Clinical Observation Of Heat-sensitive Moxibustion Combined With Acupuncture In The Treament Of Sequelae Stage Of Peripheral Facial Paralysis

Purpose:To investigate the clinical efficacy of thermal moxibustion combined with acupuncture in the treatment of peripheral facial palsy in the posterior phase by observing and comparing the difference in efficacy between acupuncture and thermal moxibustion combined with acupuncture in the treatment of this disease,to observe the distribution pattern of thermal sensitized acupoints in this disease and to improve its clinical treatment plan.Methods:From January 2022 to October 2022,60 patients who attended the Second Department of Acupuncture and Moxibustion of the Affiliated Hospital of Jiangxi University of Chinese Medicine and Fusheng Hospital were selected for inclusion in this study in strict accordance with the inclusion and exclusion criteria,and were randomly divided into 30 patients in the observation group and 30 patients in the control group.The control group was treated with acupuncture(including milli-needle acupuncture and trigeminal acupuncture),referring to the "Thirteenth Five-Year Plan" edition of "Acupuncture and Moxibustion Therapy" edited by Gao Shuzhong and Yang Jun,and after the patients had taken a break of about 3 minutes from acupuncture,they were then treated with trigeminal acupuncture to bleed the oral mucosa.In the observation group,on the basis of the control group,two acupuncture points were selected for thermal moxibustion each time based on the high incidence of heat-sensitive acupuncture points detected in the previous period,until the patient’s heat-sensitive moxibustion sensation disappeared,and the heat-sensitized acupuncture points were recorded in time.Milli-needle acupuncture and thermosensitization moxibustion were performed weekly for 5 consecutive days followed by a break of 2 days,once/day;trigeminal acupuncture for oral mucosal bloodletting was performed once a week for8 weeks.Patients in both groups underwent two H-B facial nerve function grading assessments and facial disability index(FDI)scores before and after treatment,with the FDI score divided into two components: somatic function(FDIP)and social life function(FDIS).Records were made and all data were finally summarised for statistical analysis.Result:1.The 60 patients included successfully completed this study.The differences between the two groups in terms of basic information(including age,gender and duration of disease)and pre-treatment observables(H-B facial nerve function classification,FDI score)were not statistically significant and comparable.2.After the treatment,the grading on the H-B facial nerve function grading was significantly lower in both groups than before the treatment,and the difference between the two groups was statistically significant(P < 0.01)in both intra-group comparisons and statistically significant(P < 0.05)in the inter-group comparisons.The FDIP score was significantly higher in both groups than before treatment,with a statistically significant difference between the two groups(P < 0.01)and between groups(P < 0.01).The FDIS scores were significantly lower in both groups than before treatment,with statistically significant differences in both groups for intra-group comparisons(P < 0.01);the differences between groups were significant(P < 0.01).It was suggested that both different treatment modalities had an improvement effect on the symptoms of the posterior phase of peripheral facial palsy,and thermal moxibustion combined with acupuncture was more effective.3.At the end of the treatment,2 patients(6.66%)in the observation group were cured,14 patients(46.67%)showed significant improvement in symptoms,12 patients(40.00%)showed improvement in symptoms and 2patients(6.67%)showed basically no improvement in symptoms,with a total effective rate of 93.33%;in the control group,no patients were cured,9 patients(30.00%)showed significant improvement in symptoms,13patients(No patients in the control group were cured,9 patients(30.00%)had significant improvement in symptoms,13 patients(43.33%)had improvement in symptoms and 8 patients(26.67%)had no improvement in symptoms,with a total effective rate of 73.33%.The total efficacy of the two groups was statistically analysed,and the total efficacy of the two groups was tested by chi-square test,P=0.038<0.05.Combining the above results,it is suggested that both methods are effective,and the efficacy of thermal moxibustion combined with acupuncture is better.4.During the trial,it was found that the heat-sensitized acupoints in the posterior phase of peripheral facial palsy were mostly Yangbai,Cheek Chee,Zygomaticus,Di Cang and Foot San Li,etc.The moxibustion sensation of high-frequency heat-sensitized acupoints was mainly based on heat transmission,heat expansion,heat transfer and non-thermal sensation,and the start of moxibustion sensation was initiated in 4-16 minutes,with a wide span,mainly concentrated in about 7-13 minutes,and the duration of moxibustion sensation was about 40 minutes.Conclusion:1.Thermal moxibustion combined with acupuncture and needling both have better efficacy for patients in the posterior phase of peripheral facial palsy,both can effectively improve facial nerve function and enhance somatic function and social life function,thermal moxibustion combined with acupuncture has better efficacy than acupuncture.2.Thermal moxibustion can enhance the effect of acupuncture in the posterior phase of peripheral facial palsy,and is conducive to optimizing the treatment plan for the posterior phase of peripheral facial palsy.3.The main heat-sensitized acupoints in the post-peripheral facial palsy period are Yangbai,Cheek Chee,Zygomaticus,Di Cang and Foot San Li,etc.The moxibustion sensation starts to activate in 4-16 minutes and lasts for about 40 minutes.