Discussion On TCM Syndrome Elements And Tongue Imaging Rules At Acute Stage Of Peripheral Facial Paralysis

Objective:this subject renders preliminary discussion on the syndrome elements and tongue imaging rules at the acute stage of peripheral facial paralysis, principally from the literature and clinic perspectives, in an aim to lay theoretical and clinical basis for syndrome differentiation by TCM.Methods:1Literature research:through electronic and manual searching, a total of272literature articles concerning or related to peripheral facial paralysis at acute stage over the past32years(1981-2012) has been collected. Names of such syndromes have been normalized according to "Chinese Terms in Traditional Chinese Medicine and Pharmacy","Diagnostics of Traditional Chinese Medicine" and "Differential diagnostics of TCM syndrome". Syndrome elements were thus extracted and analyzed by statistical software SPSS13.0to eventually generalize the distribution rules of syndrome elements, such as disease location and nature, of each disease.2Clinical research:clinical data of300acute peripheral facial paralysis suffers treated in both the out-patient and in-patient departments of the affiliated hospital of Chengdu University of TCM were collected through comprehensive analysis by four examination methods. Syndrome were differentiated by two TCM practitioners with associate professional title or above and analyzed by statistical software SPSS13.0to eventually generalize the distribution rules of syndrome elements, such as disease location and nature, patterns and tongue images.Results:1Literature research:1.1The top3most-mentioned syndrome elements of disease location on acute peripheral facial paralysis are sequenced as:meridian, liver and spleen.1.2The top4most-mentioned syndrome elements of disease nature on acute peripheral facial paralysis are sequenced as:wind, cold, heat, phlegm. 1.318patterns are commonly seen in acute peripheral facial paralysis with the top3sequenced as:wind-cold obstructing collateral pattern, wind-heat blocking collateral. pattern, and wind-phlegm invading the collateral pattern.1.425tongue images are commonly seen in acute peripheral facial paralysis with the top3sequenced as:pink tongue coated by thin white moss, pink tongue coated by thin yellow moss, and red tongue coated by thin yellow moss=slightly pale tongue coated by thin white moss.2Clinical research:2.1The top3most-mentioned syndrome elements of disease location on acute peripheral facial paralysis are sequenced as:meridian, spleen and lung.2.2The top4most-mentioned syndrome elements of disease nature on acute peripheral facial paralysis are sequenced as:wind, cold, heat, phlegm=dampness.2.311patterns are commonly seen in acute peripheral facial paralysis with the top3sequenced as:wind-cold attacking the collateral pattern, wind-heat blocking collateral pattern, and wind-phlegm blocking the collateral pattern.2.4Eight tongue images are commonly seen in acute peripheral facial paralysis with the top3sequenced as:pink tongue coated by thin white moss, pink tongue coated by thin yellow moss, and pink tongue coated by white thick greasy moss.3Comparison with Literature and Clinical researches:3.1Comparison of disease location syndrome elements:both literature and clinical researches find meridian the most frequently detected element, while followed by liver and spleen in literature research and by spleen and lung in clinical research.3.2Comparison of disease nature syndrome elements:both literature and clinical researches rank the same elements as the top three.3.3Comparison of pattern distribution:both literature and clinical researches list the same patterns as the top three.3.4Comparison of tongue images:both literature and clinical researches place the same two tongue images upon the first two ranks, while followed by red tongue coated by thin yellow moss=slightly pale tongue coated by thin white moss in literature results, and pink tongue coated by white thick greasy moss in clinical results.Conclusions:1As meridian has been regarded by both researches the top syndrome element of disease location for acute peripheral facial paralysis, dredging the meridians is thus preferentially recommended in clinical treatment.2According to the top three syndrome elements(wind, cold and heat) of disease nature for acute peripheral facial paralysis, preferred clinical treatment includes expelling wind, dissipating cold or clearing heat.3Since both researches unveil generally the same pattern distribution rules as the most commonly recognized ones, TCM treatment shall focus on dispelling wind and removing obstruction in meridians.4The broadly identical tongue imaging rules found in both researches suggest that as acute peripheral facial paralysis is generally superficially located, slight acupuncture technique is recommended, with fewer acupoints selected on the sick side and more selected afar. In-take herbal drugs featuring light, dissipating, diffusing and penetrating, such as Yinhua, Bohe and Jingjie, are preferential options.