cupping on the affected side in addition to the intervention given to the warm needling moxibustion group. The two groups were both treated once a day, 10 times as a treatment course, for 3 courses in total. The House-Brackmann （H-B） facial nerve grading system was observed before and after the intervention to evaluate the facial nerve function in the two groups, and the therapeutic efficacies were also compared between the two groups. Results： The two treatment protocols both can promote the recovery of facial nerve function. The total effective rate was 92.0% in the acupuncture-cupping group versus 72.0% in the warm needling moxibustion group, and the between-group difference was statistically significant （P〈O.05）. Conclusion： Warm needling moxibustion plus flash cupping can produce a more significant efficacy than dry warm needling moxibustion in treating remission-stage peripheral FP due to wind-cold.

Subcutaneous Needling and Peripheral Facial Palsy： A Report of 30 Cases

Seventy cases were classified into wind-cold and wind-heat on the basis of syndrome differentiation. Acupoints of Yangming meridians of both hand and foot and points located in the face, including major points： Yangbai （GB 14）, Cuanzhu （BL 2）, Jingming （BL 1）, Chengqi （ST 1）, Dicang （ST 4）, Jiache （ST 6）, Juliao （ST 3）, and Hegu （LI 4）. Subcutaneous needling is applied. Recovery rate is 91.4%.

Observation on Therapeutic Effect of Facial Paralysis Treated with Electroacupuncture plus Hydro-acupuncture

Objective： To observe the therapeutic effect of electroacupuncture on Jiaozheng （Extra） plus hydro-acupuncture in treating facial paralysis, and to explore a better acupuncture therapy for treating facial paralysis. Methods： One hundred and nineteen cases with peripheral facial paralysis were randomly allocated into an observation group （60 cases） and a control group （59 cases） by the visiting sequence. The cases in the observation group were treated with electroacupuncture on Jiaozheng （Extra） plus hydro-acupuncture, and the cases in the control group were treated with normal acupuncture. The treatment was conducted once a day and 7 times as a course, with 1-2 d interval. Evaluation were done after 6 courses. Results： Comparing the cure and marked efficacy rate, observation group was much better than control group, and there was statistical difference （P〈0.05）; after 14-day treatment, the cure and marked efficacy rate of the observation group and the control group was 78.3% and 49.2%, respectively; after 21-day treatment, the cure and marked efficacy rate of the observation group and the control group was 88.3% and 67.8%, respectively. There was significant difference between the two groups （P〈0.01）. Conclusion： The therapeutic effect of electroacupuncture mainly on Jiaozheng （Extra） plus hydro-acupuncture in treating facial paralysis was better and with shorter courses.

Therapeutic Effect Observations on Individualized Treatment of Peripheral Facial Palsy

Objective： To investigate the curative effect of individualized treatment on peripheral facial paralysis. Methods： A treatment group of 121 patients was treated with acupuncture under an individualized plan based on the condition of disease. For a control study, 118 patients were treated with conventional acupuncture. The courses of treatment and the curative effects were compared. Results： The cure and marked efficacy rate was 90.9% in the treatment group and 69.5% in the control group. There was a significant difference （P〈0.01）. There was also a significant difference in the cure and marked efficacy rate in each courses of treatment between the two groups （P〈0.01）. Conclusion： Individualized acupuncture treatment is better in the effect and shorter in the courses than conventional acupuncture treatment for peripheral facial paralysis.

Time Selection of Acupuncture Treatment for Facial Paralysis

Objective： To investigate the optimal time for treating facial paralysis with acupuncture therapy, Methods： Eighty-six patients with facial paralysis in different disease durations were treated with same needling technique. Patients of the treatment group at the developing stage were dealt with moderate stimulation, and at the stationary stage and the recovery stage with strong stimulation. Patients of the control group at the developing stage were treated with drugs improving micro-circulation and nerve functions, and glucocorticoids, at the stationary stage and the recovery stage with the same methods as in the treatment group. Results： The cure rate in the treatment group and the control group were 88.1% and 68.2% respectively, and the former has shorter treatment course. Conclusion： Acupuncture therapy has better effect on facial paralysis than routine Western medicine, and shorter treatment course.

Therapeutic efficacy observation on combining auricular and routine acupuncture for peripheral facial paralysis in acute stage

Objective： To investigate the clinical efficacy of combining auricular and routine acupuncture for peripheral facial paralysis in acute stage. Methods： A total of 60 eligible cases were randomly allocated into a treatment group （n=30） and a control group （n=30）. Cases in treatment group received auricular and routine acupuncture, whereas cases in the control group received routine acupuncture alone. Both groups were treated for 10 d. Results： The recovery rate was 73.3% in the treatment group and 53.3% in the control group, showing a statistical difference （P〈0.05）. Conclusion： Combining auricular and routine acupuncture is effective for peripheral facial paralysis in acute stage and has a better effect than routine acupuncture.

Clinical study on skin needling plus heat-sensitive moxibustion for chronic facial paralysis

Objective：To observe the clinical efficacy of skin needling plus heat-sensitive moxibustion in treating chronic facial paralysis. Methods：Sixty patients with chronic facial paralysis were divided into an observation group and an acupuncture group by using the random number table, 30 in each group. Patients in the observation group were given skin needling plus heat-sensitive moxibustion; while patients in the acupuncture group were given conventional acupuncture. Results：Three treatment courses later, the total effective rate was 93.3% in the observation group versus 86.7% in the control group, and the difference was statistically significant （P〈0.05）. Conclusion：Skin needling plus heat-sensitive moxibustion can produce a more significant efficacy than conventional acupuncture in treating chronic facial paralysis.