| Peripheral facial paralysis, also called Bell palsy, is the common disease often occurred in the neurology department. The incidence of this disease amounted to 15-40/100 thousand. The disease might occur at any age of doth gender, while people of 20-40 years old have more chances to suffered this disease. The patients of peripheral facial paralysis may have the clinical syndromes including facial asymmetry, distortion of commissure so that one side corner of the mouth is skew, shoal nasolabial fold, and when patients want to frown and close their eyes, usually they will fail to do these movement usually. Also they could not plump up their cheek, and when they have meals the liquid will easily outflow from the corner of the mouth and the food is embedded in the clearance between the tooth and cheek. While some patients will have pains behind the eras and lose their sense of the taste on the 2/3 of the tongue.The mechanism of this disease is still not very clear. Most scholars believe that the occurrence of peripheral facial paralysis is partly due to virus which caused non-suppurative inflammation. The inflammation hit the facial nerve so that the vasospasm, ischemia and dropsy occurred on the local facial nerve. The facial nerve lost the control of the facial muscle because of the nerve deficiency. Most patients who suffered this disease would have a good prognosis according to the clinical report that 71%-90% of the patients will fully recovered through treatment or just let it go. However, some unlucky patients will not recovery from the facial asymmetry due to their complex disease condition or their off-treatment in the early days. Patients will have great psychological pressure during their social activities because their facial muscles lose dominance in facial expression.Western medicine doctors mainly use drugs to treat the peripheral facial paralysis nowadays. But we all know that the western drugs usually have many adverse reactions, such as the side effects of oral hormone and nonspecific of antiviral treatment. The weakness constrains the therapeutic effect of western medicine. But from the ancient times, Chinese traditional doctors gathered their medical experiences on treating peripheral facial paralysis, including acupuncture and Chinese herb treatment. While needling treatment is a green treatment so that the WHO recommended it as one of the optimal plan for peripheral facial paralysis. At present there are a lot of clinical researches for the treatment of facial paralysis. Many research results present that acupuncture was an effective therapy which can be widely used as a common method of facial paralysis, and because of its distinct curative effect and less side effect, acupuncture is the ideal treatment method for facial paralysis.Jin’s Three-needle Therapy is an important content of lingnan school academic and 3-needle for facial paralysis had been widely applied in clinical practice for the treatment of peripheral facial paralysis. On the base of the past researches, this thesis will study its possible mechanism of action and choose the optimal overall treatment of this disease, so as to provide an effective therapy and improve life quality of facial paralysis patients.Objectives:In this study, we strictly applied the common clinical research method of randomized controlled trial. We meant to contrast the clinical differences among these three treatment plans to treat the peripheral facial paralysis. One plan was bleeding-acupuncture together with the JIN-three-needle therapy, one was simple JIN-three-needle therapy and the other treatment was acupuncture which had been used wildly in the clinic according to the teaching material books. At the same time, our intention was also to analysis whether the bleeding-acupuncture could play any role in the treatment of peripheral facial paralysis. The JIN-three-needle therapy and the routine treatment for peripheral facial paralysis which would act on more roles in the treatment for peripheral facial paralysis was also our research aim. On the basis of these researches,we would like to preliminary analysis the possible mechanism of the bleeding-acupuncture and the JIN-three-needle therapy for peripheral facial paralysis and whether they had any clinical meanings and promotion value for more patients who suffered this disease.Methods: 90 patients who had been diagnosed as peripheral facial paralysis between the year of 2014 and 2015 in the Tradional Chinese Medical Clinic of Xiehe in the city of Kaohsiung in Taiwan Province were randomly divided into 3groups such as the treated group, the control-A group and the control-B group on the basis of their visiting orders, which meant 30 cases in each group. The three groups were given the basic treatments in the department of Neurology hormone therapy, antiviral therapy and nourishing-nerve treatment. Then, each group was given the acupuncture therapy. The treated group was provided the combination treatment of bleeding-acupuncture and Jin’s Three-needle Therapy. The control-A group was given the simple Jin’s Three-needle Therapy while the control-B group was the conventional acupuncture recorded by our book. The bleeding-acupuncture was manipulated once in one week and other treatment were manipulated once in one day and had a rest-day after their six-days’treatment and three weeks’treatments were needed in this study which meant that therapy course was three weeks. Two scale as House-Braekrnann Scale and Portmann Simple Scale were in this study to contrast the research patients before the treatment was manipulates and 7 days,14 days and 21 days after treatments these two scales were also compared. During the research process if there were any adverse events occurred, these things should be recorded strictly by special research-man so that we could analysis whether it would influence the safety of the therapy or not.Results:All the patients who enrolled in this research in the three groups had a comparable base materials such as the average age, average course of disease, gender and as well as the score of the scale of simple Portmann according to statistical comparison because they had no statistical meaning. This showed that the subjects in this study could be compared in statistics and could be included in the research.1. After 7 days treatments, three P scores had been calculated compared with themselves as 0、0.042、0.022. This indicated that the three different methods all could improve the symptoms of the patients of peripheral facial paralysis. When the three groups were compared, other three P scores had been calculated as 0.046、0.032、0.494. The data illustrated that the treated group showed better therapeutic effect when compared with the two control groups. The difference had statistical meaning because the P score was below 0.05. The data indicated that bleeding-acupuncture could improve the symptoms of the peripheral facial paralysis and accelerate the recovery process when compared with the JIN-three needle acupuncture and the routine acupuncture. However, the comparison between the two control groups showed no statistical meaning as the P score was above 0.05. This indicated that the JIN-three needle acupuncture and the routine acupuncture both could improve the symptoms of the patients suffered the peripheral facial paralysis.2. After the total course of the study had been completed, three P scores had been calculated compared with themselves as 0、0、0.006. This indicated that the three different methods all could improve the symptoms of the patients of peripheral facial paralysis. When the three groups were compared, other three P scores had been calculated as 0.001、0、0.157. The data illustrated that the treated group showed better therapeutic effect when compared with the two control groups. The difference had statistical meaning because the P score was below 0.05. The data indicated that bleeding-acupuncture could improve the symptoms of the peripheral facial paralysis and accelerate the recovery process when compared with the JIN-three needle acupuncture and the routine acupuncture. However, the comparison between the two control groups showed no statistical meaning as the P score was above 0.05. This indicated that the JIN-three needle acupuncture and the routine acupuncture both could improve the symptoms of the patients suffered the peripheral facial paralysis.Conclusion:Compared with the Jin’s Three-needle Therapy and the routine acupuncture, the bleeding-acupuncture combined with Jin’s Three-needle Therapy could shorten and progress the course of this disease, also it will have a lower chance to get sequela. These all showed that bleeding-acupuncture played an important role in treating peripheral facial paralysis. During the research, we had not discovered any significant adverse event,and this showed that the safety of bleeding-acupuncture was guaranteed and because of the therapy was easy to manipulated, this kind of treatment should be widely promoted in the clinic so that patients would benefit earlier. |
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