本文關鍵詞： 急性周圍性面癱 地塞米松 針刺療法 科摩羅傳統(tǒng)按摩法　出處：《南京中醫(yī)藥大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的：通過觀察西藥加針刺治療急性周圍性面癱和西藥加科摩羅傳統(tǒng)按摩法治療急性周圍性面癱的臨床療效,對兩種治療方案的療效進行比較,探討西藥加針刺治療周圍性面癱的優(yōu)勢,為周圍性面癱的針刺治療在科摩羅的推廣應用提供臨床依據(jù)。方法：60例急性周圍性面癱均為科摩羅國立醫(yī)院門診病人,按就診順序先后,分為對照組(單號,西藥加科摩羅傳統(tǒng)按摩方法)和治療組(雙號,西藥加針刺)各30例。對照組采用方案為腎上腺皮質(zhì)激素(地塞米松)40mmg/天,口服每次20mg,2次/天,連續(xù)用藥七天(這是科摩羅國立醫(yī)院治療急性周圍性面癱的常規(guī)用藥)。治療組在與對照組用相同的腎上腺皮質(zhì)激素(地塞米松)的基礎上,加針刺陽白、攢竹、絲竹空、地倉、頰車、牽正、翳風、合谷。配穴：鼻唇溝平坦加迎香,人中溝偏歪加水溝,味覺減退或舌麻加廉泉。針刺方法：患者采取仰臥位,采用蘇州華佗廠生產(chǎn)的“華佗牌”25-40mm長的一次性無菌米針進行針刺。穴位常規(guī)消毒后,陽白透魚腰,攢竹向魚腰或睛明方向針刺,地倉透頰車,迎香向鼻根部斜刺,水溝向上斜刺,廉泉向舌根方向針刺,其余穴常規(guī)針刺。面部穴采用平補平瀉法,合谷用瀉法。留針30min,每天治療一次,每周治療5天。二組均觀察5周。觀察指標：面部表情、眼裂閉合程度、鼻唇溝變淺程度、口角歪斜程度、額紋消失程度等主要癥狀。二組均于治療前、后記錄患者的病情并分析、比較其臨床療效。結(jié)果：1、主癥、癥狀比較：治療組治療前、后主癥、癥狀積分比較,有統(tǒng)計學意義(P0.05)。對照組治療前、后積分比較,雖然也有好轉(zhuǎn),但無統(tǒng)計學意義(P0.05)。治療組治療后的主癥、癥狀積分和對照組同期比較,有統(tǒng)計學意義(P0.05),腎上腺皮質(zhì)激素加針刺治療急性周圍性面癱的療效明顯好于腎上腺皮質(zhì)激素加科摩羅傳統(tǒng)按法。2、總有效率比較：治療組30例治療后痊愈8例,顯效16例,愈顯率為80%,有效6例,無效0例�？傆行�100%；對照組治療后沒有痊愈的,顯效只有1例,愈顯率為3.33%,有效29例,無效0例總有效率100%。兩組總有效率雖相似,但治療組的愈顯率明顯高于對照組。說明腎上腺皮質(zhì)激素加針刺治療周圍性面癱的總有效率優(yōu)于腎上腺皮質(zhì)激素加科摩羅傳統(tǒng)按摩法,尤其是愈顯率更為突出。3、在5周的針刺治療過程中,沒有發(fā)生任何不良反應。結(jié)論：1、腎上腺皮質(zhì)激素加針刺與腎上腺皮質(zhì)激素加科摩羅傳統(tǒng)按摩法均是治療急性周圍性面癱的有效方法。2、腎上腺皮質(zhì)激素加針刺治療急性周圍性面癱的療效優(yōu)于腎上腺皮質(zhì)激素加科摩羅傳統(tǒng)按摩法,具有痊愈率高、療程短等優(yōu)勢。3、針刺療法是治療急性周圍性面癱安全、有效的方法。
[Abstract]:Objective: to observe the clinical effects of western medicine combined with acupuncture in treating acute peripheral facial paralysis and western medicine plus Comorian traditional massage in the treatment of acute peripheral facial paralysis. To explore the advantages of western medicine plus acupuncture in the treatment of peripheral facial paralysis, and to provide a clinical basis for the popularization and application of acupuncture treatment of peripheral facial paralysis in Comoros. Methods 60 cases of acute peripheral facial paralysis were all outpatients of Comorian National Hospital. According to the order of visit, they were divided into control group (single number, western medicine plus Comorian traditional massage method) and treatment group (double number, western medicine and acupuncture). The control group was treated with adrenocortical hormone (dexamethasone 40mmg / day). The treatment group was treated with the same adrenocortical hormone (dexamethasone) and acupuncture on the basis of the same adrenocortical hormone (dexamethasone) as the control group. Zanzhu, Silk Bamboo empty, ground Cang, buccal car, pull Zheng, Yi Feng, Hegu. Matching points: nasolabial groove flat plus incense, human middle groove inclined to add water ditch, taste loss or tongue Ma Jia Lian Quan. Acupuncture method: the patient takes supine position, A single sterile rice needle of 25-40 mm in length produced by Huatuo Factory in Suzhou was used for acupuncture. After routine disinfection of acupoints, Yang white penetrated the fish waist, and the bamboo was needled toward the fish waist or clear direction, and the barnyard was punctured to the root of the nose, and the incense was skewed to the root of the nose. Shuigou upward oblique prick, Lianquan to the root of tongue acupuncture, the rest point routine acupuncture. Facial acupoints with flat tonifying and reducing method, Hegu method. Retention of acupuncture 30 minutes, treatment once a day, treatment 5 days a week. Both groups were observed for 5 weeks. Observation index: facial expression, The degree of closure of eye fissure, the degree of shallow nasolabial sulcus, the degree of obliquity of mouth angle, the degree of disappearance of frontal stripe, etc. Before and after treatment, the patients in both groups were recorded and analyzed, and their clinical effects were compared. Symptom comparison: before and after treatment, the scores of main symptoms and symptoms in the treatment group were significantly higher than those in the control group (P 0.05). Although the scores before and after treatment in the control group were also improved, there was no significant difference between the treatment group and the treatment group. Symptom score was compared with control group in the same period. The effect of adrenocortical hormone plus acupuncture on acute peripheral facial paralysis was better than that of adrenocortical hormone combined with Comorian traditional method .2.The total effective rate was compared: 8 cases were cured and 16 cases had remarkable effect after treatment in the treatment group. The effective rate was 80%, the effective rate was 6 cases, and the ineffective rate was 0 cases. The total effective rate was 100 cases. In the control group, there were only 1 case with remarkable effect, only 1 case with remarkable effect after treatment. The effective rate was 3.33%, the effective rate was 29 cases, and the total effective rate was 100 cases. The total effective rate of the two groups was similar, But the effective rate of the treatment group was significantly higher than that of the control group. It showed that the total effective rate of adrenocortical hormone plus acupuncture in treating peripheral facial paralysis was better than that of adrenal corticosteroid plus Comorian traditional massage. In particular, the recovery rate is more prominent. 3. During the 5 weeks of acupuncture treatment, Conclusion 1, adrenocortical hormone plus acupuncture and adrenocortical hormone plus Comorian traditional massage are effective methods for the treatment of acute peripheral facial paralysis, and adrenocortical hormone plus acupuncture are effective methods for treatment of acute peripheral facial paralysis. The curative effect of acute peripheral facial paralysis is better than that of adrenal corticosteroid plus Comorian traditional massage. Acupuncture therapy is a safe and effective method for the treatment of acute peripheral facial paralysis.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.6

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