针刺联合化风丹治疗风寒型周围性面瘫35例疗效观察  

Clinical Observation of Acupuncture Combined with Huafeng Elixir(化风丹)in Treatment of 35 Cases of Peripheral Facial Paralysis with Wind-cold Type

作　　者：陈静[1] 戴明[1] 桂熠 王延红[1] CHEN Jing;DAI Ming;GUI Yi;WANG Yanhong(Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai,200032)

机构地区：[1]上海中医药大学附属龙华医院,上海市徐汇区200032

出　　处：《中医杂志》2021年第15期1332-1337,共6页Journal of Traditional Chinese Medicine

摘　　要：目的观察针刺联合化风丹治疗风寒型周围性面瘫的临床疗效和安全性。方法将74例风寒型周围性面瘫患者随机分为针刺组与针药组各37例。两组均给予常规针刺治疗,针药组在针刺基础上给予化风丹口服,每次0.72g,每日3次,每服用18天停服6天,共治疗8周。于治疗前及治疗4周、8周时比较两组House-Brackmann (H-B)面神经功能分级、面部残疾指数量表(FDI)评分(包括躯体功能评分和社会功能评分)、中医症状积分量表评分,并评价两组临床疗效,记录不良事件发生情况。结果最终纳入统计共69例,其中针药组35例,针刺组34例。治疗4周时针药组治愈率62.86%,总有效率91.43%;针刺组治愈率47.06%,有效率82.35%。治疗8周时针药组治愈率88.57%,总有效率97.14%;针刺组治愈率64.71%,有效率88.24%。两组治愈率及总有效率治疗8周均高于治疗4周(P<0.05或P<0.01);治疗4周、8周针药组治愈率均高于同期针刺组(P<0.05)。针药组H-B面神经功能分级治疗4周以Ⅰ、Ⅱ级为主,治疗8周以Ⅰ级为主;针刺组治疗4周以Ⅰ、Ⅱ、Ⅲ级为主,治疗8周以Ⅰ、Ⅱ级为主。两组患者治疗4周、8周躯体功能评分高于治疗前,而社会功能评分及中医症状积分低于治疗前(P<0.01)。针药组治疗4周、8周躯体功能评分高于同期针刺组,而中医症状积分低于同期针刺组(P<0.05)。针药组痊愈患者31例,平均治愈疗程(31.13±1.71)天;针刺组分别为22例、(36.91±2.85)天,针药组治愈疗程较针刺组明显缩短(P<0.05)。针药组不良事件发生率为5.7%,针刺组为5.9%,两组比较差异无统计学意义(P>0.05)。结论针刺联合化风丹治疗风寒型周围性面瘫能有效改善患者面神经功能及临床症状,缩短治愈疗程,提高社会功能,临床疗效优于单用针刺治疗,且安全性好。Objective To explore the clinical effectiveness and safety of acupuncture combined with Huafeng Elixir(化风丹) in treating peripheral facial paralysis(PFP) of wind-cold type. Methods Seventy-four patients with wind-cold type PFP were randomly divided into acupuncture group and combination(acupuncture plus medicine) group with 37 cases in each group. Both groups were given acupuncture, and oral Huafeng Elixir was additionally administered in combination group with 0.72 g each time, three times daily;medication was stopped for six days after 18 days of administration;the treatment duration was eight weeks. The House-Brackmann(H-B) facial nerve function grading score, facial disability index(FDI) score(including physical function score and social function score), and traditional Chinese medicine(TCM) symptom score were compared between groups before treatment and after 4 and 8 weeks of treatment;the clinical effectiveness was evaluated, and the occurrence of adverse events was recorded. Results A total of 69 patients were finally analyzed, including 35 patients in the combination group and 34 in the acupuncture group. After 4-week treatment, the cure rate was 62.86% and the total effective rate was 91.43% in the combination group, while those in the acupuncture group were 47.06% and 82.35%, respectively. After 8-week treatment, the cure rate and total effective rate were 88.57% and 97.14% in the combination group while those were 64.71% and 88.24% in the acupuncture group. The 8-week results of cure rate and total effectiveness rate were significantly higher than 4-week results(P<0.05 or P<0.01), and cure rate of both 4-week and 8-week were significantly higher in the combination group than in acupuncture group(P<0.05). In terms of the H-B facial nerve function, patients in the combination group were mainly grade Ⅰ and Ⅱ after 4-week treatment and grade I after 8-week treatment, while those in the acupuncture group were mainly grade Ⅰ, Ⅱ and Ⅲ after 4-week treatment and grade Ⅰ and Ⅱ after 8-week tr

关 键 词：周围性面瘫 针刺疗法 化风丹 风寒型 面神经功能 

分 类 号：R246.6[医药卫生—针灸推拿学]