本文選題：面肌痙攣　切入點：顳三針　出處：《云南中醫(yī)學院》2017年碩士論文

【摘要】：目的:觀察治療組(常規(guī)針刺+顳三針+小醒腦開竅法)和對照組(常規(guī)針刺)治療原發(fā)性面肌痙攣的臨床效果,為治療該病尋找優(yōu)勢化的治療方案提供參考。方法:將70例患者采用隨機數(shù)字分組法分為治療組(體針+顳三針+小醒腦開竅法)和對照組(常規(guī)針刺),每組35人。每組隔日治療一次,10次為一個療程,每個療程后對兩組面肌痙攣強度(Cohen分級)、頻度(Penn分級)的變化進行療效評價,并用統(tǒng)計學的方法進行分析。結果:1.治療前:治療前對兩組患者的年齡、證型、病程等基本資料進行比較,均P0.05,差異無統(tǒng)計學意義,兩組患者的資料具有可比性。對兩組患者治療前的痙攣強度、頻度分級組間比較,均為P0.05,差異無統(tǒng)計學意義,兩組患者具有可比性。2.治療期間:(1)第一療程結束:治療組在第一療程治療結束時痙攣強度、頻度與治療前組內(nèi)比較,均為P0.05,差異有統(tǒng)計學意義,表明治療組治療方法對痙攣強度、頻度有改善。對照組在第一療程治療結束時痙攣強度、頻度與治療前組內(nèi)比較,均為P0.05,差異有統(tǒng)計學意義,表明對照組治療方法對痙攣強度、頻度有改善。將兩組痙攣強度、頻度分級組間比較,均為P0.05,差異無統(tǒng)計學意義。表明治療組與對照組在第一療程治療結束時緩解痙攣強度和頻度的程度上組間比較無明顯差異。(2)第二療程結束:第二療程結束時,將兩組痙攣強度、頻度分級組間比較,P0.05,差異有統(tǒng)計學意義。表明治療組與對照組在第二療程治療結束時緩解痙攣強度和頻度的程度上組間比較有差異,治療組優(yōu)于對照組。3.第三個療程結束:(1)痙攣強度、頻度比較:三個療程結束時,將兩組痙攣強度、頻度分級組間比較,均為P0.05,差異有統(tǒng)計學意義。表明三個療程結束后,兩組治療方法均能明顯降低面肌痙攣的強度、頻度,且治療組的痙攣強度、頻度下降效果明顯優(yōu)于對照組。(2)總體療效組間比較:治療組35例患者,脫落4例,完成治療共計31例,其中治愈13例,顯效12例,有效3例,無效3例,總有效率90.32%;對照組35例患者,脫落5例,完成治療共計30例,其中治愈6例,顯效8例,有效10例,無效6例,總有效率80.0%。兩組總有效率P0.05,差異有統(tǒng)計學意義,表明治療結束后兩組皆有較好的療效,治療組療效明顯優(yōu)于對照組,面肌痙攣的強度、頻度有了明顯的改善。(3)病程分布的療效分析:將治療組和對照組按病程分布情況比較療效,治療組P0.01,差異有顯著統(tǒng)計學意義;對照組P0.05,差異有統(tǒng)計學意義。說明病程越短療效越好。4.隨訪結果:治療結束3月后電話隨訪痊愈患者,治療組痊愈13例,輕度復發(fā)4例。對照組痊愈6例,輕度復發(fā)3例,其余沒有異常情況。結論:1.常規(guī)針刺+顳三針+小醒腦開竅法治療原發(fā)性面肌痙攣有效,且療效優(yōu)于常規(guī)針刺;2.治療原發(fā)性面肌痙攣病程越短療效越好。
[Abstract]:Objective: to observe the clinical effect of treating primary hemifacial spasm in the treatment group (routine acupuncture method) and the control group (routine acupuncture method), so as to provide reference for the treatment of primary facial spasm.Methods: 70 patients were randomly divided into two groups: treatment group (body acupuncture) and control group (routine acupuncture group, 35 persons in each group).Each group was treated every other day for 10 times as a course of treatment. After each course of treatment, the changes of strength of hemifacial spasm, Cohen grade, frequency and Penn grade were evaluated and analyzed by statistical method.The result is 1: 1.Before treatment: the two groups of patients before the age, syndrome type, course of the basic data were compared, all P0.05, the difference was not statistically significant, the two groups of patients with comparable data.There was no significant difference in spasm intensity and frequency between the two groups (P 0.05), and there was no significant difference between the two groups.At the end of the first course of treatment, the intensity of spasticity in the treatment group was significantly higher than that in the pre-treatment group (P 0.05), indicating that the treatment group had improved the intensity and frequency of the spasm.The spasm intensity and frequency of the control group at the end of the first course of treatment were all significantly higher than that of the pre-treatment group (P 0.05), which indicated that the control group had improved the intensity and frequency of the spasm.There was no significant difference in spasm intensity and frequency between the two groups (P 0.05).The results showed that there was no significant difference in the degree of relieving spasm intensity and frequency between the treatment group and the control group at the end of the first course of treatment.There was significant difference between the frequency grading groups (P 0.05).The results showed that there was significant difference between the treatment group and the control group in the degree of relieving spasm intensity and frequency at the end of the second course of treatment, and the treatment group was better than the control group.Comparison of spasm intensity and frequency at the end of the third course of treatment: at the end of the three courses, the spasmodic intensity and frequency of the two groups were compared as P0.05, the difference was statistically significant.The results showed that the strength and frequency of hemifacial spasm were significantly decreased in both groups after three courses of treatment, and the effect of spasm intensity and frequency in the treatment group was significantly better than that in the control group.Among them, 13 cases were cured, 12 cases were effective, 3 cases were effective, 3 cases were ineffective, and the total effective rate was 90.32 cases.10 cases were effective, 6 cases were ineffective, the total effective rate was 80.0%.The total effective rate of the two groups was significantly higher than that of the control group (P 0.05), the difference was statistically significant, which indicated that the two groups had better curative effect after the end of the treatment, and the curative effect of the treatment group was obviously better than that of the control group.The curative effect analysis of the disease course distribution: the treatment group and the control group according to the course of disease distribution comparison curative effect, the treatment group P0.01, the difference has the significant statistical significance, the control group P0.05, the difference has the statistical significance.The shorter the course, the better the curative effect. 4.Results: 13 cases were cured and 4 cases had mild recurrence in the treatment group.In the control group, 6 cases were cured, 3 cases were mild recurrence, and the rest were not abnormal.Conclusion 1.Routine acupuncture was effective in treating primary hemifacial spasm, and the curative effect was better than that of routine acupuncture.The shorter course of treatment of primary hemifacial spasm, the better.
【學位授予單位】：云南中醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R246.6

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