针刺结合柴胡桂枝汤加减对急性期Bell面瘫(风寒证)患者面肌功能恢复的影响  

Effects of Acupuncture Combined with Chaihu Guizhi Decoction on Clinical Efficiency and Facial Function Recovery in Bell′s Facial Paralysis Patients of Acute Wind-cold Type

作　　者：徐明珠 路树超 杨述玉 Xu Mingzhu;Lu Shuchao;Yang Shuyu(Beijing Xuanwu Traditional Chinese Medicine Hospital,Beijing 100050,China)

机构地区：[1]北京市宣武中医医院,北京100050 [2]北京市密云区中医医院,北京101500

出　　处：《中国中医急症》2020年第8期1391-1394,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：北京中医药科技发展资金项目(QN2016-18)。

摘　　要：目的观察针刺结合柴胡桂枝汤加减治疗急性期Bell面瘫(风寒证)患者临床疗效及其对面肌功能恢复的影响并探讨其作用机制。方法82例患者采用随机数字表法分为两组各41例。对照组行常规西医治疗,观察组在此基础上加以针刺结合柴胡桂枝汤加减治疗。比较两组患者临床疗效、面肌功能、面部动静态指标、血清一氧化氮、内皮素及不良反应。结果观察组总有效率95.12%高于对照组的80.49%(P<0.05)。两组治疗前眼轮匝肌、口轮匝肌波幅比较,差别均不大(均P>0.05)。两组治疗后眼轮匝肌、口轮匝肌波幅与治疗前比较均上升,且观察组上升幅度更大(均P<0.05)。两组治疗前静态D1、微笑D1、静态D2、噘嘴D2比较,差别均不大(均P>0.05)。两组治疗后患者静态D1、微笑D1、静态D2、噘嘴D2与治疗前比较均下降,且观察组下降幅度更大(均P<0.05)。两组治疗前血清一氧化氮、内皮素比较,差别均不大(均P>0.05)。两组治疗后患者血清一氧化氮均升高,内皮素水平均下降,且观察组改善均优于对照组(均P<0.05)。对照组未出现明显不良反应,观察组出现2例(4.88%)不良反应,其中皮疹1例,腹泻1例。结论常规西医治疗基础上加针刺结合柴胡桂枝汤加减治疗急性期Bell面瘫(风寒证)较单独使用常规西医治疗可明显提高临床疗效,改善患者面肌功能及面部动静态指标,其作用机制可能与降低内皮素,升高一氧化氮水平有关。Objective:To explore the effects of acupuncture combined with Chaihu Guizhi Decoction on the clinical efficacy and facial muscle function recovery in patients with Bell-type facial paralysis of acute cold type.Methods:82 patients were randomly divided into 2 groups,41 patients in each.The control group received conventional Western medicine treatment,and the observation group was treated with acupuncture combined with Chaihu Guizhi Decoction on that basis.The clinical efficacy,facial muscle function,facial dynamic and static indicators,serum nitric oxide,endothelin and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 95.12%,significantly higher than that of the control group(80.49%)(P<0.05).After treatment,the wave amplitude of orbicularis oculi and orbicularis oris in both groups increased significantly,but that in the observation group was higher(P<0.05).After treatment,the static D1,smiling D1,static D2,and pouting D2 in the two groups were significantly decreased,but the decline was greater in the observation group(P<0.05);The level of NO was significantly increased and the level of endothelin decreased significantly in both groups.But the amplitude of the observation group was significantly larger than that of the control group(P<0.05).There were no obvious adverse reactions in the control group,and 2 cases(4.88%)in the observation group.There was no statistically significant difference between the groups(P>0.05).Conclusion:On the basis of conventional Western medicine,acupuncture combined with Chaihu Guizhi Decoction can obviously improve the clinical effect,the function of facial muscles and the dynamic and static indexes of the face.The mechanism may be related to the decrease of endothelin and the increase of nitric oxide.

关 键 词：BELL面瘫 针刺 柴胡桂枝汤 急性期 风寒 面肌功能 

分 类 号：R245[医药卫生—针灸推拿学]