针灸治疗特发性面神经麻痹研究的反思及建议  

Reflections and suggestions on the researches of acupuncture-moxibustion for idiopathic facial palsy

作　　者：陈思璇 李妍 莫溪桐 颜芃 胡效萌 孙畅 范刚启[1] CHEN Sixuan;LI Yan;MO Xitong;YAN Peng;HU Xiaomeng;SUN Chang;FAN Gangqi(Nanjing TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing 210001,Jiangsu Province,China)

机构地区：[1]南京中医药大学附属南京中医院,江苏南京210001

出　　处：《中国针灸》2025年第3期379-384,共6页Chinese Acupuncture & Moxibustion

摘　　要：分析针灸治疗特发性面神经麻痹(Bell麻痹)的研究现况。针灸治疗Bell麻痹应用广泛、研究颇丰,但对针灸有效性的研究缺乏分层讨论,难以凸显针灸治疗的必要性和优势;安全性问题缺乏充分讨论;研究普遍存在专业设计及统计设计缺陷,循证证据质量不高,国际指南对针灸的推荐力度较弱;指南对关键问题缺乏深入探讨,缺乏公认的最佳方案等。建议相关研究完善对影响Bell麻痹预后的病位、病情、病程、基础疾病、辨证分型等病情资料的评估,分层验证针灸疗效,重视针灸的安全性问题,提高研究质量,统一分期标准,多维疗效评价,系统优化介入时机、穴位选择、针刺工具、手法、干预措施、方案组合等针灸治疗要素,推动针灸治疗Bell麻痹的研究迈上新的台阶。This article analyzes the current status of the researches on acupuncture-moxibustion for idiopathic facial palsy(Bell's palsy).Acupuncture-moxibustion is widely applied in treatment of Bell's palsy and the relevant researches are enriched.But the hierarchical discussion on the effectiveness is reported inadequately.Consequently,the necessity and advantages of acupuncture-moxibustion are hardly prominent.Besides,the safety of acupuncture-moxibustion in treatment is not fully explored.The common shortcomings are presented in professional study and statistical designs,and the quality of the evidences is not high.The recommendation strength of acupuncture-moxibustion is weak in international guidelines.The crucial questions are not deeply discussed,and there are lack of the recognized optimal protocol in clinical practical guidelines.It is suggested that the researches should improve the evaluation of the disease itself that may affect the prognosis of Bell's palsy,such as location,conditions and duration of illness,basic diseases and syndrome/pattern differentiation.The effect of acupuncture-moxibustion should be verified hierarchically,the questions on safety should be emphasized,the quality of study should be improved,the staging of treatment should be specified and the effect of acupuncture-moxibustion should be evaluated in multi-dimensions,and the elements of acupuncture-moxibustion should be optimized systematically in the aspects of timing,acupoint selection,needle devices,manipulation,intervention measures and regimen composition.So as to promote the research of acupuncture-moxibustion for Bell's palsy to a new process.

关 键 词：特发性面神经麻痹 Bell麻痹 针灸 有效性 安全性 研究设计 

分 类 号：R24[医药卫生—中医临床基础]