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甘肃省中医院针灸科
纸质出版日期:2015
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张宏涛, 邱连利. 分期三通刺法治疗急性期中重度周围性面瘫的疗效观察[J]. 针刺研究, 2015,40(5):419-422.
ZHANG Hong-tao, QIU Lian-li. “Santong Needling”by Stages for Moderate and Severe Peripheral Facial Paralysis in the Acute Period[J]. Acupuncture research, 2015, 40(5): 419-422.
张宏涛, 邱连利. 分期三通刺法治疗急性期中重度周围性面瘫的疗效观察[J]. 针刺研究, 2015,40(5):419-422. DOI: 10.13702/j.1000-0607.2015.05.015.
ZHANG Hong-tao, QIU Lian-li. “Santong Needling”by Stages for Moderate and Severe Peripheral Facial Paralysis in the Acute Period[J]. Acupuncture research, 2015, 40(5): 419-422. DOI: 10.13702/j.1000-0607.2015.05.015.
目的:观察分期三通刺法论治急性期中重度周围性面瘫的临床疗效。方法:将60例急性期中重度周围性面瘫患者随机分为分期三通刺法组30例和经筋刺法组30例。分期三通刺法组采用"面瘫急性期轻通浅刺针法、静止期强通透穴斜刺针法、恢复期补通透穴平刺针法"的三通刺法
经筋刺法组采用经筋刺法
两组患者均每天治疗1次
10次为1个疗程
共治疗3个疗程。分别于每个疗程结束后比较两组患者面神经症状、体征评分
并于3个月后用生存质量简表进行随访评价。结果:治疗后两组面神经症状、体征评分比较均较治疗前改善(P<0.05)
且分期三通刺法组的改善作用优于经筋刺法组(P<0.05)。分期三通刺法组总有效率[93.3%(28/30)]明显高于经筋刺法组[80.0%(24/30)
P<0.05]。治疗前及治疗结束后3个月随访
两组患者生存质量均无明显变化(P>0.05)。结论:分期三通刺法论治急性期中重度周围性面瘫疗效优于经筋刺法。
Objective To observe clinical effects of"Santong needling"by stages for patients with moderate and severe peripheral facial paralysis(PFP)in the acute period.Methods Sixty patients with moderate and severe PFP were equally and randomly divided into Santong needling group and control group.The patients of the Santong needling group were treated by shallow puncture of Yifeng(TE 17
on the affected side)and Hegu(LI 4
on the healthy side)without needle manipulation in the acute stage("Qing-tong"
mild dredging)
by oblique-penetrative puncture of Dicang(ST 4)to Jiache(ST 6)
etc.
and moderate manipulation of needles in the resting stage("Qiang-tong"
stronger dredging)
and by oblique-penetrative puncture of Dicang(ST 4)to Jiache(ST 6)
etc.
and reinforcing needling manipulation in the recovery stage("Bu-tong"
tonifying dredging).The patients of the control group were treated by"Jingjin"(musculotendon)puncture of the same acupoints.The treatment was conducted once daily
5times per week for 6weeks.The 0-3-grade scores of therapeutic effects were evaluated according to the severity of the patients' symptoms and signs(including forehead stripes
palpebral fissure
nasolabial groove
drooping of the mouth angle
bulging cheek-air leak
food residue
dysgeusis
hyperacusi
lacrimation
and orbicularis oculi reflex).The therapeutic effect index=(score of pre-treatment-score of post-treatment)/score of pre-treatment x100%.The patients' life quality scores were assessed by using the World Health Organization Quality of Life(WHOQOL)-BREF questionnaire.Results After the treatment
the scores of clinical symptoms and signs were significantly decreased in both control and Santong needling groups in comparison with pre-treatment in the same one group(P<0.05)
suggesting an improvement of facial nerve function after 6weeks' treatment.Of the two 30 patients in the control group and Santong needling group
11(36.7%)and 15(50.0%)were cured
8(26.7%)and 9(30.0%)experienced marked improvement
5(16.6%)and 4(13.3%)were effective
and 6(20.0%)and 2(6.7%)invalid
with the effective rates being 80.0% and 93.3%
respectively.The therapeutic effect of Santong needling group was evidently superior to that of the control group(P<0.05).Three-months' follow up showed that the WHOQOL-BREF scores were comparable between pre-and post-treatment in the same one group and between the two groups(P>0.05).Conclusion Santong needling by stages is effective in improving clinical symptoms and signs of patients with moderate and severe peripheral facial paralysis.
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