CAJ | 학술논문

目的：观察针刺合谷穴治疗缺血性脑卒中所致中枢性面瘫的临床疗效，探索其量效关系及最优针刺方案。方法将150例缺血性脑卒中所致中枢性面瘫患者依据针刺行针时间和针刺方向构成的不同刺激量随机分为4个合谷量学组(A、B、C、D组)和对照组(E组)，合谷组治疗方案为不同刺激量针刺合谷穴加中西医基础治疗方案，对照组仅采用中西医基础治疗方案，疗程为14 d。疗效指标为House-Brackmann面神经分级量表、多伦多面神经分级量表和面神经麻痹程度分级量表。结果治疗后各组患者3种量表评分均较治疗前有明显提高(P＜0.05)，且治疗前后量表评分改善率均存在明显组间差异(P＜0.05)。结论研究提示合谷穴对缺血性脑卒中后中枢性面瘫患者有确切临床疗效，采用逆经脉方向斜刺进针，捻转行针5 s针刺合谷穴，对缺血性脑卒中后中枢性面瘫患者临床症状量表评分改善率及有效率最优。
목적：관찰침자합곡혈치료결혈성뇌졸중소치중추성면탄적림상료효，탐색기량효관계급최우침자방안。방법장150례결혈성뇌졸중소치중추성면탄환자의거침자행침시간화침자방향구성적불동자격량수궤분위4개합곡량학조(A、B、C、D조)화대조조(E조)，합곡조치료방안위불동자격량침자합곡혈가중서의기출치료방안，대조조부채용중서의기출치료방안，료정위14 d。료효지표위House-Brackmann면신경분급량표、다륜다면신경분급량표화면신경마비정도분급량표。결과치료후각조환자3충량표평분균교치료전유명현제고(P＜0.05)，차치료전후량표평분개선솔균존재명현조간차이(P＜0.05)。결론연구제시합곡혈대결혈성뇌졸중후중추성면탄환자유학절림상료효，채용역경맥방향사자진침，념전행침5 s침자합곡혈，대결혈성뇌졸중후중추성면탄환자림상증상량표평분개선솔급유효솔최우。
Objective To observe the efficacy of acupuncture at Hegu (LI4) in treating central facial palsy due to cerebral ischemia, and to explore the dose-effect correlation and the optimal acupuncture protocol.Method Totally 150 patients with central facial palsy due to ischemic stroke were randomized into four groups to receive acupuncture at Hegu with different stimulation parameters plus the conventional integrated Chinese and Western medicine (group A, B, C, D) according to the acupuncture time and direction, and a control group (group E) only to receive the conventional Chinese and Western medicine treatment. The treatment lasted 14 d. The House-Brackmann facial nerve grading system, Toronto Facial Grading System and facial palsy grading scale were adopted as the evaluation indexes.Result After intervention, the scores of the three indexes were all significantly increased in the five groups (P<0.05), and the inter-group comparisons showed significant differences in comparing the improvement rate (P<0.05).Conclusion The study shows that acupuncture at Hegu is effective in treating central facial palsy due to cerebral ischemia, and with the inverse insertion of the needle and manipulation for 5 min at Hegu should be the optimal protocol regarding the improvement of the symptom score and effective rate.