反思Bell麻痹治疗中的过度与不足

Rethink of the Treatments for Bell's Palsy on Excessive and Inadequate

针灸治疗Bell麻痹的效果早已得到广泛认可,但一些现象仍值得思考,多数Bell麻痹属于轻中度,一般预后良好,然而临床上中西医的多种治疗方法往往同时使用,是否存在过度治疗的现象?过度治疗势必造成医疗资源的浪费且无益于患者康复;另一方面,少数预后差的重度面瘫,常规针灸治疗效果不理想,缺少特效的治疗手段和预防措施。近年来发现Bell麻痹的发病,与潜伏的单纯疱疹病毒被激活密切相关,面瘫康复的结果主要取决于面神经损伤或变性程度。减轻面神经变性程度,关键在于发病早期及时干预。Bell麻痹初期需要进行适当的预后判断,分辨出重度面瘫并加强治疗以提高康复水平减轻后遗症。今后临床研究应侧重面瘫发病初期规范的针灸治疗,以及加快重症面瘫恢复的特效方法等方面。

Acupuncture treatment for Bell’s palsy has been widely used and accepted.However,some issues are still needed to be discussed.For most of the mild or moderate facial paralysis which probably have good prognosis,the treatments were often to be given more over needed.There are no more benefits for the patients but bring about the wasting of medical resources.In the same time,for most of the severe facial paralysis there have been no satisfied therapeutic methods even with acupuncture and moxibustion.The key to solve this problem is early treatments to be given in time so as to reduce the facial nerve injury by the viral infection.It is necessary to make an early estimating of prognosis to find the severe cases which need special therapeutic methods for better recovery.The future research works should focus on the early standardized acupuncture interfere and effective therapeutic methods for the severe Bell’s palsy.