中西医结合治疗外展神经麻痹的临床观察

Clinical observation on treatment of abducens nerve palsy with integrated Traditional Chinese and western medicine

目的观察中西医结合治疗外展神经麻痹的临床疗效。方法纳入32例(男性18例,女性14例)外展神经麻痹的患者,中医辨证为风邪中络者6例,风痰阻络证10例,脉络阻塞证4例,肝阳上亢证5例,气滞血瘀证7例。给予中西医结合治疗方式,即针刺、眼周推拿、辨证内服中药、穴位注射(丹参注射液)、复方樟柳碱颞旁注射、口服甲钴胺胶囊治疗,10 d为1个疗程,最短1个疗程,最长3个疗程,每个疗程间隔休息3d,治疗结束后对治疗前后进行疗效评定,并对相关数据进行统计学分析。结果经过第1个疗程的总有效率为81.25%,经过第2个疗程的总有效率为90.63%,经过第3个疗程的总有效率为93.75%,比较有统计学意义(P<0.05)。结论中西医结合疗法可以有效治疗治疗外展神经麻痹的所致的眼球外展受限、复视、眩晕等症状。

OBJECTIVE To observe the clinical effect of integrated traditional Chinese and western medicine on abducens nerve palsy. METHODS Thirty two cases（18 male, 14 female）with abduction nerve paralysis were treated by TCM according to syndrome differentiation. The syndrome pattern of patients were as ten cases with wind phlegm obstructing collaterals, 4 with choroid obstruction, 5 with liver yang hyperactivity and 7 with qi stagnation and blood stasis. Combination of traditional Chinese and western medicine treatment including acupuncture, eye massage, dialectical internal medicine, injection of Salvia miltiorrhiza, compound anisodine temporal injection, Mecobalamin Capsules was applied and 10 days as a course. They were treated for 1 course to 3 courses in a regime of 3 days of rest between each course. Then the curative effect was evaluated, and the related data were statistically analyzed. RESULTS The total effective rate after first course was 81.25%, the total effective rate after second course was 90.63%, and the total effective rate after third course was 93.75%. The differences between them were statistically significant（P〈0.05）. CONCLUSIONS Integrated traditional Chinese and western medicine effectively alleviated the symptoms of limited eye ball abduction, diplopia and vertigo caused by abducens nerve palsy.