补黄四五汤治疗周围性面瘫的疗效及安全性

Clinical effect and safety of Buhuangsiwu Decoction in treating patients with peripheral facial paralysis

目的:观察陈宝田教授经验方补黄四五汤治疗周围性面瘫的疗效及安全性.方法:选择符合标准的100例患者,随机分为2组,每组各50例,治疗组予补黄四五汤治疗,对照组予常规西药治疗,比较两组的疗效并进行安全性评价.结果:治疗组治愈率为44%、总有效率为92%,对照组治愈率为16%、总有效率为54%,两组治愈率及总有效率均有统计学差异(P<0.05).两组治疗前后Portmann简易评分,眼轮匝肌与口轮匝肌M波潜伏期差值、患健侧M波的波幅比、瞬目反射患侧R1、R2、R2'未出波率及其潜伏期有统计学差异(P<0.05),且治疗后治疗组与对照组之间各项指标有统计学差异(P<0.05).治疗组不良反应为腹泻,发生率为18%,可自行缓解或加入番石榴叶后消失,对照组不良反应为口干、食欲不振、面部痤疮,发生率为26%.结论:补黄四五汤与西医常规治疗均能显著改善周围性面瘫患者症状及面神经功能,且补黄四五汤疗效显著优于常规西药,安全性相对较高.

Objective： To observe the clinical effect and safety of Buhuangsiwu Decoction,an experiential prescription of professor CHEN Bao-tian,in treating peripheral facial paralysis. Methods：100 patients who met the criteria were randomly divided into two groups,treatment group and control group,each 50 cases. The treatment group was treated with Buhuangsiwu Decoction,and the control group was given western medicine treatment based on clinical guidelines. The clinical efficacy of the two groups was compared and their safety was evaluated. Results： The total effective rate was 92% in the treatment group and 54% in the control group,with the cure rate being 44% and 16%,respectively.There was significant difference between the two groups（ P〈0. 05）. Both groups improved the Portmann Simplified Scoring,the M wave latency difference between orbicularis oculi muscle and orbicularis orismuscle,the M wave amplitude ratio of suffered to healthy side,and the uninvolved rate and latency of R1,R2 and R2＇ of the blink reflex on the affected side after treatment（ P〈0. 05）,and the treatment group was superior to the control group（ P〈0. 05）. The main adverse reaction in the treatment group was diarrhea with an incidence of 18%. Most of them recovered themselves,and some of them relieved with addition of guava leaves. The adverse reactions in the control group were dry mouth,loss of appetite and face acne,and the incidence was 26%. Conclusion： Both Buhuangsiwu Decoction and western medicine based on clinical guidelines significantly improved the symptoms and the facial nerve function of patients with peripheral facial paralysis. The former showed much better efficacy than the latter and had higher safety.