巨刺法分期治疗周围性面瘫临床观察

目的比较周围性面瘫巨刺法、分期巨刺法和患侧针刺法的临床疗效差异,为针灸治疗周围性面瘫提供临床依据。方法将98例患者按随机数字表法随机分为A组(巨刺法组)33例、B组(分期巨刺法组)33例、C组(患侧针刺组)32例,3组均予相同基础用药,针刺取穴阳白、四白、颧髎、颊车、地仓、翳风、合谷。A组针刺面部健侧穴位;B组急性期(发病1～7 d)面部取健侧穴位,静止期和恢复期(发病8 d以后)面部取患侧穴位;C组针刺面部患侧穴位;每周7次,连续治疗4周。应用House-Brackmann(H-B)面神经功能评价分级系统于治疗前后对3组患者面神经功能进行评分,并比较3组疗效。结果 3组均能促进面神经功能恢复,总有效率均为100%(P0.05),A组(60.606%)和B组(66.667%)痊愈率均优于C组(46.875%)(P0.05);A组痊愈时间(20.55±4.763) d和B组(18.35±4.460) d优于C组(23.53±3.175) d(P0.05);治疗后第7天、第14天、第21天A组和B组H-B评分均优于C组(P0.05),治疗后第14天、第21天B组评分优于A组(P0.05)。结论巨刺法和分期巨刺法能加速急性期周围性面瘫的恢复,并明显缩短疗程,疗效优于针刺面部患侧穴,且早期使用巨刺法联合中期针刺患侧的疗法优于持续使用巨刺法。     

不同针灸方法早期介入周围性面瘫的临床研究

目的观察不同针灸方法早期介入周围性面瘫的临床疗效。方法将90例急性期周围性面瘫患者按随机数字表法分为A组、B组、C组,每组30例。各组均予基础西药治疗,急性期A组加用浅刺法治疗,B组加用耳针治疗,C组只予西药基础治疗。各组急性期后均采用针刺,加用电针,针后患侧面部闪罐,总疗程均为4周。观察各组临床疗效,比较改良Portmann评分、面部残疾指数躯体评分(FDIP)变化情况。结果①治疗后,各组改良Portmann评分、FDIP评分均较治疗前增加(P0.01);A组、B组治疗后改良Portmann评分、FDIP评分高于C组,差异有统计学意义(P0.01)。②临床有效率A组86.7%,B组83.3%,均高于C组的56.7%(P0.05);A组临床有效率与B组比较,差异无统计学意义(P0.05)。结论浅刺法、耳针疗法早期介入周围性面瘫均能有效改善患者的临床症状,较急性期单用西药者效果更优;急性期介入浅刺法或耳针疗法均能提高临床有效率,且不增加继发面肌痉挛的风险。     

“五联法”治疗周围性面神经麻痹的时机与疗效的评估研究

目的:探究针刺、穴位注射、罐疗、电针、TDP等"五联法"治疗急慢性周围性面神经麻痹的时机与疗效。方法:选取在2012年12月至2014年12月之间,在我院治疗的周围性面瘫患者75名,将患者分为3组,A组为急性期患者(即发病1至7天为急性期的患者,n=25),B组为静止期患者(即发病8至15天为静止期的患者,n=25),C组为恢复期患者(即发病15天以上50天以内的患者,n=25)。各组行针刺、穴位注射、罐疗、电针、TDP等"五联法"治疗方案后按照House-Brackmann面神经功能分级标准与症状积分表进行疗效评估。结果:A、B、C共3组受试者的一般情况进行比较,结果显示无统计学差异(P0.05)。3组受试者各自治疗前后均进行H-B量表评估,差异有统计学意义(P0.05)。治疗前以及前两个疗程的3组受试者H-B评分无统计学差异(P0.05);第3个疗程时,3组受试者间有统计学差异(P0.05)。结论:周围性面瘫在急性期实施针刺治疗最佳。     

周围性面瘫急性期不同干预方法疗效比较

目的:比较周围性面瘫急性期不同干预方法的疗效,探讨周围性面瘫治疗的更优方法。方法:将131例Bell’s面瘫急性期患者随机分为3组,针刺组(44例)针刺地仓、颊车、合谷、阳白、太阳等穴;电针组(45例)取穴及针刺方法与针刺组相同,并在地仓、下关、太阳、阳白进行电针治疗;针药组(42例)在急性期内口服强的松、阿昔洛韦,维生素B1、维生素B12肌肉注射,静止期、恢复期按针刺组方法治疗。以House-Brackmann分级量表判定治疗效果并观察随访1、3个月时患者未愈率。结果:针刺组愈显率为79.6%(35/44),电针组为93.4%(42/45),针药组为78.6%(33/42),电针组优于针刺组和针药组(P0.05)。针刺组病位在鼓索以上者痊愈率为54.2%(13/24),电针组为85.2%(23/27),针药组为48.0%(12/25),电针组优于针刺组和针药组(P0.01),各组鼓索以下者痊愈率经统计学处理,差异无统计学意义(P0.05),电针组随访1、3个月未愈率均明显低于针刺组和针药组(均P0.01)。结论:周围性面瘫急性期电针治疗疗效较好,提示周围性面瘫的针刺治疗宜电针早期介入。     

周围性面瘫针灸治疗时机的临床研究

目的:观察针灸治疗周围性面瘫的最佳时机。方法:将发病2天内的120例患者随机分为3组,每组各40例。A组(急性期组)急性期开始针灸治疗,B组(静止期组)静止期开始针灸治疗,C组(恢复期组)恢复期开始针灸治疗,各组在急性期开始即服用西药和TDP照射治疗。结果:A组、B组、C组临床疗效有效率分别为94.87%、88.89%、81.08%,临床疗效比较差异有统计学意义。结论:周围性面瘫急性期为针灸治疗的最佳时机,针灸介入时机越早,疗效越好。     

针刺治疗急性面神经炎介入时机的临床观察

目的:观察不同针刺介入时机对急性面神经炎症状改善情况和痊愈时间长短的影响,寻找急性面神经炎的最佳治疗时机。方法:将120例急性面神经炎患者(均为单侧发病)随机分为4组,即A组、B组、C组、D组,每组30例。A组患者发病3天内即开始施行针刺;B组患者发病前3天仅口服甲钴胺分散片、复合维生素B片,自第4天开始施行针刺;C组患者发病前5天仅口服甲钴胺分散片、复合维生素B片,自第6天开始施行针刺;D组患者发病前7天仅口服甲钴胺分散片、复合维生素B片,自第8天开始施行针刺。针刺以透刺为主,配合面颊部红外线照射,每日治疗1次,每周治疗6 d,治疗3周。比较各组治疗前与发病第7、14、28天症状体征评分(Portmann评分),比较各组病情好转的时间,并比较各组临床疗效。结果:发病第7、14、28天,4组Portmann评分均高于治疗前(均P0.05);发病第7、14、28天,A组Portmann评分高于其余3组(均P0.05),B组、C组和D组两两比较差异均有统计学意义(均P0.05)。A组总有效率为96.7%(29/30),高于其余3组[93.3%(28/30)、86.7%(26/30)、83.3%(25/30),均P0.05]。4组病情开始好转时间、显著好转时间及临床痊愈时间比较,差异有统计学意义(均P0.05),其中A组最优。结论:急性面神经炎及早介入针刺,可以适当减缓面神经损伤的进展,提高疗效,缩短临床痊愈时间。     

不同疗法对面神经麻痹预后的影响

目的:寻找治疗面神经麻痹的最有效方法。方法:将364例患者随机分成针刺组(A组)、电针组(B组)、中药组(C组)、针刺加中药组(D组)、电针加中药组(E组),治疗30次后统计疗效。结果:各组总有效率分别为77.83%、82.19%、61.11%、86.30%、96.00%。E组疗效最好,且与其他各组相比差异有非常显著性意义(P<0.01);B组与A组、C组相比差异有非常显著性意义(P<0.01)。结论:电针针剌与中药结合是治疗面神经麻痹的最有效方法,且电针治疗好于单纯针剌及单纯中药治疗。     

电针治疗不同病期周围性面瘫的临床观察

目的:探讨电针治疗周围性面瘫的最佳时机.方法:将120例患者按就诊顺序随机分为A组和B组各60例.A组在急性期开始电针和超短波治疗,B组在急性期行超短波治疗,静止期再加用电针治疗.结果:A组痊愈显效率为85.0%,总有效率为98.3%,B组分别为68.3%和91.7%(x2=7.96,P＜0.05);肌电图检测显示,治疗前和发病第8天时异常肌电图的变化两组间比较差异无显著性意义(P＞0.05);第30天时BR波转为正常或轻度异常的例数A组明显多于B组(P＜0.05),M波潜伏期缩短和波幅回升A组也明显优于B组(P＜0.05).结论:急性期电针治疗可以明显提高痊愈显效率,是针刺治疗周围性面瘫的最佳时机.     

不同疗法与急性特发性面神经麻痹预后的关系

目的:寻找治疗急性特发性面神经麻痹的最佳治疗方案.方法:将477例患者随机分为针刺治疗组(A组,常规取穴多针浅刺法)、电针治疗组(B组,常规取穴加电针)、药物治疗组(C组)、针刺加药物治疗组(D组)、电针加药物治疗组(E组),经40次治疗后进行疗效对比观察.结果:各组有效率分别为84.0%、57.1%、60.6%、95.8%、73.5%.D组疗效最好,且与其他各治疗组相比差异有非常显著性意义(P＜0.01);A组与B组、C组疗效相比差异均有非常显著性意义(P＜0.01).结论:针刺和药物的结合是治疗急性特发性面神经麻痹的最佳治疗方案,且多针浅刺法优于电针治疗与单纯药物治疗.     

不同针灸方法分期治疗贝尔面瘫疗效观察

目的观察不同分期针灸方法治疗成都地区380例贝尔面瘫患者的临床疗效。方法采用临床随机对照试验方法将372例贝尔面瘫患者随机分为A组65例、B组78例、C组75例、D组71例和E组83例。A组采用分期针刺治疗,B组采用分期针灸治疗,C组采用分期电针治疗,D组采用分期经筋排刺治疗,E组采用不分期针刺治疗。治疗4个疗程后比较各组House-Brackmann(H-B)分级量表、面部残疾指数量表(FDI)、面神经麻痹程度分级评分表及WHOQLO-BREF量表评分,并评价各组疗效。结果 5组治疗后H-B分级量表、FDI、面神经麻痹程度分级评分表及WHOQLO-BREF量表评分比较,差异均无统计学意义(P0.05)。5组临床疗效比较,差异均无统计学意义(P0.05)。结论 5种治疗方案均对贝尔面瘫均有效。在医疗条件受限、医疗资源不足的情况下,治疗贝尔面瘫推荐使用单纯针刺治疗。     

USING ACUPUNCTURE EXERCISE THERAPY TO TREAT PERIPHERAL FACIAL PARALYSIS:A RANDOMIZED CONTROLLED TRIAL

Objective: Acupuncture exercise therapy is a new and effective therapy for some nervous system diseases and motor system diseases.The problem that whether acupuncture exercise therapy is effective for patients with peripheral facial paralysis is still unclear.Therefore, we reported a randomized controlled trial of using acupuncture exercise therapy to treat peripheral facial paralysis.Methods: This was a randomized, controlled trial.A total of 302 patients were randomly allocated into acupuncture exercise group(AE, n=100), sham acupuncture and exercise group(SAE, n=101) and acupuncture group(AC, n=101).The AE group received needling at Zusanli(ST36), Hegu(LI4) and Fengchi(GB20) and the SAE group received needling at sham Zusanli(ST36), Hegu(LI4) and Fengchi(GB20).Patients exercised facial muscle, such as lifting eyebrow, mouth movement, and eye closure in the process of retaining needle for 30 min once a day.The AC group was treated with acupuncture at acupoints Sibai(ST2), Dicang(ST4), Jiache(ST6), Quanliao(SI18), Yangbai(GB14), Yingxiang(LI20) and Hegu(LI4) for 30 min once a day.The patients were treated continuously for 3 to 12 d.Patients were assessed weekly by blinded assessors, using the House-Brackmann facial nerve grading system.Results: The efficacy of the three groups was compared in terms of degree of recovery and speed of recovery.The overall improvement(grade 3 or better) was 90.1% in the AE group, 80.4% in the AC group and 78.5% in the SAE group.The degree of recovery and time of treatment in the AE group were significantly different from those in other groups(P0.05).However, the difference in the degree of recovery and time of treatment in the AC group and the SAE group was not statistically significant(P0.05).Conclusion: Acupuncture exercise therapy was effective to treat peripheral facial paralysis and exercise therapy played an important role in the course of acupuncture.     

A method of selecting acupoints for acupuncture treatment of peripheral facial paralysis by thermography

The purpose of this study is to select acupoints for acupuncture treatment of peripheral facial paralysis according to the temperature on the face of the patient detected by thermogram, to determine an objective acupoint selection method for acupuncture treatment. In the test group of 60 cases of facial paralysis, the infrared thermogram on the face was detected at the first visit, and then acupuncture was given at the acupoints on the affected side with a temperature difference of over 0.5 degrees C from the healthy side for one therapeutic course, and in each successive course the acupoints were re-determined according to the results of thermogram examination and were administrated till the end of the total therapeutic course, and 120 cases of the control group were treated with acupuncture at conventionally selected acupoints. The results showed that the cured and basically cured rate was 90.0% (54 cases) in the test group and 77.5% (93 cases) in the control group with a significant difference between the two groups (p < 0.05); and the total sessions of acupuncture were less and the course of treatment was shorter in the test group than those in the control group (both p < 0.001). The utilization rate of the acupoints selected by facial thermogram in the test group was in order of Dicang (ST 4, 92.3%), Yingxiang (LI 20, 90.6%), Taiyang (EX-HN 5, 85.5%), Yangbai (GB 14, 76.6%), Quanliao (SI 18, 72.3%), and so on. In conclusion, acupuncture at the acupoints selected by thermogram for treatment of facial paralysis in the cured rate, the therapeutic course and sessions of acupuncture is significantly superior to acupuncture at the conventionally selected acupoints, and the thermogram-aided acupoint selection method is beneficial to objectivity and modernization of acupoint selection for acupuncture and moxibustion treatments.     

特殊针法治疗面神经麻痹临床研究

目的：探寻治疗周围性面瘫的特殊针刺治疗方法。方法：将93例面神经麻痹患者随机分为观察组（50例）和对照组（43例）。观察组选取面部瘫痪表情肌穴位,额肌（阳白、阳白旁开1寸）、眼轮匝肌、颧肌（颧髎、巨髎）、提上唇肌（上迎香、迎香）、口轮匝肌（夹水沟、夹承浆、地仓）,浅刺针体穿行于肌层,每组穴位加电针断续波治疗。对照组以常规治疗方法选取穴位,加电针以疏密波治疗。比较两组的临床疗效、病程和House-Brackmann （ H-B ）分级及面神经功能评分情况。结果：观察组的总有效率为98．0％（49/50）,优于对照组的90．7％（39/43）,两组比较P＜0．05;痊愈患者在不同时间段的痊愈率上,观察组均明显优于对照组;两组治疗后的H-B面神经功能分级及面神经功能评分均较治疗前明显提高,观察组提高更明显。结论：特殊针刺疗法在治疗面神经麻痹上疗效明显优于常规针刺疗法,不仅大大的缩短了疗程,也减少了面瘫后遗症的出现。     

针刺人迎穴为主配合星状神经节阻滞术治疗周围性面瘫:随机对照研究

目的:探寻治疗周围性面瘫的较佳疗法。方法:120例患者随机分为常规针刺组(穴取阳白、四白、迎香为主)、人迎针刺组(人迎穴为主针刺)以及术针组(人迎穴为主针刺配合星状神经节阻滞术),每组40例。每天治疗1次,7次为一疗程,3个疗程后,比较3组治疗前后的面神经直接刺激诱发电位(ENoG)潜伏期和波幅,以及瞬目反射(BR)的R1值、R2值,并评定临床总疗效。结果:3组治疗均能显著缩短ENoG潜伏期,且诱发电位波幅显著升高;治疗后术针组ENoG潜伏期较常规针刺组显著降低(P<0.05),人迎针刺组诱发电位波幅较其他两组升高(均P<0.05);各组治疗后R1、R2值显著缩短,人迎针刺组和术针组治疗前后R1差值、R2差值均显著大于常规针刺组(均P<0.05),且术针组R1差值显著大于人迎针刺组(P<0.05);术针组临床愈显率为87.5%(35/40),优于人迎针刺组的77.5%(31/40),且显著高于常规针刺组的65.0%(26/40)(P<0.05)。结论:与常规针刺比较,人迎针刺组和术针组治疗周围性面瘫疗效更优,且术针组较人迎针刺组能更好地恢复受损面神经的早发反射功能。     

针刺结合He-Ne激光照射治疗面神经麻痹

目的：比较针刺结合He-Ne激光照射与西药治疗面神经麻痹的疗效差异。方法：将97例患者随机分为针刺激光组和药物组。针刺激光组55例采用针刺结合He-Ne激光穴位照射治疗,取穴以地仓、颊车、四白、牵正、下关、迎香、阳白、鱼腰、翳风、合谷等为主;药物组42例采用常规西药治疗,包括静脉点注低分子右旋糖苷、复方丹参和三磷酸腺苷注射液,肌肉注射VitB1、VitB12,同时口服谷维素、强的松。7天为一疗程,2个疗程后观察2组的临床疗效。结果：针刺激光组痊愈率81.8%,药物组痊愈率45.2%,2组痊愈率之间差异有非常显著性意义（P〈0.01）;针刺激光组有效率100.0%,优于药物组的83.3%（P〈0.01）。结论：针刺结合He-Ne激光照射治疗面神经麻痹的临床疗效优于常规药物治疗。     

早期针刺治疗周围性面瘫疗效观察

目的:观察不同时机针刺治疗周围性面瘫的疗效。方法:将52例患者随机分为治疗组(28例)和对照组(24例)。治疗组急性期(1~10天)即予针刺治疗,穴取地仓、颊车、阳白等,面部取穴不超过4个,浅刺,10天后常规取穴加电针;对照组除急性期不予针刺治疗外,余处理方法与治疗组相同。结果:治疗组痊愈率为78.6%,明显高于对照组的50.0%(P<0.05)。结论:早期针刺治疗面瘫是获取最佳疗效的关键。     

EFFECT OF NEEDLING STIMULATION QUANTITY ON THE THERAPEUTIC EFFECT OF ACU-MOXIBUSTION IN THE TREATMENT OF PERIPHERAL FACIAL PALSY IN THE EARLY STAGE

Objective: To observe the correlation between needling stimulation quantity and the therapeutic effect of acupuncture in the treatment of early stage of peripheral facial palsy. Methods: Sixty-three peripheral facial palsy patients were randomized into treatment group (n=33) and control group (n=30). In treatment group, Taiyang (EX-PIN 5), Jingrning (BL 1) and Hegu (LI 4) were punctured with gauge-36 acupuncture needles and stimulated with light twirling-reinforcing method (about 200 times/min), the acupuncture needles were retained for 20 min. In addition, moxibustion was also applied to Fengchi (GB 20) and Qianzheng (EX-HN 17) following puncturing them with gauge-30 filiform needles. In control group, conventional twirling-reducing method (about 60 times/min) was applied to Yangbai (GB 14), Cuanzhu (BL 2), Sizhukong (TE 23), etc., following puncturing them with gauge-28 filiform needles. Additionally, thermal needle was applied to Fengchi (GB 20),tained for 40 min. Results: Following 10 days‘‘ treatment,Yifeng (TE 17) and Jiache (ST 6), with the needles retained for 40 min,Results:Following 10 days‘‘ treatment,of the 33 and 30 cases in treatment and control groups, 21 (63.0%) and 12 (40.0%) were cured, 7(21.1% ) and 5 (16.7%) had remarkable improvement, 4 (12.1%) and 9 (30.0%) were effective, and 1 (3.0%) and 4 ( 13.3% ) failed in the treatment, with the cure plus markedly effective rates being 84.8% and 56.7% respectively. Statistical analysis shews that in acupuncture treatment of early stage of facial palsy, light stimulation is superior to that of heavy stimulation in the therapeutic effect.     

针刺配合刺络拔罐治疗周围性面瘫76例

目的:对比单纯针刺治疗与急性期加刺络放血,配合拔罐疗法治疗周围性面瘫的疗效。方法:将76例周围性面瘫急性期患者,按就诊顺序随机分为治疗组(38例)和对照组(38例)。两组均本着急性期着重远端取穴,针刺面部穴采用浅刺法,留针时间短,禁止加电针;后期着重局部取穴留针时间长的原则,施以相同的取穴。但治疗组于急性期加取大椎、肺俞(双侧)穴刺络放血,配合拔罐治疗,每日1次,连续使用7天。结果:观察组和对照组的有效率分别为92.1%和100%,临床治愈率分别为50%和71.1%,组间差别具有统计学意义(P<0.05)。结论:周围性面瘫急性期针刺同时加大椎、肺俞(双侧)穴刺络放血,配合拔罐治疗的疗效优于单纯针刺治疗。     

CLINICAL OBSERVATION ON 36 CASES OF SCAPULOHUMERAL PERIARTHRITIS TREATED BY ABDOMINAL ACUPUNCTURE AND BODY-ACUPUNCTURE

Ａｂｄｏｍｉｎａｌａｃｕｐｕｎｃｔｕｒｅｔｈｅｒａｐｙｉｓａｎｅｗｔｈｅｒａｐｙｏｆｍｉｃｒｏ ａｃｕｐｕｎｃｔｕｒｅｓｅｒｉｅｓａｆｔｅｒａｐｐｅａｒ ａｎｃｅｏｆｅａｒ ａｃｕｐｕｎｃｔｕｒｅ ,ｓｃａｌｐａｃｕｐｕｎｃｔｕｒｅａｎｄｈａｎｄａｃｕｐｕｎｃｔｕｒｅ .ＩｔｓａｃｕｐｏｉｎｔｓｄｉｓｔｒｉｂｕｔｅａｒｏｕｎｄＳｈｅｎｑｕｅ (ＣＶ 8)ａｎｄｆｕｎｃｔｉｏｎｉｎｒｅｇｕｌａｔ ｉｎｇｄｙｓｆｕｎｃｔｉｏｎｏｆｚａｎｇ ｆｕｏｒｇａｎｓ.Ｉｔｓｐｒｅｓｃｒｉｐ ｔｉｏｎｓａｒｅｍａｉｎｌｙｍａｄ…     

远取足三里、厉兑结合面部深透刺治疗周围性面瘫临床观察

目的:观察远取穴位对针刺疗效的影响.方法:将125例周围性面瘫患者随机分为两组.观察组75例,在面部取穴的基础上根据不同的辨证结果,分别选取足三里、厉兑穴;对照组50例,单纯面部取穴治疗,观察比较两组疗效.结果:观察组治愈率69.3%、显效率17.3%;对照组治愈率48.0%、显效率20.0%.观察组疗效优于对照组(χ2=7.337,P<0.05).结论:远取足三里、厉兑可提高针刺治疗周围性面瘫的疗效.