The Timing Choice Of Treatment Of Peripheral Facial Paralysis With Milli Fire Needle-the Experience Of Professor Huang Shixi

BackgroundPeripheral facial paralysis is a common and frequently occurring disease of the nervous system.Acute onset,symptoms can be in a few hours or 1 to 3 days to reach the peak.The clinical manifestation was that one side facial expression muscle was paralyzed,the forehead pattern of the disease disappeared,the eye fissure increased,the nasolabial sulcus was flat,and the angle of the mouth dropped to the healthy side.Facial paralysis is a face project.Even though it is not fatal,it may be disfigured if not be cured.Also suffering from facial paralysis not only reduce the quality of life of patients,but also increase the risk of depression.The incidence of facial paralysis is 26 to 34 per 100,000 and the majority of young adults.Most patients recover completely,with or without treatment,but 20%to 30%can have permanent facial.Facial paralysis,such as incomplete recovery,often can produce paralysis of muscle contracture,hemifacial spasm or joint movement,that is,the sequelae of facial paralysis.With the increase in people’s life and work pressure,the increase in the pace of life,people exercising less and taking the car instead,resulting in the gradual decline of young people’s physique,facial paralysis continues to increase,which will bring great impact on the patients and their families and the society,causing huge losses.There has been a variety of statements on the stage and time of facial paralysis.Analysis of the current literature,most of doctors agree that acute phase is in 1 to 7 days,but the quiescent period,recovery period,sequelae is different.There is no uniform standard,the majority of personal experience for the doctor.From the clinical observation,Professor Huang Shixi believes that facial paralysis staging is to guide the treatment or to determine the prognosis,due to different pathogenic factors,differences in the constitution of the patient and the severity,in addition to the acute phase(advanced)can be determined for about 1 week,the recovery period and sequelae period depending on the condition that can not be absolute determination of.In addition,the question of the timing of intervention in acupuncture and moxibustion is controversial,especially in the early stage of facial paralysis.At present,two kinds of views:modern medicine do not recommend early acupuncture intervention because the facial nerve was compressed in the early stage of the disease and the acupuncture stimulation will lead to increased tissue permeability,tissue fluid increased,edema;traditional medicine think that should be based on the principle of prevention for the diseases in order to protect of righteousness and control transfer.Therefore,it is of great practical significance to improve the understanding of peripheral facial paralysis,and to explore the treatment time and the economic and effective treatment.PurposeTo observe the curative effect of the milli fire needle combined with body acupuncture and moxibustionin the treatment of the patients with facial paralysis within 7 days and the onset of 8 to 30 days and explore the optimal intervention time.MethodAccording to the inclusion criteria,60 patients were divided into A group and B group,each group of 30 cases.The incidence of 7 days for the A group,the incidence of 8 to 30 days for the B group,the two groups were mainly used milli fire needle combined with body acupuncture and moxibustion.Acupoints:taiyang,sizhukong,yangbai,Sibai,Quanliao,Yingxiang,Xiaguan,Chengjiang,Dicang through Jiache,Yifeng,bilateral Hegu.The milli fire needle prick Yifeng,Fengchi,Qianzheng,yangbai,Yingxiang,Dicang.We placed 2cm long needle moxa cone in the sun,Xiaguan,Yifeng,Quanliao acupoints,each time the needle for 20min.First 3 times,the milli fire needle was needed for 1 times a day,after that two days 1 times.Acupuncture treatment is 1 times every day.10 times as a course of treatment,each treatment interval of 2 days,a total of six courses were observed,respectively,after the first 2,4,6 treatment efficacy,and 30 days after the last treatment follow-up evaluation of long-term efficacy,using House-Brackman(HB)Facial nerve function classification and symptom score of TCM syndrome.Result(1)The end of the statistical results of treatment,the peripheral facial paralysis patients’ facial nerve function and symptoms and symptoms of Chinese medicine have improved for the incidence of 7 days and the incidence of 8 to 30 days.The milli fire needle combined with body acupuncture and moxibustion therapy has a positive effect on the recovery of peripheral facial paralysis within 30 days,and the improvement of symptom and TCM symptoms and symptoms in 7 days is better than that of 8 to 30 days.(2)Peripheral facial paralysis within 7 days of intervention mainly milli fire needle combined with body acupuncture and warm acupuncture therapy,from the second course of treatment the difference was statistically significant.The incidence of 8 to 30 days of interventional therapy after second courses of treatment group compared with no statistical significance,there were significant differences between the fourth and sixth treatment。This suggests that within 7 days of onset of intervention facial nerve recovered faster.(3)From the last 30 days follow-up statistics we can see that cure rate and the total effective rate of A and B groups were improved,and the group A recovery rate and the total efficiency was significantly higher than that in B group,indicating that the treatment of milli fire needle can not only accelerate nerve recovery,but also has a good effect on the long-term curative effect.(4)After the 6th course of treatment,8 patients were found to be ineffective.The patients were treated with V and VI,which were severe paralysis and general paralysis.The higher the facial nerve grade was,the more severe the nerve injury was and nerve recovery is more difficult.The last 30 days of follow-up treatment of patients also found that facial nerve grade in the class Ⅲ and below,often within 30 days to return to grade Ⅰ.(5)Statistics of the sixth course of treatment after 60 cases of peripheral facial paralysis in patients with facial nerve classification and the relationship between the cure rate can be seen,the two were negatively correlated,that is,the higher the incidence of facial nerve grade,the lower the cure rate.That also shows the onset of facial nerve the higher the grade and the facial nerve is slow to recover.ConclusionBased on the study of peripheral facial paralysis literature and analysis of other medical research results and clinical observation,combined with Professor Huang Shixi on peripheral facial paralysis treatment of unique insights,we believe that the onset of peripheral facial paralysis within 7 days can be involved in acupuncture Treatment.Acupuncture intervention will not only aggravate the clinical symptoms,but also improve the clinical efficacy and the cure rate and shorten the course of disease.