牵正散合桃红四物汤加减及针刺联合康复功能训练治疗周围性面瘫(风痰阻络证) 临床研究
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R745.1+2;R246.6

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Clinical Study on Qianzheng Powder and Modified Taohong Siwu Tang Combined with Needling and Functional Rehabilitation Training for Peripheral Facial Palsy with Wind-Phlegm Obstructing Collaterals Syndrome
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    摘要:

    目的:观察牵正散合桃红四物汤加减及针刺联合康复功能训练治疗周围性面瘫(风痰阻络证) 的临床疗效。方法:选择98 例周围性面瘫(风痰阻络证) 患者为研究对象,随机分为对照组和观察组各49 例。对照组患者给予常规西药联合康复功能训练治疗,观察组患者在康复训练的基础上给予牵正散合桃红四物汤加减及针刺联合治疗。观察并比较2 组患者面部运动Portmann 评分、主要症状的改善时间、面部神经功能分级的变化,测定血清中白细胞介素-6(IL-6)、神经生长因子(NGF)、转化生长因子-β1(TGF-β1) 水平,对比2 组临床疗效。结果:治疗后,观察组的有效率为93.88%,显著高于对照组的79.59%(P<0.05)。与同组治疗前比较,治疗后2 组面部运动Portmann 评分升高(P<0.05),面部神经功能分级均改善(P<0.05),血清IL-6 水平降低(P<0.05),NGF、TGF-β1 水平均升高(P<0.05);与对照组治疗后比较,观察组面部运动Portmann 评分较高(P<0.05),鼓颊、抬眉、闭目的改善时间均明显缩短(P<0.05),面部神经功能改善更优(P<0.05),血清IL-6 水平较低(P<0.05),NGF、TGF-β1 水平较高(P<0.05)。结论:牵正散合桃红四物汤加减及针刺联合康复功能训练治疗周围性面瘫(风痰阻络证) 疗效肯定,有利于促进临床症状的缓解,促进受损面部神经功能的恢复,推断其起效可能与调控血清中IL-6、NGF、TGF-β1 等水平以消除炎性水肿、营养面神经,改善受损面部神经营养状况有关。

    Abstract:

    Abstract:Objective:To observe the clinical effect of Qianzheng powder and modified Taohong Siwu tang combined with needling and functional rehabilitation training for peripheral facial palsy with wind- phlegm obstructing the collaterals syndrome. Methods:A total of 98 cases of patients with peripheral facial palsy with wind-phlegm obstructing the collaterals syndrome were selected as the study objects,and randomly divided into the control group and the observation group,49 cases in each group. The control group was given routine western medicine combined with functional rehabilitation training, and the observation group was additionally given Qianzheng powder combined with modified Taohong Siwu tang and needling based on the treatment of the control group. The changes in Portmann score of facial movement,improvement time of main symptoms,and grading of facial nerve function were observed and compared between the two groups;levels of interleukin- 6(IL-6),nerve growth factor(NGF),and transforming growth factor-β1(TGF-β1) in serum were detected;the clinical effect was compared. Results:After treatment,the effective rate was 93.88% in the observation group,significantly higher than that of 79.59% in the control group(P<0.05). After treatment,Portmann scores of facial movement in the two groups were increased when compared with those in the same group before treatment(P<0.05);the grading of facial nerve function was improved(P<0.05);IL-6 levels in serum were decreased(P<0.05),and levels of NGF and TGF-β1 were increased(P<0.05). Compared with those in the control group after treatment,in the observation group,the Portmann score of facial movement was higher(P<0.05); the improvement time of cheek blowing, eyebrows raising, and eyes closing was significantly shortened(P<0.05);the improvement of facial nerve function was better(P<0.05);the IL- 6 level in serum was lower(P< 0.05), and levels of NGF and TGF- β1 were higher(P<0.05). Conclusion: In the treatment of peripheral facial palsy with wind- phlegm obstructing the collaterals syndrome, the therapy of Qianzheng powder and modified Taohong Siwu tang combined with needling and functional rehabilitation training has significant curative effect, which conduces to promoting relief of clinical symptoms,and promotes recovery of injured facial nerve function. It can be concluded that the onset of the disease may be related to elimination of inflammatory edema by regulating levels of IL-6,NGF,and TGF-β1 in serum,and improvement of nutritional status of injured facial nerve by nurturing facial nerve.

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周景巍,陈敏华.牵正散合桃红四物汤加减及针刺联合康复功能训练治疗周围性面瘫(风痰阻络证) 临床研究[J].新中医,2021,53(5):27-32

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  • 在线发布日期: 2021-03-15
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