| Objective: To observe the connection between the time of needle remaining and clinical efficacy of primary hemifacial spasm,to evaluate the difference in the efficacy between the30-min and 50-min needle retaining on primary hemifacial spasm,to explore the time-effect relationship of acupuncture treatment for this disease,and to further explore the correlation between the retention time of acupuncture and the efficacy of primary hemifacial spasm in different types,to derive a better needle retention time for acupuncture treatment and provide a quantitative reference for the clinical treatment of primary hemifacial spasm by acupuncture.Methods: 74 patients with primary hemifacial spasm who met the inclusion criteria and were seen at the Acupuncture Department of the Affiliated Hospital of Tianjin Academy of TCM between 09,2020 and 10,2021 were selected.SPSS25.0 was used to randomly divide the patients into a 30-min retention group and a 50-min retention group of 37 cases each.The needle retention time is calculated from the completion of all needle feeds to the start of the needle.All patients were placed in a supine position,and the main acupuncture points were selected according to the 10 th edition of Acupuncture and Moxibustion Therapeutics,the planning textbook of the National Higher Institute of Traditional Chinese Medicine,including Yifeng(SJ 17),Cuanzhu(BL 2),Fengchi(GB 20),Hegu(LI 4),Taichong(LR 3).Matching points are taken from the trigger point on the affected side(see twitch reduction with finger pressure);and the syndrome type of blood deficiency and wind-generating with Xuehai(SP10),Zusanli(ST 36),the syndrome type of heart and spleen deficiency with Shenmen(HT 7),Sanyinjiao(SP 6),the liver wind stirring up internally with Shenmai(BL 62),Zhaohai(KI 6).The same acupuncture technique was applied to all patients,i.e.,the needles were inserted and withdrawn slowly,and no manipulation was applied during needle retention.All patients received treatment 3 times a week(Monday,Wednesday,Friday),10 treatments are one course,and this study performed in 3 courses of treatment.The Cohen Albert facial spasm intensity grading criteria,Penn facial spasm frequency grading criteria,facial disability index(FDI),and self-developed TCM symptom scale score were used as the observation indexes.The efficacy evaluation criteria were developed according to the Diagnostic Efficacy Criteria for Chinese Medical Conditions 2017 edition issued by the Chinese Medicine Administration and combined with Cohen Albert and Penn grading improvement,evaluated before and after treatment,respectively,and safety testing and follow-up surveys were performed,and the results were statistically analyzed.Result: A total of 74 patients with primary hemifacial spasm were included in this study,4 were lost,and 70 were studied,with a drop-out rate of 5.41%,which was in line with the planned drop-out rate.1.General situation analysis: the two groups of patients compared general information(including gender,age,course of the disease,TCM syndromes),intensity and frequency of hemifacial spasm,FDI,and TCM symptom score before treatment,they have no statistical differences(P>0.05)and were comparable.2.Comprehensive efficacy judgment analysis: after the treatment,the total effective rate was 91.43% and the recovery rate was 82.86% in the 50-min retention group;the total effective rate was 77.14% in the 30-min retention group,and the recovery rate was 57.14%.No statistically difference between two group total effective rate(P>0.05),but there are differences in the cure rate(P<0.05).3.Comparison of Cohen grading: before and after treatment of Cohen classification comparison difference was statistically significant(P<0.05),hierarchical decreased after treatment,it means the intensity of the hemifacial spasm has improved.The difference after treatment was significant(P<0.05),suggesting that the effect of 50 min needle retention group was more significant.4.Comparison of Penn grading: compared before and after treatment,the Penn classification was reduced,and the difference was statistically significant(P<0.05);compared between groups after treatment,the difference was statistically significant(P<0.05).It is suggested that both groups have efficacy in reducing the frequency of facial muscle spasm,and the efficacy is more significant in the group with 50 min needle retention.5.Comparison of FDI scores: after treatment,both FDIP and FDIS were improved,statistics prove that the difference is significant(P<0.01);FDIP of two groups after treatment by the statistical tests,differences in meaningless(P>0.05),while FDIS comparative difference was statistically significant(P<0.05).It was suggested that the effect of the two groups was equal in remitting the physical function of FDI;in terms of remitting the social function of FDI,the needle retention group for 50 min had better effects.6.Comparison of self-developed TCM symptom scale score: there was a discrepancy(P<0.01)in the intra-group comparison before and after treatment in both groups,and a discrepancy(P<0.05)in the inter-group comparison after treatment.It is suggested that both groups have efficacy in remitting the symptoms of TCM,and the efficacy is more significant in the 50-min retention group.7.Comparison of TCM symptom scores of patients with different evidence types with the same needle retention time:(1)30-min needle retention group: there was no meaningful distinction in TCM symptom score between different types before and after therapy(P>0.05),suggesting that30-min needle retention did not significantly improve the TCM symptoms of patients with different types of symptoms(blood deficiency and wind,heart and spleen deficiency,and liver and wind internal motion).(2)50-min needle retention group: the distinction in the TCM symptom scores before and after therapy were statistically significant(P<0.01)when comparing patients with the liver wind internal movement type and the blood deficiency wind type,and the liver wind internal movement type and both the heart and the spleen are deficient type,while the differences between the blood deficiency wind type and both the heart and the spleen are deficient type were not statistically significant(P>0.05).It is suggested that the effect of retaining the needle for 50 min in improving the TCM symptoms of patients with Blood Deficiency and Wind and Heart-Spleen Deficiency types is better than that of patients with Liver Wind internal movement type.8.Comparison of TCM symptom scores of patients with different retention times for the same type of evidence.(1)Blood deficiency generates wind type: the difference of TCM symptom scores before and after treatment was higher in patients in the 50-min needle retention group than in the30-min needle retention group(P<0.01).(2)Heart and spleen deficiency type: the difference in TCM symptom scores before and after treatment was higher in the 50-min needle-retention group than in the 30-min needle-retention group(P<0.01).(3)Type of internal movement of liver wind: the distinction between the groups before and after therapy of TCM symptom scores was not statistically meaning(P>0.05).It is suggested that the degree of improvement of TCM symptoms in patients with blood deficiency and wind generation type and heart and spleen two deficiency type of this disease by retaining acupuncture for 50 min was more obvious than by retaining acupuncture for 30 min,while there was no significant difference between retaining acupuncture for 30 min or 50 min on the improvement of TCM symptoms in patients with liver and wind internal movement type of this disease.Conclusion:1.Through this experiment,the tutor applied the academic idea of static restraint to treat primary hemifacial spasm,and treatment based on syndrome differentiation is further verified.2.Acupuncture has significant curative effect on primary hemifacial spasm,and the difference of needle retention time has an impact on the curative effect of this disease.From the trend of various observation indicators,the curative effect of retaining needles for 50 minutes is better than that of retaining needles for 30 minutes.In addition,50 min of needle retention was more effective in remitting the TCM symptom scores of patients with blood deficiency and spleen deficiency than those with internal movement of liver wind.Considering that due to the relatively small sample size of this trial,the coverage of syndrome types of the included patients is relatively insufficient,and further research is needed.3.Combined with the clinical status and research results,acupuncture needles can be retained for 30 min for the treatment of primary hemifacial spasm,and 50 min for better results.To save time and cost for treating more patients,we can consider extending the retention time for patients with the deficiency type of the disease to improve the efficacy. |
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