拔罐疗法结合针刺治疗面瘫急性期耳后疼痛33例

赵正恩　汪　玲



拔罐疗法结合针刺治疗面瘫急性期耳后疼痛33例

赵正恩汪玲△

目的观察拔罐疗法结合针刺治疗面瘫耳后疼痛的临床疗效。方法将60例患者按随机数字表分为2组，试验组33例，对照组27例。试验组：针刺治疗后，取阳白、地仓、颊车、颧髎、翳风、完骨，依次闪罐，至皮肤局部潮红为度，然后在翳风、完骨留罐约3～5分钟。对照组：单纯采用针刺治疗。治疗1周后，均只行电针治疗。 结果试验组和对照组治疗时间分别为(18.90±3.82)d、(22.78±3.85)d，两组在治疗时间方面差异具有统计学意义(P<0.05)。试验组治愈20例，显效7例，有效6例，无效0例；对照组治愈15例，显效5例，有效7例，无效0例。试验组治愈率及显效率均高于对照组，两组比较差异无统计学意义(P>0.05)。结论拔罐配合针刺治疗面瘫耳后疼痛临床疗效显著，治疗时间、治愈率均优于对照组，可予以临床推广。

拔罐疗法; 面瘫; 耳后疼痛

面瘫又称周围面神经炎，多为面神经麻痹。在临床观察中，患者在急性期可出现耳周疼痛。其中面瘫急性期多为发病7d内，病情进行性加重，伴耳周及下颌角处疼痛[1]。目前，笔者以拔罐疗法配合针刺治疗面瘫急性期耳后疼痛60例，进行临床疗效观察。

1　资料与方法

1.1一般资料选取2014年3月—2015年10月在我院门诊诊断为“周围面神经炎”的患者60例。并且排除因脑梗死、脑出血等其他原因造成的面瘫，且在发病后出现耳后疼痛。按随机表进行分组，试验组33例，对照组27例。其中试验组女性20例，男性13例，年龄在25～65岁，平均年龄(40.32±15.54)岁；对照组27例，女性19例，男性8例，年龄在23～68岁，平均年龄(41.57±17.89)岁。两组在年龄和性别方面的差异无统计学意义(P>0.05)。

1.2诊断标准参照“周围性面神经麻痹的中西医结合评定及诊疗标准(草案)”[2]，确定本病诊断标准。

1.3纳入标准①符合诊断标准；②发病在1周内；③伴有耳后疼痛的患者；④年龄在20～75岁；⑤签署知情同意书，自愿参加本研究者。

1.4治疗方法试验组及对照组均先行普通针刺治疗，选穴为：阳白、攒竹、鱼腰、太阳、颧髎、听宫、颊车、地仓、翳风、完骨、合谷。浅刺，留针约20～30分钟。试验组：在针刺后取阳白、地仓、颊车、颧髎、翳风、完骨，依次闪罐，至皮肤局部潮红为度，然后在翳风及完骨处留罐约3～5分钟。对照组：只行针刺治疗。1周后，只采用电针继续治疗，1次/d，每次留针约20～30分钟。1个月后进行疗效评价。

2　结果

2.1两组治疗时间比较试验组和对照组面瘫患者治疗时间分别为(18.90±3.82)d、(22.78±3.85)d，两组在治疗时间方面差异具有统计学意义(P<0.05)。

2.2两组疗效比较治疗1月后，进行疗效评价，试验组和对照组患者均完成试验，无脱落。比较两组治疗好转情况，试验组和对照组治愈率分别为60.61%、55.56%，两组差异无统计学意义(P>0.05)。拔罐结合针刺治疗面瘫急性期耳后疼痛优于单纯针刺治疗。见表1。

表1　两组疗效比较　(例，%)

3　讨论

面瘫又称“口僻”“吊线风”等。中医学认为本病的发生，多数是由外邪的侵入和机体功能状态相互作用所致[3]。耳后疼痛为面瘫的常见临床表现之一，西医认为主要因面神经血管痉挛，局部缺血、水肿，神经营养缺乏，而出现的耳后疼痛，且多发生在面瘫急性期[4]。面瘫急性期为发病7d内，急性期为外邪初袭未盛，正气微耗未衰之时[5]。拔罐疗法能扶正与祛邪兼顾，具有温经散寒、活血通脉、消肿止痛、固本等作用[6]。

本试验在面瘫急性期出现耳后疼痛，即采用面部闪罐疗法，祛邪而不伤正气，完骨、翳风穴位于面神经出口处，发挥局部治疗作用。经本试验观察，急性期拔罐结合针刺可缩短面瘫恢复时间，且临床疗效优于常规针刺。

[1]张翠彦,王艳香.梅花针叩刺放血与氦氖激光照射治疗面瘫急性期伴耳周疼痛的疗效比较[J].针刺探究,2011,36(6):433-436.

[2]杨万章,吴芳,张敏.周围性面神经麻痹的中西医结合评定及疗效标准(草案)[J].中西医结合心脑血管病杂志,2005,3(9):786-787.

[3]刘淑霞.脑病中医特色诊疗全书[M].北京：化学工业出版社,2011：214.

[4]孙宏伟,李琳.刺络拔罐法治疗周围性面瘫耳后疼痛症40例[J].光明中医,2010,25(9):1674.

[5]侯书伟,张昌云,王长春.论面瘫针灸治疗量的控制[J].中国针灸,2012,32(7):607-681.

[6]吴振英,秦立新.拔罐疗法为主治疗面瘫急性期临床体会[J].中国中医急症,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

四川省绵竹市人民医院康复医学科(绵竹 618200)

10.3969/j.issn.1003-8914.2016.14.040

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

(本文校对：陈立2015-11-10)