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梅花针叩刺放血与氦氖激光照射治疗面瘫急性期伴耳周疼痛的疗效比较
引用本文:张翠彦,王艳香.梅花针叩刺放血与氦氖激光照射治疗面瘫急性期伴耳周疼痛的疗效比较[J].针刺研究,2011,36(6).
作者姓名:张翠彦  王艳香
作者单位:北京大学人民医院针灸理疗科,北京,100044
摘    要:目的:比较梅花针叩刺放血疗法和氦氖激光照射疗法在治疗面瘫急性期伴耳周疼痛患者中的效果。方法:采用随机数字表法将60例门诊面瘫急性期伴耳周疼痛患者随机分为梅花针组(28例)和对照组(32例)。梅花针组采用梅花针叩刺翳风和完骨穴区,直至微微出血为度,再以火罐闪火法吸拔出血;对照组采用氦氖激光照射疗法照射该两穴区,每穴6min,共12min。两组每日各治疗1次。耳周疼痛消失之后两组均改为常规针刺治疗,共治疗20次。两组均给予西药基础治疗1个月。对两组治疗次数、治疗前后House-Brackmann(HB)面神经功能评分和肌电图结果进行比较。结果:从治疗开始至耳周疼痛消失,梅花针组和对照组所需的治疗次数分别为(2.9±1.0)次、(6.0±2.2)次(P=0.000);治疗前两组HB面神经功能评分分别为(3.3±1.5)分、(3.3±1.4)分(P=0.869),治疗开始后1个月分别为(1.8±1.1)分、(2.5±1.2)分(P=0.033),治疗开始后3个月分别为(1.5±0.9)分、(2.2±1.5)分(P=0.032);发病后1~2周时,两组肌电图患侧和健康侧复合肌肉动作电位波幅比值分别为(52.1±20.5)%、(51.2±22.6)%(P=0.870),治疗开始后3个月时分别为(79.2±11.3)%、(69.8±17.9)%(P=0.017)。结论:对于面瘫伴有耳周疼痛的患者,急性期采用梅花针叩刺放血疗法比氦氖激光照射治疗所需治疗次数少、起效快,并且具有更好的远期疗效。

关 键 词:面瘫  急性期  梅花针  氦氖激光照射  面神经功能  面肌功能

Comparison of Therapeutic Effects between Plum-blossom Needle Tapping plus Cupping and Laser Irradiation in the Treatment of Acute Facial Palsy Patients With Concomitant Peri-auricular pain
ZHANG Cui-yan , WANG Yan-xiang.Comparison of Therapeutic Effects between Plum-blossom Needle Tapping plus Cupping and Laser Irradiation in the Treatment of Acute Facial Palsy Patients With Concomitant Peri-auricular pain[J].Acupuncture Research,2011,36(6).
Authors:ZHANG Cui-yan  WANG Yan-xiang
Abstract:Objective To compare the therapeutic effects of plum-blossom needle therapy with cupping and laser irradia-tion in the treatment of acute facial paralysis with ipsilateral peri-auricular pain.Methods Sixty outpatients with acute facial paralysis and ipsilateral peri-auricular pain were divided into plum-blossom needle(treatment) group(n=28) and laser-irradiation(control) group(n=32).In the acute stage,patients of the treatment group were treated with plum-blossom needle tapping in combination with cupping at Yifeng(TE 17) and Wangu(GB 12),while those of the control group treated with He-Ne laser irradiation over the same two acupoints until the peri-auricular pain disappeared.The treatment was given once daily.Following disappearance of the pain,routine acupuncture treatment of Yifeng(TE 17),Wangu(GB 12),Dicang(ST 4),etc.was given conti-nuously to patients of the two groups,once daily for 20 times.The treatment times for healing ipsilateral peri-auricular pain,and the electromyogram(EMG,compound muscle action potential) of the ipsilateral musculus orbicularis oris were recorded.Scores of the facial nerve function were given to House-Brackmann Facial Nerve Grading System.Results The treatment times for healing peri-auricular pain in the treatment group and laser irradiation group were 2.9±1.0 and 6.0±2.2 respectively(t=6.816,P=0.000).The scores of House-Brackmann scale of the paralyzed side in the treatment group and control group were(3.3±1.5) points and(3.3±1.4) points(P>0.05) before the treatment;(1.8±1.1) points and(2.5±1.2) points(P<0.05) one month after the treatment,and(1.5±0.9) points and(2.2±1.5) points(P<0.05)three months after the treatment,respectively.The amplitude ratios of compound muscle action potential between the affected side and the healthy side in the treatment group and control group were(52.1±20.5)% and(51.2±22.6)%(P>0.05) during the first two weeks after onset,and(79.2±11.3)% and(69.8±17.9)%(P<0.05)three months after the treatment,respectively.Conclusion Plum-blossom needle tapping plus cupping is significantly superior to that of He-Ne laser irradiation in reducing the treatment sessions for relieving peri-auricular pain during acute stage,and improving facial and muscular functions in the treatment of acute facial paralysis patients.
Keywords:Facial paralysis  Acute stage  Pulm-blossom needle therapy  Laser irradiation  Facial nerve function  Facial muscular function
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