文章摘要
不同毫针针刺手法配合透刺治疗周围性面瘫的临床研究
Clinical study of different needling manipulations combined with penetrating needling in the treatment of peripheral facial paralysis
投稿时间:2020-02-24  修订日期:2020-02-24
DOI:
中文关键词: 周围性面瘫  不同毫针针刺手法  中医症状评分  免疫球蛋白
英文关键词: peripheral facial paralysis  different needle acupuncture techniques  TCM symptom score  immunoglobulin
基金项目:
作者单位E-mail
高嘉营 辽宁中医药大学附属医院 辽宁沈阳 110032 gaojiaying1985@163.com 
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中文摘要:
      目的:通过不同毫针针刺手法配合透刺治疗周围性面瘫患者,探究其临床疗效与机制,并检测观察血清中IgG、IgA、IgM水平的变化及意义。方法:应用随机对照方法收集于我院2016年4月~2018年11月期间诊治的150例周围性面瘫患者,随机分为3组(每组50例)。针刺补法组治疗方式为透刺联合捻转补法,针刺泻法组治疗方式为透刺联合捻转泻法,平补平泻组治疗方式为透刺联合捻转平补平泻法,隔日治疗1次,1个周期治疗10次,治疗20次后观察临床疗效、中医症状评分、Stennert面神经麻痹评分改善情况,并检测外周血清IgG、IgA、IgM的表达水平,比较免疫指标的变化与病情、疗效的关系。结果:治疗后,补法组治疗有效率为88%,泻法组为84%,平补平泻组为80%,与平补平泻组比较,针刺补法组提高更为显著(P<0.05);三组患者治疗前与治疗后中医症状评分结果:三组患者经治疗后,症状均有所改善,差异明显(P<0.05);治疗后,针刺补法组与平补平泻组比较,口角歪斜程度、眼裂闭合程度有较明显的改善,差异有统计学意义(P<0.05);经治疗3组患者的Stennert面神经麻痹评分均显著降低(P<0.05),治疗后组间进行对比,补法组与泻法组比较无差异(P>0.05),与平补平泻组比较差异显著(P<0.05),泻法组与平补平泻组进行对比无差异(P>0.05);经治疗3组血清IgG、IgA、IgM表达水平均显著降低(3组P值=0.000<0.05),补法组与平补平泻组对比降低更为明显(P<0.05)。结论:针刺补法治疗优于平补平泻针刺治疗,能显著提高周围性面瘫的临床治疗有效率,有效改善面神经功能及中医症状,且可以通过血清IgG、IgA、IgM表达水平及检测结果的异常改变来预测周围性面瘫发病的严重程度并对疗效进行判断,应广泛推广。
英文摘要:
      Objective:To explore the clinical efficacy and mechanism of different needling manipulations combined with penetrating needling in the treatment of peripheral facial paralysis,and to detect and observe the changes and significance of serum IgG,IgA and IgM levels.Methods:150 patients with peripheral facial paralysis treated in our hospital from April 2016 to November 2018 were randomly divided into three groups (50 cases in each group).Acupuncture reinforcing method group was treated by penetrating needling combined with twisting reinforcing method. Acupuncture reinforcing and reducing method group was treated by penetrating needling combined with twisting reinforcing and reducing method. Pingbu reinforcing and reducing group was treated by penetrating needling combined with twisting reinforcing and reducing method once every other day and 10 times in a cycle.After 20 times of treatment,clinical efficacy,TCM symptom score and Stennert facial nerve paralysis score were observed,and peripheral serum IgG was detected.The expression levels of IgA and IgM were compared,and the relationship between the changes of immune indexes and the condition and curative effect was compared.Results:After treatment,the effective rate was 88% in Bufa group,84% in Xiexi group and 80% in Pingbu Pingxie group.Compared with Pingbu Pingxie group,the improvement of acupuncture Bufa group was more significant(P<0.05).The scores of TCM symptoms in three groups before and after treatment were as follows:After treatment,the symptoms of the three groups were improved,with significant difference(P<0.05);after treatment,the acupuncture Bufa group and Pingbu Pingxie group improved significantly(P<0.05).Compared with the control group,the degree of deviation of mouth angle and closure of ocular fissure were significantly improved(P<0.05),and the scores of Steiner facial paralysis in the three groups were significantly decreased(P<0.05).After treatment,there was no difference between the two groups(P>
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