Clinical Study On The Law Of Acupoints Heat-sensitization In Convalescent Patients With Bell’s Palsy

ObjectiveThe study was going to sum up the law of distribution and chang of heat-sensitive acupoints by observing the appearance of acupoints heat-sensitization and the changes related to therapeutic effect in the convalescent period with Bell’s palsy.In order to provide an effective treatment plan of heat-sensitive moxibustion therapy for the clinical treatment of Bell’s palsy in the convalescent period.MethodsThe research was a clinical non-randomized controlled observational study.All subjects were recruited from the outpatient and ward of acupuncture department of Guangdong Hospital of Traditional Chinese Medicine from March 2019 to December 2019.A total of 138 cases were included.All heat-sensitive acupoints were searched of all patients according to the operation standard of heat-sensitive moxibustion.Besides,the researcher recorded the location,number,meridian distribution,manifestation and intensity of heat-sensitive acupoints.Each patient selected the three most sensitive acupoints among the detected acupoints and then took photos for them.The patients treated with suspended moxibustion by themselves everyday.Each acupoints was treated for 30 minutes everyday.Each patient accepted a total of 4 weeks treatment.Since the beginning of this study,each patient should record the implementation of heat-sensitive moxibustion and the changes of heat-sensitive acupoints every day which concluded the location,manifestation and intensity of heat-sensitive acupoints.The researcher should follow up the implementation of heat-sensitive moxibustion and the changes of acupoints by telephone or message or WeChat every 3 or 4 days.After 1 week,2 weeks,3 weeks and 4 weeks or at the time the patient recovered,the researcher should detect and record the changes of heat-sensitive acupoints.The curative effect of heat-sensitive moxibustion therapy was evaluated by House-Brackmann Grade when patients were cured or after the treatment.All data collected was established database with SPSS18.0 software.All data was analyzed by t test,variance analysis,rank sum test and chi-square test(Fisher’s exact probability method).The test level was α=0.05.Results①The occurrence rate of acupoints heat-sensitivity in the convalescent period with Bell’s palsy was 82.61%.There was no significant difference in the occurrence rate among different genders,different diseased sides,different ages,different education levels,different courses of disease,different lesion locations,different severity of disease and different syndrome differentiation types of the Bell’s palsy patients(P>0.05).②The distribution law of heat-sensitive acupoints in convalescent patients with Bell’s palsy:The most frequency heat-sensitive acupoint was Xiaguan(ST7),Yifeng(SJ17),Cuanzhu(BL2),Dicang(ST4),Yangbai(GB14),Jiache(ST6),Quanliao(S118),Qianzheng(EX-HN16),Shangguan(GB3),Juliao(ST3),Yingxiang(LI20),Hegu(LI4),Fengchi(GB20),Sibai(ST2),Taiyang(EX-HN5),Shuaigu(GB8),Daying(ST5),Quchi(LI11),Sizhukong(SJ23),Zusanli(ST36)and Shousanli(LI10).The occurrence rate of Xiaguan(ST7),Yifeng(SJ17),Cuanzhu(BL2),Dicang(ST4),Yangbai(GB14),Jiache(ST6),Quanliao(SI18),Shangguan(GB3),Juliao(ST3),Yingxiang(LI20),Fengchi(GB20),Sibai(ST2),Shuaigu(GB8),Daying(ST5)and Quchi(LI11)after treatment is less than those before treatment(P<0.05).There was significant difference in the occurrence rate of Taiyang(EX-HN5),Daying(ST5),Sizhukong(SJ23),Zusanli(ST36)and Shousanli(LI10)among different severity of disease before treatment(P<0.05).There was significant difference in the occurrence rate of Yingxiang(LI20),Sibai(ST2),Shuaigu(GB8),Sizhukong(SJ23)and Zusanli(ST36)among different severity of disease after treatment(P<0.05).The more serious the disease,the higher the incidence.There was significant difference in the occurrence rate of Jiache(ST6),Quanliao(SI18),Hegu(LI4),Fengchi(GB20),Shuaigu(GB8),Daying(ST5),Sizhukong(SJ23)and Zusanli(ST36)among different lesion locations(P<0.05).The higher the lesion site,the higher the incidence.There was no significant difference in the occurrence rate of most heat-sensitive acupoints among different courses of disease(P>0.05).The occurrence rate of deficiency of Qi and Blood in Zusanli(ST36),Shousanli(LI10),Hegu(LI4)and Quchi(LI11)was higher than that of other types of syndrome which without removing external evils(P<0.05).③The quantity distribution of the heat-sensitive acupoints in the convalescent patients with Bell’s palsy:There were 80 heat-sensitive acupoints detected before the treatment and 72 after the treatment of the 112 effective cases.The total frequency before the treatment was 1861 and 1098 after the treatment.There were 4 cases which were failed to detect the heat-sensitive acupoints after treatment.The number of heat-sensitive acupoints after the treatment was less than that before the treatment(P<0.05).There was no significant relationship between the number distribution of the heat-sensitive acupoints and different genders,different diseased sides,different ages,different education levels and different courses of disease(P>0.05),but related to different lesion locations,different severity of disease and different syndrome differentiation types.The higher the lesion site,the more the number of heat-sensitive acupoints and the lower the lesion site,the less the number of heat-sensitive acupoints(P<0.05).The more serious the disease was,the more the number of heat-sensitive acupoints was and the lighter the condition was,the fewer the number of heat-sensitive acupoints was(P<0.05).The number of heat-sensitive acupoints was less when the external evil had not been eliminated,and more when the external evil had been eliminated(P<0.05).④The meridian distribution law of heat-sensitive acupoints in the convalescent patients with Bell’s palsy:There were 10 meridians and extraordinary points involved.The meridians were Gallbladder Meridian of Foot-Shaoyang(GB),Stomach Meridian of Foot-Yangming(ST),Large Intestine Meridian of Hand-Yangming(LI),Bladder Meridian of Foot-Taiyang(BL),Sanjiao Meridian of Hand-Shaoyang(SJ),Conception Channel(RN),Governor Channel(GU),Small Intestine Meridian of Hand-Taiyang(SI),Liver Meridian of Foot-Jueyin(LR)and Lung Meridian of Hand-Taiyin(LU).The extraordinary points involved were Qianzheng(EX-HN16),Taiyang(EX-HN5),Yuyao(EX-HN3),Bailao(EX-HN15)and Jiachengjiang.The most frequent meridians before and after the treatment were Stomach Meridian of Foot-Yangming(ST),Gallbladder Meridian of Foot-Shaoyang(GB)and Large Intestine Meridian of Hand-Yangming(LI).The occurrence rate before treatment was higher than that after treatment of these three meridians(P<0.05).The most frequent extraordinary points before and after the treatment were Qianzheng(EX-HN16),Taiyang(EX-HN5)and Yuyao(EX-HN3).The occurrence rate before treatment was higher than that after treatment of Yuyao(EX-HN3)(P<0.05).There was no significant difference in the occurrence rate of Qianzheng(EX-HN16)and Taiyang(EX-HN5)before and after the treatment(P>0.05).⑤The manifestation law of heat-sensitive acupoints in convalescent patients with Bell’s palsy:The manifestations of heat-sensitive acupoints included diathermy,heat expansion,heat transfer,local non heat far heat,surface non heat deep heat,other non thermal sensation and compound sensation.The most frequent manifestations were heat expansion and heat transfer.The occurrence rate before treatment was higher than that after treatment of heat expansion(P<0.05).There was no significant difference in the occurrence rate of heat transfer before and after the treatment(P>0.05).⑥The most sensitive acupoints in the recovery period of Bell’ s palsy:The most sensitive acupoints in the top 10 were Qianzheng(EX-HN16),Yifeng(SJ17),Quanliao(SI18),Jiache(ST6),Cuanzhu(BL2),Xiaguan(ST7),Yingxiang(LI20),Juliao(ST3),Dicang(ST4)and Sibai(ST2).The main acupoints were lacated on Stomach Meridian of Foot-Yangming(ST)and Gallbladder Meridian of Foot-Shaoyang(GB).The main manifestation was heat expansion.The most sensitive acupoints distributed around the ears were Qianzheng(EX-HN16),Yifeng(SJ17)and Xiaguan(ST7).The most sensitive acupoints distributed around the eyes were Cuanzhu(BL2)and Sibai(ST2).The most sensitive acupoints distributed on the cheek were Quanliao(SI18),Jiache(ST6),Yingxiang(LI20),Juliao(ST3)and Dicang(ST4).⑦The evaluation of clinical efficacy:The total effective rate of heat-sensitive moxibustion therapy in the recovery period of Bell’s palsy was 78.57%.The grade of H-B after heat-sensitive moxibustion therapy was significantly lower than before(P<0.05).There was significant difference in curative effect among different severity of disease(P<0.05).The effective rate was 86.67%in grade Ⅱ,88.24%in grade Ⅲ,73.08%in grade Ⅳ,61.90%in grade V and 0%in grade Ⅵ.It was suggested that mild and moderate patients had the best effect,followed by moderately severe and severe patients,and extremely severe patients had the worst effect.⑧The relationship between the distribution,quantity and therapeutic effect of heat-sensitive acupoints:It was different that the occurrence rate of 21 high frequency heat-sensitive acupoints among distinct therapeutic effects before and after the treatment.There were 15 high frequency heat-sensitive acupoints with different incidence before and after treatment of the recovered patients(P<0.05).There were 7 high frequency heat-sensitive acupoints with different incidence before and after treatment of the markedly effective patients(P<0.05).The occurrence rate of these acupoints after treatment is less than those before treatment.There was no difference in the occurrence rate of 21 high-frequency acupoints before and after treatment of the effective patients and the invalid ones(P>0.05).There was statistical significance in the quantity of heat-sensitive acupoints among distinct therapeutic effects before and after the treatment(P>0.05).The number of heat-sensitive acupoints after the treatment was less than that before the treatment(P<0.05).There was great variation in the number of heat-sensitive acupoints before and after the treatment between the cured and the markedly effective patients.There was slight variation in the number of heat-sensitive acupoints before and after the treatment between the effective and the invalid patients.Conclusion①The heat-sensitive acupoints in the convalescent patients with Bell’s palsy were mainly distributed locally.The acupoints were mainly distributed in the three meridians which were Gallbladder Meridian of Foot-Shaoyang(GB),Stomach Meridian of Foot-Yangming(ST)and Large Intestine Meridian of Hand-Yangming(LI).The main forms of thermal sensitivity were heat expansion and heat transfer.②It was concluded that heat-sensitive acupoints were dynamic.The heat-sensitive acupoints showed different characteristics at different stages of the disease.They changed as the disease progressed.And they were changing by the variation with the disease condition.The location and quantity distribution of the heat-sensitive acupoints was not related to the course of disease,but related to the severity of the disease,the location of the disease and the syndrome differentiation types.③Heat-sensitive moxibustion therapy was effective in the recovery period of Bell’s palsy.It was suggested that mild and moderate patients had the best effect,followed by moderately severe and severe patients,and extremely severe patients had the worst effect.The changes of distribution and quantity of heat-sensitive acupoints were related to different therapeutic effects.The better the therapeutic effect,the larger the change of distribution and quantity.The worse the therapeutic effect,the smaller the change of distribution and quantity.