發(fā)布時間：2018-09-19 21:16

【摘要】：目的:本研究選用隨機對照法,經(jīng)過將井穴放血聯(lián)合星狀神經(jīng)節(jié)阻滯(stellate ganglion block,SGB)治療急性期Bell面癱的臨床效果與常規(guī)的針刺治療進行對比,目的在于探究井穴放血聯(lián)合星狀神經(jīng)節(jié)阻滯(stellate ganglion block,SGB)對急性期Bell面癱的療效是否優(yōu)于普通的針刺治療。方法:本研究選取2014年9月至2016年10月于河北北方學院附屬第二醫(yī)院神經(jīng)內科門診就診及住院治療經(jīng)臨床確診的急性期Bell面癱患者92例。按照隨機數(shù)表法,將其分為研究組與對照組,每組46例。兩組患者的基礎治療均給予強的松、泛昔洛韋、甲鈷胺膠囊以及維生素B1,研究組急性期給予井穴放血及星狀神經(jīng)節(jié)阻滯(stellate ganglion block,SGB),急性期過后給予常規(guī)針刺治療;對照組急性期只給予上述基礎藥物治療,急性期過后給予常規(guī)針刺治療。觀察兩組患者的年齡、病程、性別以及病因,兩組患者治療前面癱的程度分級及患病側,兩組患者治療前后的眼裂情況、額紋深淺、鼻前庭活動情況、閉眼情況、示齒時嘴角歪斜情況、鼻唇溝深淺情況、舌前三分之二的味覺、吹口哨及鼓腮狀況、耳后疼痛情況以及聽覺情況的十項評分,兩組患者治療前后的H-B總評分、FDI評分以及兩組患者的療效。結果:兩組患者年齡、性別、病程方面比較,差異無統(tǒng)計學意義(P0.05)。兩組每種病因的患者例數(shù)相比較,差異無統(tǒng)計學意義(P0.05)。治療前研究組輕中度面癱患者21例、中重度面癱患者25例與對照組輕中度面癱患者23例、中重度面癱患者23例,患者患病側研究組右側22例、左側24例與對照組右側24例、左側22例,差異無統(tǒng)計學意義(P0.05)。治療前研究組眼裂大小評分、額紋深淺評分、鼻前庭活動情況評分、閉眼情況評分、示齒時嘴角歪斜情況評分、鼻唇溝深淺情況評分、舌前三分之二的味覺評分、吹口哨及鼓腮狀況評分、耳后疼痛情況評分、聽覺評分與對照組評分相比,差異無統(tǒng)計學意義(P0.05)。治療后研究組眼裂大小評分、額紋深淺評分、鼻前庭活動情況評分、閉眼情況評分、示齒時嘴角歪斜情況評分、鼻唇溝深淺情況評分、舌前三分之二的味覺評分、吹口哨及鼓腮狀況評分、耳后疼痛情況評分、聽覺評分明顯小于對照組各項評分,差異有統(tǒng)計學意義(P0.05)。研究組治療前H-B總評分、社會功能評分及軀體功能評分與對照組的各項評分相比較,差異無統(tǒng)計學意義(P0.05)。研究組治療后H-B總評分明顯小于對照組治療后H-B總評分,差異有統(tǒng)計學意義(P0.05)。研究組總有效率97.83%明顯大于對照組84.78%,顯效及治愈的人數(shù)均分別多于對照組,差異有統(tǒng)計學意義(P0.05)。研究組治療后社會功能評分明顯小于對照組,研究組治療后軀體功能評分明顯大于對照組,差異有統(tǒng)計學意義(P0.05)。結論:井穴放血聯(lián)合星狀神經(jīng)節(jié)阻滯(stellate ganglion block,SGB)療法的臨床療效要明顯優(yōu)于普通的針刺治療,井穴放血聯(lián)合星狀神經(jīng)節(jié)阻滯(stellate ganglion block,SGB)療法值得在臨床上進行推廣。
[Abstract]:Objective: To compare the clinical effect of well point bleeding combined with stellate ganglion block (SGB) in the treatment of acute Bell facial paralysis with that of conventional acupuncture, and to explore the effect of well point bleeding combined with stellate ganglion block (SGB) in the treatment of acute Bell facial paralysis. Methods: From September 2014 to October 2016, 92 patients with Bell facial paralysis were selected from the Department of Neurology, the Second Affiliated Hospital of Hebei North University. According to the method of random number table, they were divided into study group and control group, with 46 patients in each group. All the patients were given prednisone, famciclovir, Mecobalamin capsule and vitamin B1 as the basic treatment. The study group was given well point bloodletting and stellate ganglion block (SGB) in the acute phase and routine acupuncture treatment after the acute phase. The age, course of disease, sex and etiology of the two groups were observed. The degree of facial paralysis and the side of the disease were graded before and after treatment. The ocular fissure, frontal lines, nasal vestibular activity, eye closure, angle of mouth when showing teeth, depth of nasolabial groove, two-thirds of the sense of taste before the tongue, whistling and drum were observed before and after treatment. Results: There was no significant difference in age, sex and course of disease between the two groups (P 0.05). There was no significant difference in the number of patients with each cause between the two groups (P 0.05). Before treatment, 21 patients with mild to moderate facial paralysis, 25 patients with moderate to severe facial paralysis and 23 patients with mild to moderate facial paralysis, 23 patients with moderate to severe facial paralysis, 22 patients with right side of the study group, 24 patients with left side of the control group and 24 patients with right side, 22 patients with left side of the control group, the difference was not statistically significant (P 0.05). There was no significant difference between the study group and the control group in terms of shallow score, nasal vestibular activity score, eye closure score, mouth angle deviation score, nasolabial groove depth score, two-thirds of the taste score before the tongue, whistle and gill status score, postaural pain score, and auditory score (P 0.05). The scores of fissure size, frontal vein depth, nasal vestibular activity, eye closure, mouth angle deviation, nasolabial groove depth, two-thirds of the tongue, whistling and gills, post-aural pain, and auditory scores were significantly lower than those of the control group. Significance (P 0.05). There was no significant difference in the total H-B score, social function score and somatic function score between the study group and the control group before treatment (P 0.05). The total H-B score in the study group was significantly lower than that in the control group after treatment (P 0.05). The total effective rate in the study group was 97.83% higher than that in the control group (P 0.05). The score of social function in the study group was significantly lower than that in the control group, and the score of somatic function in the study group was significantly higher than that in the control group (P 0.05). The clinical effect of e-ganglion block (SGB) therapy is obviously better than that of ordinary acupuncture therapy. The combination of well point bleeding and stellate ganglion block (SGB) therapy is worthy of clinical promotion.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R745.12

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