面瘫针灸临床路径探究及临床疗效评价

目的:评价"面瘫针灸诊疗方案"的临床疗效及"面瘫针灸临床路径"指导下规范实施方案的优势,为诊疗方案和临床路径的推广提供依据。方法:将60例周围性面瘫急性期患者随机分为路径组(治疗组,30例)和非路径组(对照组,30例),治疗组依照"面瘫针灸临床路径"诊疗流程及诊疗方案实施治疗,对照组采用常规针刺治疗。观察周期为8周。评价两组患者的临床疗效及中医症状体征评分的变化,比较两组患者的诊疗费用及对治疗的满意度。结果:治疗组的显效率和总有效率分别为96.67%和100%,对照组的显效率和总有效率分别为86.67%和96.67%,治疗组疗效优于对照组(P0.05)。治疗2周时,治疗组患者的症状体征评分即显著降低(P0.01);治疗4周、6周、8周时,两组患者的症状体征评分较治疗前均显著降低(P0.01);且治疗6周、8周时,治疗组患者的评分低于对照组(P0.05)。治疗过程中,治疗组患者的诊疗费用低于对照组(P0.05),且治疗组患者的满意度优于对照组(P0.05)。结论:"面瘫针灸临床路径"的实施可有效提高治疗效果,减少医疗费用,易于被患者接受,值得推广和应用。

Evaluation on Clinical Acupuncture Pathway in Treating Patients with Peripheral Facial Paralysis

  Objective: To evaluate the clinical effect of Acupuncture Treatment Scheme for Facial Paralysis and assess the clinical value of Acupuncture Clinical Pathway for Facial Paralysis, so that to provide a basis for popularization and application of treatment scheme and clinical pathway.   Methods: Sixty patients of peripheral facial paralysis at acute stage were randomly divided into two groups:the treatment group in which 30 patients were treated under the guidance of clinical pathway and the control group in which 30 patients were treated by conventional acupuncture therapy. The observation course was 8 weeks. The clinical effect and the scores of symptoms and signs were evaluated, and the cost of diagnosis and treatment and the satisfaction degree of the patients were compared between the two groups.   Results: The remarkably effective rate and the total effective rate of treatment group were 96.67% and 100% respectively, and the remarkably effective rate and the total effective rate of the control group were 86.67% and 96.67% respectively, the effect of treatment group was better than that of the control group (P<0.05). After 2 weeks of treatment, the scores of symptoms and signs were obviously decreased in the treatment group (P<0.01); after 4 weeks, 6 weeks and 8 weeks of treatment, the scores were significantly decreased in both groups (P<0.01); after 6 weeks and 8 weeks of treatment, the scores of treatment group were lower than those of the control group (P<0.05). In the course of treatment, the cost of the treatment group was lower than that of the control group (P<0.05), and the satisfaction degree of the treatment group was better than that of the control group (P<0.05).   Conclusion: The application of acupuncture clinical pathway of peripheral facial paralysis can effectively improve the therapeutic effect, reduce the medical cost, and be easily accepted by the patients, and it is worthy to apply the acupuncture clinical pathway in clinic.