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  本文關鍵詞： 面癱 氣血不足 針藥合治 心理輔導 面肌功能鍛煉 臨床療效　出處：《湖北中醫(yī)藥大學》2013年碩士論文　論文類型：學位論文

【摘要】：目的 氣血不足型面癱嚴重影響患者身體和心理健康，本研究觀察臨床采用針刺配合中藥內(nèi)服為主、心理輔導與面部肌肉鍛煉為輔綜合治療該疾病的療效，并進行對比研究，探索較佳治療方法，提高康復率，為針藥綜合治療此型面癱提供全面可靠的依據(jù)。 方法 將符合氣血不足證型的64例周圍性面癱患者分為針刺綜合治療組（針刺組）和針藥綜合治療組（針藥組）兩組，針刺組32例采用針刺治療為主，心理輔導與面部肌肉鍛煉為輔治療。針刺取穴在一般面癱常規(guī)所取穴位的基礎上加上補益氣血，活血調(diào)氣的穴位，隔日一次，2周為一療程。配合適當?shù)拇朕o和方法適時適度引導患者進行心理調(diào)節(jié)，樹立正確疾病觀、康復觀；指導患者自行進行面部肌肉鍛煉，適當把握鍛煉的方法、強度和時限。以上治療方法均在治療兩個療程后評定療效。針藥組32例除采用上述針刺及輔助治療外，再予牽正散合八珍湯隨癥加減方口服，日一付，2周為一療程。在研究開始和完成一定療程后據(jù)病情變化記錄面神經(jīng)功能評分，完成面部殘疾指數(shù)問卷，記錄軀體功能指數(shù)FDIP,社會功能指數(shù)FDIS，統(tǒng)計分析其變化的顯著性意義，并進行安全性評價，由此評定兩組的臨床療效。 結(jié)果 1.兩組臨床療效比較：針刺組治愈率為32.3%，愈顯率為80.7%，總有效率為93.5%；針藥組治愈率為19.4%，愈顯率為51.7%，總有效率為77.4%。針藥組總有效例數(shù)、總有效率、治愈率、愈顯率均高于針刺組，經(jīng)統(tǒng)計學處理，差異有統(tǒng)計學意義（P0.05）。 2.兩組面神經(jīng)功能評分比較：治療前兩組間面神經(jīng)功能評分比較，無顯著差異（P0.05）。治療后兩組面神經(jīng)功能評分均增高(P0.05)，與針刺組比較，針藥組增高更明顯，且差異有統(tǒng)計學意義（P0.05）。 3.兩組FDI評分比較：治療前兩組間FDIP、FDIS比較，無顯著差異（P0.05）。治療后兩組FDIP、FDIS均增高(P0.05)，與針刺組比較，針藥組增高更明顯，且差異有統(tǒng)計學意義（P0.05）。 4.兩種療法治療氣血不足型面癱均未出現(xiàn)針刺不良反應，針藥組口服中藥后未出現(xiàn)不良反應。 結(jié)論 1.兩組臨床療效比較表明針藥組的治愈率和愈顯率優(yōu)于針刺組，提示針藥綜合治療氣血不足面癱有更確切的臨床療效，有助于提高此型面癱的康復率。 2.兩組治療方法都有助于改善患者面神經(jīng)功能，針藥組改善更明顯。 3.兩組治療方法都可提高患者的軀體功能指數(shù)和社會功能指數(shù)，針藥組提高更明顯。 4.兩組療法治療氣血不足型面癱均安全有效。
[Abstract]:Purpose Deficiency of qi and blood type facial paralysis seriously affected the patients' physical and mental health. This study observed the clinical efficacy of acupuncture combined with traditional Chinese medicine, psychological counseling and facial muscle exercise for the comprehensive treatment of the disease. A comparative study was carried out to explore a better treatment method and to improve the recovery rate, and to provide a comprehensive and reliable basis for the comprehensive treatment of this type of facial paralysis with acupuncture and medicine. Method Sixty-four patients with peripheral facial paralysis were divided into two groups: acupuncture group (acupuncture group) and acupuncture medicine group (acupuncture group). 32 cases in acupuncture group were treated mainly with acupuncture. Psychological counseling and facial muscle training as a supplementary treatment. Acupuncture points in the general facial paralysis on the basis of the routine points to add tonifying Qi and blood, blood points, Qi-regulating points, once every other day. 2 weeks as a course of treatment. With appropriate words and methods to guide the patients to conduct psychological adjustment, to establish a correct view of disease, rehabilitation view; Guide patients to exercise their own facial muscles, and properly grasp the methods of exercise. Strength and time limit. All the above treatment methods were evaluated after two courses of treatment. In addition to the above acupuncture and auxiliary treatment, 32 cases in the acupuncture and medicine group were given oral administration of Daozheng San and Bazhen decoction with syndrome plus or minus. Two weeks as a course of treatment. After the beginning of the study and the completion of a course of treatment according to the disease changes recorded facial nerve function score, complete the facial disability index questionnaire, recorded the body function index, social function index (FDIS). Statistical analysis of the significance of its changes, and safety evaluation, so as to evaluate the clinical efficacy of the two groups. Results 1. Comparison of clinical efficacy between the two groups: the cure rate of acupuncture group was 32.3g, the effective rate was 80.7 and the total effective rate was 93.5; The cure rate of acupuncture and medicine group was 19.4, the effective rate was 51.7 and the total effective rate was 77.4. The total effective cases, total effective rate, cure rate and effective rate of acupuncture group were higher than those of acupuncture group. The difference was statistically significant (P 0.05). 2. Comparison of facial nerve function score between the two groups before treatment, there was no significant difference in facial nerve function score between the two groups before treatment (P 0.05). After treatment, the score of facial nerve function in both groups increased significantly (P 0.05). Compared with the acupuncture group, the acupuncture and medicine group increased more obviously, and the difference was statistically significant (P 0.05). 3. Comparison of FDI scores between the two groups: before treatment, there was no significant difference between the two groups (P 0.05). After treatment, the FDI scores of the two groups were higher than that of the control group (P 0.05). Compared with the acupuncture group, the acupuncture and medicine group increased more obviously, and the difference was statistically significant (P 0.05). 4. There were no side effects of acupuncture in the treatment of facial paralysis with deficiency of qi and blood, but no adverse reactions in the group of acupuncture and medicine after oral administration of traditional Chinese medicine. Conclusion 1. The comparison of clinical curative effect between the two groups shows that the cure rate and curative effect of acupuncture and medicine group are better than that of acupuncture group, which indicates that the comprehensive treatment of acupuncture and medicine has more accurate clinical effect on facial paralysis due to deficiency of qi and blood, which is helpful to improve the rehabilitation rate of this type of facial paralysis. 2. Both treatment methods can improve the facial nerve function of the patients, especially in the acupuncture and medicine groups. 3. Both treatment methods can improve the body function index and social function index of the patients, especially in the acupuncture and medicine group. 4. Both groups were safe and effective in the treatment of deficiency of qi and blood.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R246.6

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