淺刺針法治療貝爾面癱急性期的臨床研究
發(fā)布時間：2019-06-13 14:54
【摘要】：目的:通過隨機(jī)對照設(shè)計,與單純西藥口服治療作對比研究淺刺針法治療貝爾面癱急性期的臨床療效;重點在于規(guī)范針灸治療貝爾面癱的量化操作,提倡早期干預(yù),輕淺刺激,以激發(fā)經(jīng)氣,振奮陽氣為度;為貝爾面癱急性期的治療提供一份有效的循征證據(jù)。方法:收集廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院,針灸科、康復(fù)科、腦病科和廣西中醫(yī)藥大學(xué)第一附屬醫(yī)院仁愛分院針灸科,廣西壯醫(yī)院針灸科、廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院針灸科診斷為貝爾面癱急性期患者。把符合貝爾面癱急性期診斷患者60例,按就診次序進(jìn)行患者的編號,根據(jù)編號運用計算機(jī)軟件SPSS22.0按1:1比例進(jìn)行編號隨機(jī)分組,分為試驗組30例(淺針針法組),和對照組30例(單純西藥組)。分別評價治療1周和治療2周后的House-Brachmann(H-B)面神經(jīng)功能,面部殘疾指數(shù)FDI,癥狀體征綜合改善情況,不良事件和安全性評價。結(jié)果:1.納入治療前試驗組和對照組的病情、病程、年齡、性別不存在明顯的統(tǒng)計學(xué)差異,即基線一致;組間具有可比性。2.House-Brachmann面神經(jīng)分級評價:試驗組和對照組治療1周和治療2周的House-Brachmann面神經(jīng)分級療效和治療前組內(nèi)療效比較存在統(tǒng)計學(xué)差異,P0.05,治療1周后的試驗組和對照組的組間House-Brachmann面神經(jīng)分級療效比較不存在統(tǒng)計學(xué)差異,P0.05,治療2周后的試驗組和對照組的組間House-Brachmann面神經(jīng)分級療效比較存在統(tǒng)計學(xué)差異,P0.05。3.House-Brachmann面神經(jīng)評分:治療1周后唯有對照組組內(nèi)比較在“味覺障礙”和“聽覺過敏”不存在療效上的統(tǒng)計學(xué)差異,P0.05,其他方面和試驗組所有指標(biāo)都存在統(tǒng)計學(xué)上的差異,P0.05;治療1周后的組間比較在“皺眉”、“眼險開合”、“鼻唇溝”、“聳鼻運動”、“示齒歪斜”、“鼓腮”、綜合評分上不存在統(tǒng)計學(xué)差異,P0.05;但是在“食物滯留”、“味覺障礙”、“聽覺過敏”、“流淚不適”、“耳周疼痛”上存在統(tǒng)計學(xué)差異,P0.05。治療2周后試驗組和對照組組內(nèi)比較在所有指標(biāo)上都存在統(tǒng)計學(xué)差異,P0.05,而治療2周后組間比較僅在“皺眉”、“眼險開合”、“鼻唇溝”、“食物滯留”、“聽覺過敏”、和綜合評分上存在統(tǒng)計學(xué)差異,P0.05。4.殘疾指數(shù)FDI:在治療1周后,試驗組的軀體FDI和社會FDI組內(nèi)比較都存在統(tǒng)計學(xué)差異,P0.05,而對照組在組內(nèi)比較軀體FDI上不存在統(tǒng)計學(xué)差異,P0.05,治療1周后組間比較,軀體FDI不存在統(tǒng)計學(xué)差異,P0.05,社會FDI存在統(tǒng)計學(xué)差異,P0.05。治療2周后在試驗組和對照組的組間、組內(nèi)比較都存在統(tǒng)計學(xué)差異,P0.05。5.癥狀體征綜合改善情況:治療1周后試驗組痊愈2例,顯效5例,有效10例,無效13例;對照組痊愈3例,顯效6例,有效8例,無效13例;經(jīng)Wilcoxon秩和檢驗后,發(fā)現(xiàn)Z=-0.291,P=0.771,統(tǒng)計學(xué)上不存在明顯的差異。治療2周后試驗組痊愈13例,顯效10例,有效5例,無效2例;對照組痊愈6例,顯效8例,有效6例,無效10例;Wilcoxon秩和檢驗后,發(fā)現(xiàn)試驗組和對照組療效比較,Z=-2.702,P=0.007,存在明顯的統(tǒng)計學(xué)差異。結(jié)論:淺刺針法和單純西藥口服治療貝爾面癱急性期都有療效,從短期療效、副作用、安全性方面考慮淺刺針法療效明顯優(yōu)于單純西藥口服治療。但其確切的療效仍然需要多中心、高質(zhì)量、大規(guī)模的試驗去驗證支持。
[Abstract]:Objective: To study the clinical effect of acupuncture in the treatment of the acute phase of Bell's facial paralysis by a randomized controlled design, compared with the traditional western medicine oral therapy. The focus is to regulate the quantitative operation of acupuncture and moxibustion in the treatment of Bell's facial paralysis, and to promote early intervention and light-light stimulation to stimulate the menstrual flow. It is an effective way to follow the treatment of the acute phase of Bell's paresis. Methods: The first Affiliated Hospital of the Chinese University of Traditional Chinese Medicine, the Acupuncture and Moxibustion Section, the Medical College, the Encephalopathy Section and the First Affiliated Hospital of the Chinese Medicine University in Guangxi, the Acupuncture and Moxibustion Section of the First Affiliated Hospital of Guangxi University of Traditional Medicine, the Acupuncture and Moxibustion Section of the Zhuang Hospital of Guangxi, and the Department of Acupuncture and Moxibustion of the Affiliated Ruikang Hospital of Guangxi University of Traditional Chinese Medicine were diagnosed as the patients with the acute phase of Bell facial paralysis. 60 patients who were in the acute phase of Bell's facial paralysis were given the number of the patients according to the order of treatment. The number of the patients was randomly divided according to the number using the computer software SPSS10.0 according to the ratio of 1:1. The number of the patients was divided into three groups (30 cases of superficial acupuncture) and 30 cases of the control group (simple western medicine group). House-Brachmann (H-B) facial nerve function, facial disability index, comprehensive improvement of symptoms and signs, adverse events and safety evaluations were evaluated for 1 week and 2 weeks after treatment, respectively. Results:1. There was no significant statistical difference in the condition, course, age, and sex of the pre-treatment and control groups, that is, the baseline was consistent; the groups were comparable.2. House-Brachmann's facial nerve grading evaluation: There was a statistically significant difference in the curative effect of the two-week and 2-week-old House-Brachmann facial nerve in the test group and the control group, P0.05). There was no statistical difference between the two groups of House-Brachmann's facial nerve in the test group and the control group after 1 week of treatment. There was a statistically significant difference in the efficacy of House-Brachmann's facial nerve in the test group and the control group after 2 weeks of treatment. The results showed that there was no statistically significant difference in the therapeutic effect of the "gustatory disorder" and the "auditory allergy" in the control group after 1 week of treatment, P0.05, There was a statistically significant difference in all other aspects and in the test group, P0.05; there was no statistical difference between the groups in the "frowning", "opening and closing of eyes", "nasolabial", "nasal movement", "tooth skew", "a drum" and comprehensive scores after 1 week of treatment, but in the "food retention", the "gustatory disorder", There was a statistical difference in "auditory allergy", "lacrimation" and "ear-to-ear pain", P0.05. There was a statistical difference between the test group and the control group after 2 weeks of treatment, but the difference between the groups was only in the "frowning", the "opening and closing of eyes", the "nasolabial", the "food retention", the "auditory allergy", and the comprehensive score after 2 weeks of treatment. The results showed that there was no statistical difference between the body FDI and the social FDI group in the test group after 1 week of treatment, but there was no statistical difference in the body FDI in the control group, P0.05, compared with that of the control group after 1 week of treatment, there was no statistical difference between the body and the body, P0.05, There was a statistical difference in the social FDI, P0.05. There was a statistically significant difference between the groups in the test group and the control group after 2 weeks of treatment, P 0.05. The comprehensive improvement of symptoms and signs:2 cases were cured after 1 week of treatment,5 cases were effective,10 cases were effective,13 cases were not valid,3 cases were cured in the control group,6 cases were markedly effective,8 cases were effective and 13 cases were not valid; after Wilcoxon rank and test, Z =-0.291, P = 0.771, and there was no significant difference in statistics. After 2 weeks of treatment,13 cases were cured,10 cases were effective,5 cases were effective,2 cases were not valid,6 cases were cured in the control group,8 cases were markedly effective,6 cases were effective and 10 cases were not valid; after Wilcoxon rank and test, the results of the test group and the control group were found to be comparable, and Z =-2.702, P = 0.007, and there was a significant statistical difference. Conclusion: It is effective to treat the acute phase of Bell's facial paralysis by the method of superficial needling and simple western medicine, and the effect of the acupuncture on the short-term effect, side effect and safety is better than that of the traditional western medicine. But its exact efficacy still requires a multi-center, high-quality, large-scale trial to validate support.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.6
本文編號：2498598
[Abstract]:Objective: To study the clinical effect of acupuncture in the treatment of the acute phase of Bell's facial paralysis by a randomized controlled design, compared with the traditional western medicine oral therapy. The focus is to regulate the quantitative operation of acupuncture and moxibustion in the treatment of Bell's facial paralysis, and to promote early intervention and light-light stimulation to stimulate the menstrual flow. It is an effective way to follow the treatment of the acute phase of Bell's paresis. Methods: The first Affiliated Hospital of the Chinese University of Traditional Chinese Medicine, the Acupuncture and Moxibustion Section, the Medical College, the Encephalopathy Section and the First Affiliated Hospital of the Chinese Medicine University in Guangxi, the Acupuncture and Moxibustion Section of the First Affiliated Hospital of Guangxi University of Traditional Medicine, the Acupuncture and Moxibustion Section of the Zhuang Hospital of Guangxi, and the Department of Acupuncture and Moxibustion of the Affiliated Ruikang Hospital of Guangxi University of Traditional Chinese Medicine were diagnosed as the patients with the acute phase of Bell facial paralysis. 60 patients who were in the acute phase of Bell's facial paralysis were given the number of the patients according to the order of treatment. The number of the patients was randomly divided according to the number using the computer software SPSS10.0 according to the ratio of 1:1. The number of the patients was divided into three groups (30 cases of superficial acupuncture) and 30 cases of the control group (simple western medicine group). House-Brachmann (H-B) facial nerve function, facial disability index, comprehensive improvement of symptoms and signs, adverse events and safety evaluations were evaluated for 1 week and 2 weeks after treatment, respectively. Results:1. There was no significant statistical difference in the condition, course, age, and sex of the pre-treatment and control groups, that is, the baseline was consistent; the groups were comparable.2. House-Brachmann's facial nerve grading evaluation: There was a statistically significant difference in the curative effect of the two-week and 2-week-old House-Brachmann facial nerve in the test group and the control group, P0.05). There was no statistical difference between the two groups of House-Brachmann's facial nerve in the test group and the control group after 1 week of treatment. There was a statistically significant difference in the efficacy of House-Brachmann's facial nerve in the test group and the control group after 2 weeks of treatment. The results showed that there was no statistically significant difference in the therapeutic effect of the "gustatory disorder" and the "auditory allergy" in the control group after 1 week of treatment, P0.05, There was a statistically significant difference in all other aspects and in the test group, P0.05; there was no statistical difference between the groups in the "frowning", "opening and closing of eyes", "nasolabial", "nasal movement", "tooth skew", "a drum" and comprehensive scores after 1 week of treatment, but in the "food retention", the "gustatory disorder", There was a statistical difference in "auditory allergy", "lacrimation" and "ear-to-ear pain", P0.05. There was a statistical difference between the test group and the control group after 2 weeks of treatment, but the difference between the groups was only in the "frowning", the "opening and closing of eyes", the "nasolabial", the "food retention", the "auditory allergy", and the comprehensive score after 2 weeks of treatment. The results showed that there was no statistical difference between the body FDI and the social FDI group in the test group after 1 week of treatment, but there was no statistical difference in the body FDI in the control group, P0.05, compared with that of the control group after 1 week of treatment, there was no statistical difference between the body and the body, P0.05, There was a statistical difference in the social FDI, P0.05. There was a statistically significant difference between the groups in the test group and the control group after 2 weeks of treatment, P 0.05. The comprehensive improvement of symptoms and signs:2 cases were cured after 1 week of treatment,5 cases were effective,10 cases were effective,13 cases were not valid,3 cases were cured in the control group,6 cases were markedly effective,8 cases were effective and 13 cases were not valid; after Wilcoxon rank and test, Z =-0.291, P = 0.771, and there was no significant difference in statistics. After 2 weeks of treatment,13 cases were cured,10 cases were effective,5 cases were effective,2 cases were not valid,6 cases were cured in the control group,8 cases were markedly effective,6 cases were effective and 10 cases were not valid; after Wilcoxon rank and test, the results of the test group and the control group were found to be comparable, and Z =-2.702, P = 0.007, and there was a significant statistical difference. Conclusion: It is effective to treat the acute phase of Bell's facial paralysis by the method of superficial needling and simple western medicine, and the effect of the acupuncture on the short-term effect, side effect and safety is better than that of the traditional western medicine. But its exact efficacy still requires a multi-center, high-quality, large-scale trial to validate support.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R246.6
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