本文關(guān)鍵詞：排針平刺治療特發(fā)性面神經(jīng)麻痹的臨床療效評(píng)價(jià)　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

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【摘要】：背景:特發(fā)性面神經(jīng)麻痹也稱貝爾麻痹(Bell麻痹),是臨床常見(jiàn)的疾病之一。本病發(fā)病率高,根據(jù)流行病學(xué)調(diào)查,我國(guó)每年至少有335萬(wàn)人出現(xiàn)貝爾麻痹,本病每年發(fā)病率達(dá)26-34/10萬(wàn)[1]。早在1979年貝爾麻痹即被世界衛(wèi)生組織認(rèn)定為適宜針灸治療的疾病之一,當(dāng)前對(duì)于本病的針刺治療方法多樣,但仍有部分貝爾麻痹療效欠佳。本研究旨在通過(guò)對(duì)比排針平刺聯(lián)合基礎(chǔ)治療、常規(guī)針刺聯(lián)合基礎(chǔ)治療以及單純基礎(chǔ)治療這三種不同的治療方法在貝爾麻痹治療中的療效,為本病的治療提出新的思路和方法。目的:通過(guò)嚴(yán)格的隨機(jī)、對(duì)照試驗(yàn),觀察排針平刺結(jié)合基礎(chǔ)治療、常規(guī)針刺結(jié)合基礎(chǔ)治療以及單純基礎(chǔ)治療在貝爾麻痹中的療效,采用House-Brackmann分級(jí)量表以及功能積分量表來(lái)記錄治療前后面部功能情況,客觀評(píng)價(jià)三種不同治療方法對(duì)于貝爾麻痹的作用。方法:從南京市中醫(yī)院腦病科門診、病房、針灸科門診Bell麻痹患者中篩選出符合標(biāo)準(zhǔn)患者共80例,根據(jù)隨機(jī)對(duì)照表,分為排針平刺組(治療組)40例及傳統(tǒng)針刺組(對(duì)照組)40例,從南京市第一醫(yī)院神經(jīng)科門診Bell麻痹患者中篩選基礎(chǔ)治療組(單純口服藥物)40例�；A(chǔ)治療組為強(qiáng)的松及甲鈷胺口服;治療組采用排針平刺加基礎(chǔ)治療,無(wú)補(bǔ)瀉手法,留針4-6h;對(duì)照組以常規(guī)針刺加基礎(chǔ)治療,予以平補(bǔ)平瀉手法,留針時(shí)間30min�？诜幬镒曰颊呔驮\時(shí)開(kāi)始服用;針刺均從發(fā)病1周開(kāi)始,以2周作為1個(gè)療程;每周周一至周五共針刺5次;每周進(jìn)行一次療效評(píng)估,針刺總療程1個(gè)月。將記錄到的數(shù)據(jù)以SPSS16.0軟件進(jìn)行分析處理。結(jié)果:經(jīng)統(tǒng)計(jì)分析,三組病例治療前的基線資料(性別、年齡、病程、H-B面神經(jīng)功能計(jì)分)具有可比性(p0.05)。1、在臨床總療效方面治療組(排針平刺組)總有效率90%,對(duì)照組(常規(guī)針刺組)總有效率85%,基礎(chǔ)治療組總有效率77.5%。總有效率治療組對(duì)照組基礎(chǔ)治療組,經(jīng)統(tǒng)計(jì)學(xué)分析三組療效無(wú)統(tǒng)計(jì)學(xué)差異P=0.183(p0.05),在第3周愈顯率方面,治療組排針平刺組愈顯率35%,對(duì)照組(常規(guī)針刺組)愈顯率15%,基礎(chǔ)治療組愈顯率12.5%,愈顯率治療組對(duì)照組基礎(chǔ)治療組,經(jīng)統(tǒng)計(jì)學(xué)分析,三組愈顯率存在統(tǒng)計(jì)學(xué)差異p=0.031(p0.05)。2、在臨床癥狀改善方面(H-B積分量表),治療前組間比較無(wú)統(tǒng)計(jì)學(xué)差異(p0.05),具有可比性。組內(nèi)對(duì)比治療組、對(duì)照組及基礎(chǔ)治療組治療前后比較均有統(tǒng)計(jì)學(xué)差異(p0.05),組間對(duì)比,三組治療前后H-B評(píng)分無(wú)統(tǒng)計(jì)學(xué)差異(p=0.9050.05)。結(jié)論:1.三種治療方法對(duì)于特發(fā)性面神經(jīng)麻痹的臨床癥狀均有改善,最終療效相當(dāng);2.在特發(fā)性面神經(jīng)麻痹的治療中排針平刺結(jié)合基礎(chǔ)治療較其他兩種治療方法顯效更快。
[Abstract]:Background: idiopathic facial paralysis, also known as Bell's palsy of Bell's palsy, is one of the common clinical diseases. The incidence of this disease is high, according to epidemiological investigation. Bell's paralysis occurs in at least 3.35 million people in China every year, with an annual incidence of 26-34 / 100, 000. [As early as 1979 Bell's paralysis was recognized as one of the diseases suitable for acupuncture and moxibustion treatment by the World Health Organization (WHO). At present, there are various methods of acupuncture treatment for this disease. However, some of Bell's palsy still have poor curative effect. The purpose of this study is to combine the basic treatment with peeled acupuncture and flat acupuncture. General acupuncture combined with basic treatment and simple basic treatment in the treatment of Bell paralysis the efficacy of three different methods for the treatment of this disease put forward new ideas and methods. Objective: through strict randomization. In the control experiment, the curative effect of Pai Acupuncture combined with basic treatment, conventional Acupuncture combined with basic Therapy and simple basic treatment in Bell's paralysis was observed. House-Brackmann scale and functional integral scale were used to record the facial function before and after treatment. Objective to evaluate the effect of three different treatment methods on Bell's palsy. Methods: 80 patients with Bell paralysis were selected from the Department of Encephalopathy, Department of Encephalopathy, Department of Acupuncture and moxibustion in Nanjing Hospital of traditional Chinese Medicine. According to the random control table, 40 cases in the treatment group and 40 cases in the traditional acupuncture group were divided into two groups: the control group (n = 40) and the control group (n = 40). The basic treatment group (40 cases) was selected from the outpatient department of the Department of Neurology of the first Hospital of Nanjing. The primary treatment group was prednisone and mecobalamin. In the treatment group, the treatment group was treated with Pai acupuncture and acupuncture plus basic treatment without reinforcing and reducing manipulation, and the acupuncture was kept for 4-6 hours. The control group was treated with routine acupuncture plus basic treatment, and was treated with flat tonifying and reducing manipulation for 30 mins. The oral medicine was taken from the time of the patient's visit. Acupuncture all started from 1 week of onset and took 2 weeks as a course of treatment. Five times a week from Monday to Friday; The data were analyzed by SPSS16.0 software. Results: after statistical analysis, the baseline data (sex) of the three groups before treatment were analyzed. Age, course of disease and score of H-B facial nerve function were comparable. The total effective rate of the treatment group was 90% in the total clinical curative effect. The total effective rate of the control group (routine acupuncture group) was 85g, the total effective rate of the basic treatment group was 77.5%. The total effective rate of the control group was 77.5%. The total effective rate of the control group was the basic treatment group. After statistical analysis, there was no statistical difference among the three groups (P < 0. 183, P 0. 05). In the third week, the effective rate of treatment group was 35%. The obvious rate of the control group (routine acupuncture group) and the basic treatment group were 15%, 12.5% and 12.5%, respectively. There was statistical difference between the three groups in the effective rate of recovery. There was no statistical difference between the three groups in the improvement of clinical symptoms by H-B integral scale (p0.05). Comparison group, control group and basic treatment group were compared before and after treatment, there were significant differences between the two groups. There was no statistical difference in H-B score between the three groups before and after treatment. Conclusion the three treatments have improved the clinical symptoms of idiopathic facial paralysis, and the final curative effect is similar. 2. In the treatment of idiopathic facial paralysis, the combination of acupuncture and acupuncture combined with basic treatment was more effective than the other two methods.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.6

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