| Purpose: Based on orthogonal design,to explore the effects of different acupuncture factors(acupuncture mode,acupuncture prescription and acupuncture frequency)on the treatment of subacute bell facial paralysis,so as to provide the best scheme for the clinical treatment of subacute bell facial paralysis.Methods: This study selected 32 patients with Bell facial paralysis who met the inclusion and exclusion criteria from the outpatient department of encephalopathy and acupuncture of the Second Affiliated Hospital of Tianjin University of traditional Chinese medicine from April 2021 to January 2022.In this study,three factors of acupuncture mode,acupuncture prescription and acupuncture frequency were selected,two levels were selected respectively,the orthogonal design of three factors and two levels was adopted,and the experiment was carried out according to the L8(27)orthogonal table.A total of 8 treatment schemes were obtained.32 patients with Bell facial paralysis were randomly divided into 8 groups with 4cases in each group by Excel.Based on filiform needle therapy,each group was treated according to the treatment scheme obtained by orthogonal design.Two weeks was a course of treatment,with a total of two courses of treatment.The evaluation time points of facial nerve function evaluation standard and facial disability index(FDI)scale are before enrollment,after one course of treatment or after cure,after two courses of treatment or after cure,and the evaluation time points of electromyography are before enrollment and after graduation.The recovery criteria in the evaluation criteria of facial nerve were the main criteria.After leaving the group,the untreated patients continued to treat according to the treatment plan until the patients were cured,and the total course of disease was recorded.The evaluation indexes were analyzed by relevant statistical methods,and finally the optimal scheme for the treatment of subacute bell facial paralysis was selected.Result:(1)Comparison between groups1)Before treatment,the gender,age,disease location,postauricular pain,course of disease,facial nerve function score,fdip / FDIS score and amplitude ratio of affected side of facial nerve motor conduction examination(orbicularis oculi muscle,orbicularis oris muscle and frontal muscle)were compared between the groups.Using relevant statistical methods,there was no significant difference in various evaluation indexes between the groups(P >0.05).2)After treatment,the curative effects of each group were compared: the eight groups of orthogonal design were effective in the treatment of subacute stage of bell facial paralysis,and the curative effect difference between each group was statistically significant(P < 0.05),among which the difference between groups 1,2 and 3 and groups 7 and 8 was statistically significant(P < 0.05).3)All groups were evaluated by FDIS and the improvement of the total motor index of the ipsilateral muscle(FDIS)after treatment,and the improvement of the total motor index of the ipsilateral muscle(FDIS / FDIS)and the improvement of the total motor index of the ipsilateral muscle(FDIS / FDIS)were compared The improvement ratio of amplitude ratio and total course of disease in the affected side of facial nerve motor conduction examination(orbicularis oculi muscle,orbicularis oris muscle and frontal muscle)were statistically significant(P < 0.05);There was no significant difference in the improvement score of facial nerve function score(the first observation time point)and the improvement score of fdip /FDIS score(the first observation time point and the second observation time point)among the groups(P > 0.05).(2)Selection of the best scheme to improve each index1)Before treatment,the gender,age,location of disease,postauricular pain,course of enrollment,facial nerve function score,fdip/fdis score,and the amplitude ratio of affected side of facial nerve motor conduction test(orbicularis oculi muscle,orbicularis oris muscle,frontal muscle)were compared between the two levels of each factor.Using the relevant statistical method,there was no statistically significant difference in each index between the two levels of each factor(P > 0.05),which was comparable.2)The best scheme to improve the score of facial nerve function: after one course of treatment or cure,the best scheme to improve the score of facial nerve function is: the basic formula combined with laoshizhen formula is selected for acupuncture prescription,and there is no significant difference between the selection of acupuncture method and acupuncture frequency;After two courses of treatment or cure,the best scheme to improve the score of facial nerve function is: filiform acupuncture combined with fire acupuncture,basic formula combined with laoshizhen formula,and acupuncture frequency 3 times / week.3)The best scheme to improve the score of fdip / FDIS: after one course of treatment or cure,the best scheme to improve the score of fdip is: the basic formula combined with laoshizhen formula is selected for the acupuncture prescription,the acupuncture frequency is selected for 3 times / week,and there is no significant difference in the selection of acupuncture methods;After two courses of treatment or cure,the best scheme to improve fdip score is: filiform acupuncture combined with fire acupuncture,and there is no significant difference between acupuncture prescription and acupuncture frequency;At the two observation time points,the best scheme to improve FDIS score was: there was no significant difference in the choice of acupuncture mode,acupuncture prescription and acupuncture frequency.4)The best scheme to improve the motor conduction function of facial nerve: after treatment,the best scheme to improve the motor conduction of facial nerve orbicularis oculi muscle is: filiform acupuncture combined with fire acupuncture,and there is no significant difference between acupuncture prescription and acupuncture frequency;The optimal scheme to improve the motor conduction of facial nerve orbicularis oris muscle is as follows: the acupuncture mode is filiform acupuncture combined with fire acupuncture,the acupuncture prescription is basic formula combined with laoshizhen formula,and there is no significant difference in the selection of acupuncture frequency;The optimal scheme to improve the facial nerve motor conduction frontal muscle is as follows: the acupuncture mode is filiform acupuncture combined with fire acupuncture,the acupuncture prescription is basic formula +laoshifang,and the acupuncture frequency is 3 times / week.5)The best scheme to shorten the total course of disease is: filiform acupuncture combined with fire acupuncture,and there is no significant difference between acupuncture prescription and acupuncture frequency.(3)Safety index evaluation: there were no adverse events during the treatment,and the safety factor of the treatment scheme involved in this experiment was high.Conclusion: the best plan for treating the subacute phase of Bell’s facial paralysis is: the best plan for treating the subacute phase of Bell’s facial paralysis is to use fire needle acupuncture combined with filiform acupuncture for 3 times / week,with an interval of more than 48 hours.Among them,fire needle is used to puncture the affected side,Ren Du second pulse,foot Taiyang and Foot Yangming meridians,filiform acupuncture prescription is the basic formula,combined with Lao Shi acupuncture formula. |
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