电针、特定电磁波、β-七叶皂甙钠联合西药治疗特发性面神经瘫痪的临床观察

Combination of electropuncture,TDP,beta-sodium aescinate and western medicine in treatment of patients with idiopathic facial nerve palsy

目的目前对于特发性面神经瘫痪尚无特效疗法,本研究将物理及药物治疗方法联合,探讨电针、特定电磁波(TDP)、β-七叶皂甙钠联合西药治疗特发性面神经瘫痪的临床疗效。方法将66例特发性面神经瘫痪患者按照随机数表法平均分为A、B、C三组,每组22例。A组接受常规西药治疗及电针治疗;B组在A组治疗基础上加用患侧面部耳周TDP照射治疗;C组在B组治疗基础上加用β-七叶皂甙钠静脉滴注治疗。所有患者均在发病7 d后进行电针治疗,1次/d,10次为1疗程,疗程间休息2 d,在4个疗程电针治疗结束时观察并比较3组患者临床治疗总有效率及面部残疾指数评分(FDI)。分别在治疗前及治疗结束后3个月时采用生存质量测定量表简表(WHOQOL-BREF)对患者生存质量进行评估。结果 B组总有效率较A组显著改善,由68.18%显著提高至77.27%(χ2=7.32,P<0.05),C组则进一步显著提升至86.36%,显著高于B组(χ2=6.62,P<0.05)及A组(χ2=2.51,P<0.05);患者治疗后FDI评分均显著升高(P均<0.05),治疗后B组升高较A组更为明显(P<0.05),C组较B组及A组均更为显著(P均<0.05);3个月后随访WHOQOL-BREF量表评分均显著升高(P均<0.05),治疗后B组升高较A组更为明显(P<0.05),C组较B组及A组均更为显著(P均<0.05)。结论电针、TDP、β-七叶皂甙钠联合西药治疗特发性周围性面神经瘫痪临床效果明显,能够改善患者面神经功能及生活质量。

Objective Currently, there was still no effective regimen to cure idiopathic facial nerve palsy. In this study, drug and physical treatments were combined to explore the therapy of electropuncture, TDP, beta-sodium aescinate and western medicine in treatment of patients with idiopathic facial nerve palsy. Methods 66 patients with idiopathic facial nerve palsy were divided into group A, B and C, randomly and evenly. Group A received regular western medicine and electropuncture treatment;group B received additional treatment of TDP based on group A;group C received additional treatment of beta-sodium aescinate based on group B. Total therapeutic efficacy,score of FDI（after treatment session） and WHOQOL-BREF（ before treatment and after 3-month follow-up） were observed and compared between groups. Results Efficacy of group B （77.27 % ） increased significantly compared with group A （68.18 % ） （ 2 = 7.32, P 〈 O. 05 ）, while efficacy of group C （ 86.36% ） increased more significantly than group B（ X2 = 6.62 ,P 〈 0.05 ） and group A（ 2 = 2.51, P 〈 O. 05） ; FDI score increased significantly in all groups after treatment （ all P 〈 0.05 ）, more significantly in group B than group A （ P 〈 0.05 ）, even more significantly in group C than in group A and group B （ all P 〈 O. 05 ） ; WHOQOL- BREF score increased significantly in all groups after treatment（ all P 〈 O. 05 ）, more significantly in group B than group A （ P 〈 O. 05 ）, even more significantly in group C than in group A and group B （ all P 〈 O. 05 ）. Conclusion Combination of electropuncture,TDP, beta-sodium aescinate and western medicine was suitable in treating patients with idiopathic fa- cial nerve palsy, which could improve function of facial nerve and life quality.