针药结合加穴位注射对周围性面瘫近远期的疗效观察  

Short and Long-term Efficacy of Acupuncture&Chinese Herbs Combined with Acupoint Injection on Peripheral Facial Paralysis

作　　者：王悦[1] 房其军[2] 王淑兰 徐炳国[1] 张加英[1] Wang Yue;Fang Qijun;Wang Shulan;Xu Bingguo;Zhang Jiaying(Nanjing Hospital Affiliated to Nanjing Medical University(Nanjing First Hospital),Jiangsu,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院,南京市第一医院,江苏南京210006 [2]南京大学医学院附属鼓楼医院,江苏南京210008

出　　处：《中国中医急症》2022年第8期1233-1236,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：南京市中医药青年人才培养计划(ZYQ20066)。

摘　　要：目的观察针药结合及穴位注射治疗周围性面瘫的近期临床疗效及对后遗症发生率的影响。方法将60例急性期周围性面瘫患者,随机分为观察组与对照组各30例。两组均口服牵正散加减,对照组在此基础上进行针刺治疗,观察组进行针灸加翳风穴穴位注射甲钴胺注射液的治疗。两组患者分别于入组当天及每天治疗前由专人进行神经功能评分、分级,观察治疗的起效时间,分别于治疗1、2个疗程后进行疗效统计,并于结束治疗后半年进行随访,统计患者后遗症发生情况。结果1)观察组的治疗起效时间早于对照组(P<0.05)。2)两组的治疗起效时间与治疗1疗程和2疗程后患者的神经功能评分均呈负相关(P<0.05),与H-B分级评分成正相关(P<0.05)。3)两组临床疗效比较,治疗1疗程后观察组的痊愈率和总有效率均高于对照组(P<0.05);治疗2疗程后,观察组的痊愈率明显高于对照组(P<0.05)。4)针灸治疗后半年随访发现,观察组患者后遗症发生率低于对照组(P<0.05)。结论面瘫急性期进行针灸治疗疗效肯定,治疗时起效所需时间越短,取得的临床痊愈率和总有效率更高,后遗症发生率也越低,其中以针药结合配合翳风穴穴位注射甲钴胺注射液的疗效更佳。Objective:To investigate the clinical efficacy of acupuncture combined with Chinese herbs and acu⁃point injection on peripheral facial paralysis and its influence on the incidence of sequelae.Methods:60 cases of acute facial paralysis patients were randomly divided into the control group and observation group,each with 30 cases.The control group was treated with acupuncture on the basis of traditional Chinese medicine Qianzheng San,and the observation group was treated with Yifeng acupoint injection of mecobalamine on the basis of the control group.The two groups were assessed by H-B facial nerve grading,facial nerve function score respectively daily,and statistics were conducted after 1 and 2 courses.Follow-up was conducted 6 months after the end of treatment,and sequelae of the patients were counted.Results:1)The onset time of observation group was earlier than con⁃trol group(P<0.05).2)The onset time of both groups was negatively correlated with neurological function scores and positively correlated with H-B grading of patients after both treatment courses(P<0.05).3)The clinical effica⁃cy of the observation group was better than that of the control group,and the cure rate and total effective rate of the observation group were higher than that of the control group(P<0.05).4)The follow-up study of six months af⁃ter acupuncture treatment showed that the incidence of sequelae in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Acupuncture in the acute stage of facial paralysis has a positive effect.The shorter the time required for the onset of the treatment,the high⁃er the clinical recovery rate and the total effective rate,and the lower the incidence of sequelae.The combination of acupuncture and Chinese herbs combined with Yifeng acupoint injection of mecobalamine has better efficacy.

关 键 词：周围性面瘫 针药结合 穴位注射 近期疗效 后遗症 

分 类 号：R745.12[医药卫生—神经病学与精神病学]