摘要
目的:观察大剂量激素冲击治疗重型特发性面神经炎的临床疗效,为重型特发性面神经炎的诊治提供有价值的临床诊疗方案。方法:收集安徽中医药大学第一附属医院脑病中心收治的符合标准的15例重型特发性面神经炎患者且行甲泼尼龙冲击治疗的病例进行回顾性分析研究,甲泼尼龙20mg·kg-1·d-1,连用3-5天;冲击治疗后采用泼尼松序贯疗法,给予口服泼尼松50mg,每两周减5mg,直至减完停药,总疗程4-6个月。采用House-Brackmann(H-B)面神经功能分级标准量表、面部残疾指数(FDI)量表于大剂量激素冲击治疗后第0天、30天、60天进行临床疗效评价研究。结果:(1)大剂量激素冲击疗效与发病年龄、病程长短具有极相关性,它们之间存在负相关关系;(2)在大剂量激素冲击治疗过程中,H-B面部神经功能分级量表在冲击治疗后第30天、第60天两期的疗效对比差别不大,以一种持续性的疗效进行;FDIp在冲击治疗后第30天、第60天前后的两期的疗效对比显示:第一期的疗效相对要好一些,以一种先快后慢的疗效进行。FDIs在冲击治疗后第30天、第60天前后的两期的疗效对比显示出前后反差(反向取值),起初的疗效使指数恶化,至治疗第60天时,疗效非常显著。结论:(1)大剂量激素冲击疗法疗效与发病年龄及病程长短具极强相关性;(2)大剂量激素冲击疗法疗效以一种持续性的疗效进行,应坚持激素序贯疗法,维持激素足量、足疗程治疗;使用激素的同时应重视对患者进行心理干预和调节,改善患者心理环境以获得最大的临床治疗效果;(3)大剂量激素冲击疗法治疗重型特发性面神经炎的治疗效果肯定,值得在临床上推广使用。
Objective： The research was aimed at observing the clinical effect of large dose methylprednisolone on severe acute idiopathic facial neuritis . Methods： The clinical data of 15 Severe Acute Bell＇ s Palsy from department of encephalopathy, our hospital were analyzed from September 2014 to September 2017. Methylprednisolone were given for all patients by intravenous drop infusion for one courses, which included methylprednisolone intravenous infusion for three-five days, prednisone 2 mg/kg/d were taken by all patients for 4 to 6 months, which were reduced after 4 to 12 weeks. The House-Brackmann（H-B） scale, Facial Disability Index（FDI） Scale were used in the study. Resuhs：（1） there was significantly negative correlation between age and course; （2） The H-B scale of Methylprednisolone after 30 days were no significantly better than it after 60 days of treatment; There is opposite direction in FDIs Scale, while FDIp Scale of it after 30 days were significantly better than it after 60 days of treatment. Conclusion： （1）Methylprednisolone is effective in the treatment of severe acute idiopathic facial neuritis, there was significant correlation between age and course. （2）The effect on severe acute idiopathic facial neuritis of Methylprednisolone is in a way of sustainability, and it
作者
陶庄
孙林娟
汪美霞
TAO Zhuang;SUN Linjuan;WANG Meixia(Anhui University of Chinese Medicine,Anhui Hefei 230038,China;Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)
出处
《中医药临床杂志》
2018年第7期1268-1272,共5页
Clinical Journal of Traditional Chinese Medicine
基金
安徽省名中医学术经验继承工作专项来源:安徽省中医药管理局
关键词
重型特发性面神经炎
甲泼尼龙
疗效
Methylprednisolone
Severe acute idiopathic facial neuritis y
Clinical Effect
作者简介
陶庄为安徽中医药大学2016年在读硕士。;通讯作者：汪美霞（1977-），女，副主任中医师。研究方向：中医脑病。E-mail：：meixiawang96@sina．com
