趙正恩　汪　玲

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拔罐療法結(jié)合針刺治療面癱急性期耳后疼痛33例

趙正恩汪玲△

目的觀察拔罐療法結(jié)合針刺治療面癱耳后疼痛的臨床療效。方法將60例患者按隨機(jī)數(shù)字表分為2組，試驗(yàn)組33例，對(duì)照組27例。試驗(yàn)組：針刺治療后，取陽(yáng)白、地倉(cāng)、頰車(chē)、顴髎、翳風(fēng)、完骨，依次閃罐，至皮膚局部潮紅為度，然后在翳風(fēng)、完骨留罐約3～5分鐘。對(duì)照組：?jiǎn)渭儾捎冕槾讨委煛Ｖ委?周后，均只行電針治療。 結(jié)果試驗(yàn)組和對(duì)照組治療時(shí)間分別為(18.90±3.82)d、(22.78±3.85)d，兩組在治療時(shí)間方面差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。試驗(yàn)組治愈20例，顯效7例，有效6例，無(wú)效0例；對(duì)照組治愈15例，顯效5例，有效7例，無(wú)效0例。試驗(yàn)組治愈率及顯效率均高于對(duì)照組，兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。結(jié)論拔罐配合針刺治療面癱耳后疼痛臨床療效顯著，治療時(shí)間、治愈率均優(yōu)于對(duì)照組，可予以臨床推廣。

拔罐療法; 面癱; 耳后疼痛

面癱又稱周?chē)嫔窠?jīng)炎，多為面神經(jīng)麻痹。在臨床觀察中，患者在急性期可出現(xiàn)耳周疼痛。其中面癱急性期多為發(fā)病7d內(nèi)，病情進(jìn)行性加重，伴耳周及下頜角處疼痛[1]。目前，筆者以拔罐療法配合針刺治療面癱急性期耳后疼痛60例，進(jìn)行臨床療效觀察。

1　資料與方法

1.1一般資料選取2014年3月—2015年10月在我院門(mén)診診斷為“周?chē)嫔窠?jīng)炎”的患者60例。并且排除因腦梗死、腦出血等其他原因造成的面癱，且在發(fā)病后出現(xiàn)耳后疼痛。按隨機(jī)表進(jìn)行分組，試驗(yàn)組33例，對(duì)照組27例。其中試驗(yàn)組女性20例，男性13例，年齡在25～65歲，平均年齡(40.32±15.54)歲；對(duì)照組27例，女性19例，男性8例，年齡在23～68歲，平均年齡(41.57±17.89)歲。兩組在年齡和性別方面的差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。

1.2診斷標(biāo)準(zhǔn)參照“周?chē)悦嫔窠?jīng)麻痹的中西醫(yī)結(jié)合評(píng)定及診療標(biāo)準(zhǔn)(草案)”[2]，確定本病診斷標(biāo)準(zhǔn)。

1.3納入標(biāo)準(zhǔn)①符合診斷標(biāo)準(zhǔn)；②發(fā)病在1周內(nèi)；③伴有耳后疼痛的患者；④年齡在20～75歲；⑤簽署知情同意書(shū)，自愿參加本研究者。

1.4治療方法試驗(yàn)組及對(duì)照組均先行普通針刺治療，選穴為：陽(yáng)白、攢竹、魚(yú)腰、太陽(yáng)、顴髎、聽(tīng)宮、頰車(chē)、地倉(cāng)、翳風(fēng)、完骨、合谷。淺刺，留針約20～30分鐘。試驗(yàn)組：在針刺后取陽(yáng)白、地倉(cāng)、頰車(chē)、顴髎、翳風(fēng)、完骨，依次閃罐，至皮膚局部潮紅為度，然后在翳風(fēng)及完骨處留罐約3～5分鐘。對(duì)照組：只行針刺治療。1周后，只采用電針繼續(xù)治療，1次/d，每次留針約20～30分鐘。1個(gè)月后進(jìn)行療效評(píng)價(jià)。

2　結(jié)果

2.1兩組治療時(shí)間比較試驗(yàn)組和對(duì)照組面癱患者治療時(shí)間分別為(18.90±3.82)d、(22.78±3.85)d，兩組在治療時(shí)間方面差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。

2.2兩組療效比較治療1月后，進(jìn)行療效評(píng)價(jià)，試驗(yàn)組和對(duì)照組患者均完成試驗(yàn)，無(wú)脫落。比較兩組治療好轉(zhuǎn)情況，試驗(yàn)組和對(duì)照組治愈率分別為60.61%、55.56%，兩組差異無(wú)統(tǒng)計(jì)學(xué)意義(P>0.05)。拔罐結(jié)合針刺治療面癱急性期耳后疼痛優(yōu)于單純針刺治療。見(jiàn)表1。

表1　兩組療效比較　(例，%)

3　討論

面癱又稱“口僻”“吊線風(fēng)”等。中醫(yī)學(xué)認(rèn)為本病的發(fā)生，多數(shù)是由外邪的侵入和機(jī)體功能狀態(tài)相互作用所致[3]。耳后疼痛為面癱的常見(jiàn)臨床表現(xiàn)之一，西醫(yī)認(rèn)為主要因面神經(jīng)血管痙攣，局部缺血、水腫，神經(jīng)營(yíng)養(yǎng)缺乏，而出現(xiàn)的耳后疼痛，且多發(fā)生在面癱急性期[4]。面癱急性期為發(fā)病7d內(nèi)，急性期為外邪初襲未盛，正氣微耗未衰之時(shí)[5]。拔罐療法能扶正與祛邪兼顧，具有溫經(jīng)散寒、活血通脈、消腫止痛、固本等作用[6]。

本試驗(yàn)在面癱急性期出現(xiàn)耳后疼痛，即采用面部閃罐療法，祛邪而不傷正氣，完骨、翳風(fēng)穴位于面神經(jīng)出口處，發(fā)揮局部治療作用。經(jīng)本試驗(yàn)觀察，急性期拔罐結(jié)合針刺可縮短面癱恢復(fù)時(shí)間，且臨床療效優(yōu)于常規(guī)針刺。

[1]張翠彥,王艷香.梅花針叩刺放血與氦氖激光照射治療面癱急性期伴耳周疼痛的療效比較[J].針刺探究,2011,36(6):433-436.

[2]楊萬(wàn)章,吳芳,張敏.周?chē)悦嫔窠?jīng)麻痹的中西醫(yī)結(jié)合評(píng)定及療效標(biāo)準(zhǔn)(草案)[J].中西醫(yī)結(jié)合心腦血管病雜志,2005,3(9):786-787.

[3]劉淑霞.腦病中醫(yī)特色診療全書(shū)[M].北京：化學(xué)工業(yè)出版社,2011：214.

[4]孫宏偉,李琳.刺絡(luò)拔罐法治療周?chē)悦姘c耳后疼痛癥40例[J].光明中醫(yī),2010,25(9):1674.

[5]侯書(shū)偉,張昌云,王長(zhǎng)春.論面癱針灸治療量的控制[J].中國(guó)針灸,2012,32(7):607-681.

[6]吳振英,秦立新.拔罐療法為主治療面癱急性期臨床體會(huì)[J].中國(guó)中醫(yī)急癥,2008,17(10):1457.

Cupping Therapy combined with Acupuncture in the Treatment of Acute Facial Paralysis Patients with Peri-auricular Pain for 33 Cases

ZHAO ZhengenWANG Ling

(Department of Rehabilitation Medicine, Minazhu People’s Hospital, Sichuan, Mianzhu 618200, China)

ObjectiveTo observe the clinical effect of cupping therapy combined with acupuncture in the treatment of acute facial paralysis patients with peri-auricular pain. MethodsAccording to random number table, sixty outpatients with acute facial paralysis and peri-auricular pain were divided into two groups. The treatment group had 33 cases, and the control group had 27 cases. In the treatment group, after acupuncture, flash cupping GB14, ST4, ST6, SI18, SJ17, GB12, until the skin is flushing, then retention cupping 3-5minutes at SJ17 and GB12. In the control group, patients received only the treatment of acupuncture. After 1week, the two groups both used electronic acupuncture instead of the other therapy. ResultsAfter treatment, the course of the treatment group and the control group was 18.90±3.82d and 22.78±3.85d, respectively. The course of treatment between the two groups had significant difference by comparison (P<0.05). In the treatment group, 20 cases were cured, 7 cases improved, 5 cases were effective, and 0 case were ineffective. In the control group, 15 cases were cured, 5 cases improved, 7 cases were effective, and 0 case were ineffective. The cure rate and the recovery rate of the treatment group were higher than that of the control group, respectively, but had no significant difference by comparison (P>0.05). ConclusionThe acupuncture and cupping therapy in the treatment of facial paralysis patients with peri-auricular had a good clinical effect, the treatment time and the cure rate were better than those of the control group, and it can be clinical promotion.

Cupping therapy; Facial paralysis; Peri-auricular pain

四川省綿竹市人民醫(yī)院康復(fù)醫(yī)學(xué)科(綿竹 618200)

10.3969/j.issn.1003-8914.2016.14.040

1003-8914(2016)-14-2077-02

(本文校對(duì)：陳立2015-11-10)