七叶皂苷钠、强的松治疗Bell麻痹的随机对照研究

Bell's palsy: a randomized, prospective, and controlled study on the efficacies of aescin and prednisone versus empirical treatment

目的 探讨七叶皂苷钠治疗Bell麻痹的有效性。方法 采用随机对照研究 ,收集首次诊断Bell麻痹的急性期患者 85例 ,随机分为七叶皂苷钠组 (七叶皂苷钠加基础治疗 ) 30例、强的松组 (强的松加基础治疗 ) 2 8例、基础治疗组 2 7例 ,基础治疗包括多种维生素、针灸、理疗等 ,均在发病 3天内给予相应的治疗。采用House Brach mann(H B)面神经麻痹评定标准 ,分别于治疗前与治疗后 1个月时评定面神经麻痹等级。结果 治疗前 3组患者性别、年龄、面瘫部位、发病至开始治疗时间、首次治疗时H B面瘫等级分布均无统计学差异 ,具有可比性。治疗后 1个月时三组患者H B面瘫等级经Kruskal Wallis秩和检验 ,有统计学差异 (P =0 0 4 8)。 3组间两两比较显示七叶皂苷钠组、强的松组面瘫恢复均优于基础治疗组 ,有统计学意义 (P值分别为 0 0 4 5、0 0 14 ) ;而七叶皂苷钠组与强的松组面瘫恢复比较无统计学差异 (P =0 6 16 )。结论 七叶皂苷钠可替代皮质类固醇治疗Bell麻痹 ,同时避免皮质类固醇的副作用。

Objective The objective of this randomized, prospective, and controlled study was to test the efficacy of aescin and corticosteroids in Bell's palsy. Methods 85 consecutive patients, enrolled within 72 hours of facial palsy onset, were assigned to aescin plus polyvitaminic therapy group (Aescin Group, n=30) or prednisone-polyvitaminic therapy group (Prednisone Group, n=28) or polyvitaminic therapy alone group (Control Group, n=27). We employed the Facial Nerve Grading System proposed by House and Brachmann in 1985 to evaluate the clinical grading of facial muscle strength at the first day and after 1 month of the treatment. Results The three groups were similar in mean age, proportion of the gender and the enrolled time after clinical onset. The distribution of paresis severity was homogeneous before the treatment. The outcome in aescin group was similar to that in prednisone group, but the outcome of them was superior to that in control group. Conclusions aescin is similar to prednisone in treating Bell's palsy patients and the treatment of aescin can avoid the side effect of corticosteroids.