本文關(guān)鍵詞：神經(jīng)肌肉電針?lè)ㄖ委熋嫔窠?jīng)炎的臨床研究　出處：《中國(guó)人民解放軍醫(yī)學(xué)院》2016年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 面神經(jīng)炎 電針療法 放血療法 疏密波 肌電圖

【摘要】：目的：按照301醫(yī)院針灸科多年治療面神經(jīng)炎的經(jīng)驗(yàn),通過(guò)對(duì)160例面神經(jīng)炎患者進(jìn)行神經(jīng)肌肉電針?lè)ㄅc傳統(tǒng)治療方法對(duì)照研究,并對(duì)電針刺激評(píng)價(jià)面神經(jīng)炎的信度和效度進(jìn)行研究,為面神經(jīng)炎患者臨床選取更直接、更有效、更經(jīng)濟(jì)的評(píng)價(jià)和治療方案提供依據(jù)。方法：1.針灸治療：160例面神經(jīng)炎患者采用SPSS統(tǒng)計(jì)軟件進(jìn)行完全隨機(jī)分組法編號(hào),患者按就診順序?qū)?yīng)編號(hào)分成神經(jīng)肌肉電針組(A組)和傳統(tǒng)方案治療組(B組),每組患者各80人.A組就診第1周采用耳尖穴、完骨穴、內(nèi)耳區(qū)交替放血療法；第2-4周采用沿神經(jīng)肌肉走行,即按患側(cè)枕額肌、眼輪匝肌、提上唇肌、顴肌、口輪匝肌、下唇方肌分布取穴方法取5組穴位進(jìn)行治療。穴位主要為患側(cè)陽(yáng)白穴、陽(yáng)白旁穴；瞳子移穴、承泣穴；顴移穴、地倉(cāng)穴；迎香穴、上迎香穴；夾承漿穴、承漿旁穴。B組：第1周,予口服激素、神經(jīng)營(yíng)養(yǎng)藥物及改善循環(huán)藥物進(jìn)行治療；第2-4周采用第九版《針灸治療學(xué)》面神經(jīng)炎治療方案進(jìn)行取穴治療。主要穴位有患側(cè)陽(yáng)白穴、攢竹穴、四白穴、顴毼穴、地倉(cāng)穴、頰車(chē)穴、翳風(fēng)穴、牽正穴,太陽(yáng)穴、合谷穴.兩組患者電針均給予疏密波,2～100Hz交替進(jìn)行刺激。每日1次,留針30min,5天為一療程,休息2天,繼續(xù)下一療程,連續(xù)治療4療程后觀察臨床效果。2.電針刺激法評(píng)價(jià)面神經(jīng)炎的信度和效度：采用電針刺激表情肌時(shí)的反應(yīng),即電針刺激患側(cè)面部,根據(jù)表情肌反應(yīng)程度判斷面神經(jīng)受損情況(輕度、中度、重度),并以判斷預(yù)后(好、一般、差)；同時(shí)采用肌電圖評(píng)估法,根據(jù)觀察肌電圖提示面神經(jīng)損傷程度即完全損傷、不完全損傷、無(wú)損傷,以判斷預(yù)后；根據(jù)兩種檢測(cè)結(jié)果的差異性來(lái)檢驗(yàn)電針刺激法評(píng)價(jià)面神經(jīng)炎的信度和效度。結(jié)果：1.針灸治療結(jié)果顯示：神經(jīng)肌肉電針?lè)ńM患者面癱癥狀恢復(fù)快且完全,治愈率明顯優(yōu)于傳統(tǒng)方案組(P0.01)；有效率也優(yōu)于傳統(tǒng)方案組(P0.01)。2.面癱評(píng)價(jià)結(jié)果顯示：兩種方法評(píng)介面癱損傷程度無(wú)明顯差異(P0.05),對(duì)于預(yù)后的判斷是一致性(P0.05)。結(jié)論：1.放血療法合神經(jīng)肌肉電針?lè)ㄖ委熋嫔窠?jīng)炎能夠明顯縮短面神經(jīng)炎患者的病程,且恢復(fù)的更完全,比傳統(tǒng)方案治療面神經(jīng)炎更好,臨床上治療面神經(jīng)炎可參照此方案進(jìn)行。2.電針刺激法與肌電圖評(píng)估法在評(píng)價(jià)面神經(jīng)損傷方面一致,具有良好的信度和效度.因?yàn)殡娽槾碳しê?jiǎn)便、有效、低廉,值得臨床推廣應(yīng)用。
[Abstract]:Objective: according to the experience of treating facial neuritis in Department of Acupuncture and moxibustion of 301 Hospital, 160 cases of facial neuritis were treated with neuromuscular electroacupuncture and traditional treatment. The reliability and validity of electroacupuncture stimulation in evaluating facial neuritis were studied, which was more direct and effective for the patients with facial neuritis. Methods 1. Acupuncture and moxibustion was used to treat 160 patients with facial neuritis by SPSS software. The patients were divided into neuromuscular electroacupuncture group (group A) and traditional treatment group (group B) according to the corresponding numbering according to the order of consultation. 80 patients in each group were treated with Auricular acupoint and end bone point in the first week. Internal ear area alternate bloodletting therapy; In the 2-4 weeks, the nerve muscle was used, that is, the occipital frontalis muscle, orbicularis oculi muscle, levator lip muscle, zygomaticus muscle, orbicularis oris muscle. Treatment of 5 groups of acupoints by the distribution of the lower lip muscles. The acupoints are mainly Yangbai points and Yangbai points in the affected side. The pupil moves the acupoint, the Cheng sobs the acupoint; Zygomatic-shifting acupoint, Ducang acupoint; Yingxiang point, up Yingxiang point; Group B was treated with oral hormones, neurotrophic drugs and circulatory improvement drugs in the first week. In the 2-4 weeks, we used 9th version of "Acupuncture and moxibustion Therapeutics" to treat facial neuritis. The main acupoints were Yangbai point, Zanzhu point, Sibai point, zygomaticus point, Decang point, buccal che point and Yifeng point. The patients in the two groups were stimulated by electroacupuncture at 2100Hz. Once a day, the needle was kept for 5 days as a course of treatment, and the rest was 2 days. The clinical effect was observed after 4 consecutive courses of treatment. 2. The reliability and validity of electroacupuncture in evaluating facial neuritis: the reaction of electroacupuncture on facial expression muscle, that is, electroacupuncture to stimulate the affected side. Facial nerve injury (mild, moderate, severe) was judged according to the degree of expression muscle reaction, and the prognosis was evaluated (good, average, poor). At the same time, the method of electromyography was used to evaluate the degree of facial nerve injury, that is, complete injury, incomplete injury and no injury, according to the observation of EMG, in order to judge the prognosis. According to the difference of the two test results to test the reliability and validity of electroacupuncture stimulation in evaluating facial neuritis. Results 1. The results of acupuncture and moxibustion showed that the symptoms of facial paralysis in neuromuscular electroacupuncture group recovered quickly and completely. The cure rate was significantly better than that of the traditional regimen group (P 0.01). The effective rate was also better than that of the traditional regimen group (P 0.01). The evaluation results of facial paralysis showed that there was no significant difference between the two methods in evaluating the injury degree of facial paralysis (P0.05). Conclusion: 1. Bloodletting therapy combined with neuromuscular electroacupuncture for facial neuritis can significantly shorten the course of facial neuritis and recover more completely. Compared with the traditional treatment of facial neuritis, clinical treatment of facial neuritis can refer to this program .2.Electroacupuncture stimulation method and electromyography evaluation method in the evaluation of facial nerve injury is consistent. It has good reliability and validity, because electroacupuncture stimulation is simple, effective and cheap, so it is worth popularizing in clinic.
【學(xué)位授予單位】：中國(guó)人民解放軍醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R246.6

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