目的：验证针灸分期治疗面肌痉挛的疗效,寻找治疗该病的较佳治疗方式。方法将140例患者随机分为分期治疗组(50例)、针刺组(50例)、西药组(40例)。分期治疗组按患者病程长短分为早、中、晚3期,每期采用不同药物进行穴位注射配合温针治疗。针刺组采用常规针刺留针1 h治疗。西药组口服卡马西平片,每次0.2 g,每日3次。3组治疗疗程结束后,随访半年无复发或加重,按Cohen、Albert痉挛强度分级评估疗效。结果分期治疗组、针刺组、西药组完全缓解率分别为56.0%(28/50)、14.0%(7/50)、20.0%(8/40)。分期治疗组完全缓解率明显优于针刺组和西药组(P＜0.05)。分期治疗组、针刺组、西药组总有效率分别为100.0%(50/50)、70.0%(35/50)、60.0%(24/40)。分期治疗组总有效率明显高于针刺组和西药组(P＜0.05)。结论分期治疗面肌痉挛方法疗效显著。%Objective To validate the therapeutic effect of acupuncture stage treatment on facial spasm and seek a better method for treating this disease. Method One hundred and forty patients were randomly allocated to stage treatment (50 cases), acupuncture (50 cases) and Western medicine (40 cases) groups. In the stage treatment group, treatment was divided into early, middle and late stages according to the patients’ duration of disease. Each stage provided acupuncture point injection of different medicine plus warm needling. The acupuncture group received conventional acupuncture with 1 hour retention of needles and the Western medicine group, oral administration of carbamazepine tablets, 0.2 g 3 times a day. After the completion of treatment course, a six-month follow-up was performed to determine no relapse or aggravation in the three groups and the therapeutic effects were evaluated using Cohen and Albert spasm grading criteria.Result The complete resolution rate was 56% (28/50) in the stage treatment group, 14.0% (7/50) in the acupuncture group and 20.0% (8/40) in Western medicine group. The complete resolution rate was significantly higher in the stage treatment group than in the acupuncture and Western medicine groups (P<0.05). The total efficacy rate was 100.0% (50/50) in the stage treatment group, 70.0% (35/50) in the acupuncture group and 60.0% (24/40) in the Western medicine group. The total efficacy rate was significantly higher in the stage treatment group than in the acupuncture and Western medicine groups (P<0.05).Conclusion Stage treatment has a marked effect on facial spasm.
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