加味补阳还五汤治疗单侧特发性声带麻痹的临床观察

Modified buyang huanwu decoction in the treatment of unilateral idiopathic vocal code paralysis

目的观察加味补阳还五汤治疗单侧特发性声带麻痹的疗效。方法选取34例单侧特发性声带麻痹患者,将其随机分为对照组和治疗组,各17例。对照组应用奥拉西坦注射液和醋酸泼尼松片,治疗组在对照组治疗方案的基础上配合中药汤剂加味补阳还五汤,治疗周期均为3周。观察患者入院时、治疗3周后、4个月后随访时电子喉镜、Praat软件嗓音分析[嗓音基频微扰(Jitter)、振幅微扰(Shimmer)、谐噪比(HNR)]结果及总有效率。结果治疗3周时治疗组和对照组有效率分别为70.58%、41.17%,差异具有统计学意义(P<0.05)。4个月后随访,治疗组和对照组有效率分别为94.10%、64.71%,差异具有统计学意义(P<0.01)。两组治疗前嗓音分析各项指标比较,差异无统计学意义(P>0.05)。与本组治疗前比较,治疗3周时治疗组和对照组Jitter、Shimmer降低,HNR升高,差异具有统计学意义(P<0.05)。与本组治疗3周时比较,4个月后随访时对照组Jitter、Shimmer、HNR未见明显变化(P>0.05);治疗组Jitter、Shimmer降低,HNR升高,差异具有统计学意义(P<0.05)。与对照组同时期比较,治疗3周时,治疗组Jitter降低,HNR升高,差异具有统计学意义(P<0.05),4个月后随访时治疗组Jitter、Shimmer降低,HNR升高,差异具有统计学意义(P<0.01)。结论加味补阳还五汤治疗单侧特发性声带麻痹具有较好的临床效果,能够提高本病的近、远期疗效,可推广应用。

Objective To observe the effects of the modified buyang huanwu decoction on unilateral idiopathic vocal cord paralysis. Methods A total of 34 patients of unilateral idiopathic vocal cord paralysis were randomized into a control group and a treatment group,17 cases in each one. In the control group,oxiracetam injection and prednisone acetate tablets were used. In the treatment group,on the base of the treatment as the control group,the modified buyang huanwu decoction was supplemented. The treating duration was 3 weeks. Separately,on the 1 st day of hospital stay,in 3 weeks of treatment and in follow-up after 4 months,the results of electronic laryngoscope,Praat software voice analysis（jitter,shimmer and HNR） and the total effective rate were observed. Results After 3-week treatment,the total effective rate was70. 58% in the treatment group and was 41. 17% in the control group,indicating the significant difference（P〈0. 05）. In follow-up after 4 months,the effective rate was 94. 10% in the treatment group and was 64. 71% in the control group,indicating the significant difference（P〈0. 01）. The differences were not significant in the indexes of voice analysis between the two groups before treatment（P〉0. 05）. As compared with those before treatment,the jitter and shimmer were reduced and HNR increased after 3-week treatment in the treatment group and the control group,indicating the significant differences（P〈0. 05）. In the self-comparison in 3 weeks of treatment and the follow-up after 4 months,the results of jitter,shimmer and HNR did not change obviously in the control group（P〈0. 05）; but in the control group,the results of jitter and shimmer were reduced and HNR increased,indicating the significant differences（P〈0. 05）. Compared with the control group at the same time point,in 3-week treatment,the jitter was reduced and HNR increased in the treatment group,indicating the significant differences（P〈0. 05）; in the follow-up after 4 months,the jitter and shimmer were reduced and HNR increased,indicating the significant differences（P〈0. 01）. Conclusion The buyang huanwu decoction achieves the satisfactory effects on unilateral idiopathic vocal cord paralysis. It improves the short-term and long-term effects anddeserves to be promoted in practice.