針灸治療Bell’s面癱療效的系統評價_《中國循證醫學雜志》

作者：

何俐 ¹ , 周沐科 ¹ , 周東 ¹ , 李寧 ² , 吳濱 ²

1. 四川大學華西醫院神經內科,成都,6100412. 四川大學華西醫院針灸科;

關鍵詞：

針灸 Bell’s面癱隨機對照試驗系統評價

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目的　系統評價針灸促進Bell’s面癱康復和減少其遠期發病率的效果.
方法　計算機檢索MEDLINE、EMBASE、LILAS、中國生物醫學文獻數據庫和Cochrane肌肉疾病組注冊組資料庫,檢索時間截止至2002年12月;同時檢索其它相關灰色文獻,獲取所有涉及針灸治療Bell’s面癱的隨機和半隨機對照試驗.而后選擇符合納入標準的臨床試驗,評價其方法學質量,并從中提取患者基本情況、干預措施、終點指標和結果等相關資料進行系統評價.
結果　共有3個小規模的臨床隨機對照試驗,合計288例患者符合納入標準,但因其在試驗設計、報道上存在明顯缺陷,以及試驗之間存在較大差異,不符合Meta分析條件,因而只進行了定性分析.結果顯示,針灸治療Bell’s面癱有一定療效(P均 lt;0.01).
結論　針灸治療Bell’s面癱有效,但入選的3個隨機對照試驗規模小,質量不高,降低了這一結論的可靠性.開展高質量、內在真實性好的相關隨機對照試驗非常必要.

引用本文： 何俐,周沐科,周東,李寧,吳濱. 針灸治療Bell’s面癱療效的系統評價. 中國循證醫學雜志, 2005, 05(2): 106-109. doi: 復制

1.	邵書鳳, 王中欣, 王莉. 針灸與西藥聯用治療周圍性面神經癱瘓58例[J]. 新醫學, 1999;30(1): 14.
2.	劉敏. 淺刺多針法和藥物療法治療面癱130例療效的對比觀察[J]. 針灸臨床雜志, 1996;12(5): 56.
3.	任留江. 針灸治療面癱450例[J]. 中國針灸, 1987;(3):13～14.
4.	吳經偉. 針灸面神經干治療周圍性面癱220例臨床觀察[J]. 中國針灸, 1987;(3): 19～20.
5.	李志明. 針灸為主治療面癱1 014例療效分析[J]. 中國針灸, 1987;(2): 1～3.
6.	劉桂珍. 電針為主治療急性周圍性面神經癱瘓100例[J]. 上海針灸雜志, 1995;14(6): 257.
7.	Adour KK, Byl FM, Hilsinger RL Jr, Kahn ZM, Sheldon MI. The true nature of Bell’s palsy: Analysis of 1 000 consecutive patients[J]. Laryngoscope, 1978;88(19): 787-811.
8.	May M, Klein S. Differential diagnosis of facial nerve palsy[J]. Otolaryngologic Clinics of North America, 1991;24(3): 613-645.
9.	McCormick DP. Herpes simplex as a cause of Bell’s palsy[J]. Lancet, 1972;1(7 757): 937-939.
10.	Adour KK, Ruboyianes JM, Von Doeersten PG, Byl FM, Trent CS, Queensberry CP, Hitchcock T. Bell’s palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomised, controlled trial[J]. Annals of Otolaryngology, Rhinology and Laryngology, 1996;105(5): 371-378.
11.	Jabor MA, Gianoli G. Management of Bell’s palsy[J]. Journal of the Louisiana State Medical Society, 1996;148(7): 279-283.
12.	Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N. Bell’s palsy and herpes simplex virus;identification of viral DNA in endoneurial fluid and muscle[J]. Annals of Internal Medicine, 1996;124(1 Pt 1): 27-30.
13.	Jackson CG, Von Doersten PG. The facial nerve. Current trends in diagnosis, treatment, and rehabilitation[J]. Medical Clinics of North America, 1999;83(1): 179-195.
14.	Sipe J, Dunn L. Aciclovir for Bell’s palsy (Cochrane review). The Cochrane Library. 2003,4, Update Software, Oxford.
15.	Adour KK, Wingerd J, Bell DM, Manning JJ, Hurley JP. Prednisone treatment for idiopathic facial paralysis (Bell’s palsy)[J]. New England Journal of Medicine, 1972;287(26): 1 268-1 272.
16.	Salinas RA, Alvarez G, Alvarez MI, Ferreira J. Corticosteroids for Bell’s palsy (idiopathic facial paralysis) (Cochrane Review). The Cochrane Library. 2003,4, Update Software, Oxford.
17.	Fisch U. Surgery for Bell’s palsy[J]. Archives of Otolaryngology, 1981;107(1): 1-11.
18.	Ren XQ. A survey of acupuncture treatment for peripheral facial paralysis[J]. Journal of Traditional Chinese Medicine, 1994;14(2): 139-146.
19.	He SH, Zhang HL, Liu R. Review on acupuncture treatment of peripheral facial paralysis during the past decade[J]. Journal of Traditional Chinese Medicine, 1995;15(1): 63-67.
20.	Shao SF, Wang ZX, Wang L.Acupuncture and Western Medicine for 58 Patients with Peripheral Facial Palsy[J]. New Chinese Medicine, 1999;30(1): 14.
21.	Liu M. Comparison of Acupuncture and Drug Treatment for 130 Patients with Facial Palsy[J]. Journal of Clinical Acupuncture, 1996;12(5): 56.
22.	Yu YQ. Analysis of Acupuncture for Peripheral Facial Palsy[J]. Shanghai Journal of Acupuncture and Moxibustion, 1999;18(5): 26.
23.	Ren LJ. Acupuncture for 450 Facial Palsy Patients[J]. Chinese Acupuncture, 1987;(3): 13-14.
24.	Wu JW. Acupuncture for 220 Peripheral Facial Palsy patients[J]. Chinese Acupuncture, 1987;(3): 19-20.
25.	Zhang YH. Clinical Experience in Acupuncture Treatment of Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 217-219.
26.	Li ZM. Acupuncture for 1 014 Facial Palsy Patients[J]. Chinese Acupuncture,1987;(3): 1-3.
27.	Li L. The Therapeutic Effects of Lifting-Twirling Manoeuvre in Acupuncture Treatment of Facial Paralytic Sequelae[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 203-206.
28.	Xing WT. Clinical Observation on Acupuncture Treatment of Persistent Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 18-20.
29.	Zhang XX. Electric Needle Therapy for Peripheral Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 47-49.
30.	Gao S, Gao G. Can the addition of moxibustion during acupuncture therapy improve recovery from Bell’s Palsy[J]? American Journal of Acupuncture,1998;26(1): 33-36.
31.	Zang JQ. 80 Cases of Peripheral Facial Paralysis Treated by Acupuncture with Vibrating Shallow Insertion[J]. Journal of Traditional Chinese Medicine, 1999;19(1): 44-47.
32.	Liu GZ. Electronic Acupuncture for 100 Acute Peripheral Facial Palsy Patients[J]. Journal of Shanghai Acupuncture, 1995;14(6): 257.
33.	Zhu LJ. Different Therapy for 214 Facial Palsy Patients[J]. Jiangsu Traditional Chinese Medicine, 1995;16(3): 31-32.
34.	Anon. Traditional Chinese Medicine for Facial Neuritis[J]. Journal of Youjiang Medical College for National Minorities,1998;18(2): 230-231.
35.	Shao MY. Acupuncture for 195 Patients with Facial Palsy[J]. New Chinese Medicine, 1999;15(12): 14-15.
36.	Huang XS. Qianzhengsan Herb for 86 Bell’s Palsy Patients[J]. Traditional Chinese Medicine Research, 1999;12(5): 31-32.
37.	Shui RY. Qianzhengsan Herb for 35 Peripheral Facial Palsy Patients[J]. Hebei Journal of Conjugation of Traditional Chinese Medicine and Western Medicine, 1999;8(5): 782-783.

1. 邵書鳳, 王中欣, 王莉. 針灸與西藥聯用治療周圍性面神經癱瘓58例[J]. 新醫學, 1999;30(1): 14.
2. 劉敏. 淺刺多針法和藥物療法治療面癱130例療效的對比觀察[J]. 針灸臨床雜志, 1996;12(5): 56.
3. 任留江. 針灸治療面癱450例[J]. 中國針灸, 1987;(3):13～14.
4. 吳經偉. 針灸面神經干治療周圍性面癱220例臨床觀察[J]. 中國針灸, 1987;(3): 19～20.
5. 李志明. 針灸為主治療面癱1 014例療效分析[J]. 中國針灸, 1987;(2): 1～3.
6. 劉桂珍. 電針為主治療急性周圍性面神經癱瘓100例[J]. 上海針灸雜志, 1995;14(6): 257.
7. Adour KK, Byl FM, Hilsinger RL Jr, Kahn ZM, Sheldon MI. The true nature of Bell’s palsy: Analysis of 1 000 consecutive patients[J]. Laryngoscope, 1978;88(19): 787-811.
8. May M, Klein S. Differential diagnosis of facial nerve palsy[J]. Otolaryngologic Clinics of North America, 1991;24(3): 613-645.
9. McCormick DP. Herpes simplex as a cause of Bell’s palsy[J]. Lancet, 1972;1(7 757): 937-939.
10. Adour KK, Ruboyianes JM, Von Doeersten PG, Byl FM, Trent CS, Queensberry CP, Hitchcock T. Bell’s palsy treatment with acyclovir and prednisone compared with prednisone alone: a double-blind, randomised, controlled trial[J]. Annals of Otolaryngology, Rhinology and Laryngology, 1996;105(5): 371-378.
11. Jabor MA, Gianoli G. Management of Bell’s palsy[J]. Journal of the Louisiana State Medical Society, 1996;148(7): 279-283.
12. Murakami S, Mizobuchi M, Nakashiro Y, Doi T, Hato N, Yanagihara N. Bell’s palsy and herpes simplex virus;identification of viral DNA in endoneurial fluid and muscle[J]. Annals of Internal Medicine, 1996;124(1 Pt 1): 27-30.
13. Jackson CG, Von Doersten PG. The facial nerve. Current trends in diagnosis, treatment, and rehabilitation[J]. Medical Clinics of North America, 1999;83(1): 179-195.
14. Sipe J, Dunn L. Aciclovir for Bell’s palsy (Cochrane review). The Cochrane Library. 2003,4, Update Software, Oxford.
15. Adour KK, Wingerd J, Bell DM, Manning JJ, Hurley JP. Prednisone treatment for idiopathic facial paralysis (Bell’s palsy)[J]. New England Journal of Medicine, 1972;287(26): 1 268-1 272.
16. Salinas RA, Alvarez G, Alvarez MI, Ferreira J. Corticosteroids for Bell’s palsy (idiopathic facial paralysis) (Cochrane Review). The Cochrane Library. 2003,4, Update Software, Oxford.
17. Fisch U. Surgery for Bell’s palsy[J]. Archives of Otolaryngology, 1981;107(1): 1-11.
18. Ren XQ. A survey of acupuncture treatment for peripheral facial paralysis[J]. Journal of Traditional Chinese Medicine, 1994;14(2): 139-146.
19. He SH, Zhang HL, Liu R. Review on acupuncture treatment of peripheral facial paralysis during the past decade[J]. Journal of Traditional Chinese Medicine, 1995;15(1): 63-67.
20. Shao SF, Wang ZX, Wang L.Acupuncture and Western Medicine for 58 Patients with Peripheral Facial Palsy[J]. New Chinese Medicine, 1999;30(1): 14.
21. Liu M. Comparison of Acupuncture and Drug Treatment for 130 Patients with Facial Palsy[J]. Journal of Clinical Acupuncture, 1996;12(5): 56.
22. Yu YQ. Analysis of Acupuncture for Peripheral Facial Palsy[J]. Shanghai Journal of Acupuncture and Moxibustion, 1999;18(5): 26.
23. Ren LJ. Acupuncture for 450 Facial Palsy Patients[J]. Chinese Acupuncture, 1987;(3): 13-14.
24. Wu JW. Acupuncture for 220 Peripheral Facial Palsy patients[J]. Chinese Acupuncture, 1987;(3): 19-20.
25. Zhang YH. Clinical Experience in Acupuncture Treatment of Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 217-219.
26. Li ZM. Acupuncture for 1 014 Facial Palsy Patients[J]. Chinese Acupuncture,1987;(3): 1-3.
27. Li L. The Therapeutic Effects of Lifting-Twirling Manoeuvre in Acupuncture Treatment of Facial Paralytic Sequelae[J]. Journal of Traditional Chinese Medicine, 1997;17(3): 203-206.
28. Xing WT. Clinical Observation on Acupuncture Treatment of Persistent Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 18-20.
29. Zhang XX. Electric Needle Therapy for Peripheral Facial Paralysis[J]. Journal of Traditional Chinese Medicine, 1997;17(1): 47-49.
30. Gao S, Gao G. Can the addition of moxibustion during acupuncture therapy improve recovery from Bell’s Palsy[J]? American Journal of Acupuncture,1998;26(1): 33-36.
31. Zang JQ. 80 Cases of Peripheral Facial Paralysis Treated by Acupuncture with Vibrating Shallow Insertion[J]. Journal of Traditional Chinese Medicine, 1999;19(1): 44-47.
32. Liu GZ. Electronic Acupuncture for 100 Acute Peripheral Facial Palsy Patients[J]. Journal of Shanghai Acupuncture, 1995;14(6): 257.
33. Zhu LJ. Different Therapy for 214 Facial Palsy Patients[J]. Jiangsu Traditional Chinese Medicine, 1995;16(3): 31-32.
34. Anon. Traditional Chinese Medicine for Facial Neuritis[J]. Journal of Youjiang Medical College for National Minorities,1998;18(2): 230-231.
35. Shao MY. Acupuncture for 195 Patients with Facial Palsy[J]. New Chinese Medicine, 1999;15(12): 14-15.
36. Huang XS. Qianzhengsan Herb for 86 Bell’s Palsy Patients[J]. Traditional Chinese Medicine Research, 1999;12(5): 31-32.
37. Shui RY. Qianzhengsan Herb for 35 Peripheral Facial Palsy Patients[J]. Hebei Journal of Conjugation of Traditional Chinese Medicine and Western Medicine, 1999;8(5): 782-783.

《中國循證醫學雜志》

針灸治療Bell’s面癱療效的系統評價

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《中國循證醫學雜志》

針灸治療Bell’s面癱療效的系統評價

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