We present a case of an elderly man, who initially presented with right facial nerve palsy, ipsilateral headache, elevated erythrocyte sedimentation rate(ESR) and no fever. A presumptive diagnosis of giant cell arteri...We present a case of an elderly man, who initially presented with right facial nerve palsy, ipsilateral headache, elevated erythrocyte sedimentation rate(ESR) and no fever. A presumptive diagnosis of giant cell arteritis was made and the patient was treated with highdose steroids. A temporal artery biopsy was negative. Several months later, while on 16 mg of methylprednisolone daily, he presented with severe sensorimotor peripheral symmetric neuropathy, muscle wasting and inability to walk, uncontrolled blood sugar and psychosis. A work-up for malignancy was initiated with the suspicion of a paraneoplastic process. At the same time a biopsy of the macular skin lesions that had appeared on the skin of the left elbow and right knee almost simultaneously was inconclusive, whereas a repeat biopsy from the same area of the lesions that had become nodular, a month later, was indicative of Kaposi'ssarcoma. Finally, a third biopsy of a similar lesion, after spreading of the skin process, confirmed the diagnosis of Kaposi's sarcoma. He was treated with interferon α and later was seen in very satisfactory condition, with no clinical evidence of neuropathy, normal muscle strength, no headache, normal electrophysiologic nerve studies, involution of Kaposi's lesions and a normal ESR.展开更多
目的:观察四物牵正散联合针刺治疗风寒袭络型急性期周围性面瘫的临床疗效。方法:将86例风寒袭络型急性期周围性面瘫患者按照随机数字表法分为对照组和试验组,每组各43例。对照组给予四物牵正散治疗,试验组在对照组治疗的基础上联合针刺...目的:观察四物牵正散联合针刺治疗风寒袭络型急性期周围性面瘫的临床疗效。方法:将86例风寒袭络型急性期周围性面瘫患者按照随机数字表法分为对照组和试验组,每组各43例。对照组给予四物牵正散治疗,试验组在对照组治疗的基础上联合针刺疗法。比较两组患者的临床疗效、不良反应发生率及治疗前后面神经功能评分、面部残疾指数躯体功能(facial disability index physical function, FDIP)评分、面部残疾指数社会功能(facial disability index social function, FDIS)评分、中医证候积分、FaCE量表评分、免疫功能水平(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))变化情况。结果:对照组有效率为81.39%,试验组有效率为93.02%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后面神经功能评分、FDIP评分、FDIS评分高于本组治疗前,中医证候积分较低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后FaCE量表各项评分高于本组治疗前,且治疗后试验组高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)高于治疗前,CD8^(+)低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。试验组不良反应发生率低于对照组,差异具有统计学意义(P<0.05)。结论:四物牵正散联合针刺治疗风寒袭络型急性期周围性面瘫患者,能够调节患者免疫功能,改善临床症状,且不良反应较低。展开更多
文摘We present a case of an elderly man, who initially presented with right facial nerve palsy, ipsilateral headache, elevated erythrocyte sedimentation rate(ESR) and no fever. A presumptive diagnosis of giant cell arteritis was made and the patient was treated with highdose steroids. A temporal artery biopsy was negative. Several months later, while on 16 mg of methylprednisolone daily, he presented with severe sensorimotor peripheral symmetric neuropathy, muscle wasting and inability to walk, uncontrolled blood sugar and psychosis. A work-up for malignancy was initiated with the suspicion of a paraneoplastic process. At the same time a biopsy of the macular skin lesions that had appeared on the skin of the left elbow and right knee almost simultaneously was inconclusive, whereas a repeat biopsy from the same area of the lesions that had become nodular, a month later, was indicative of Kaposi'ssarcoma. Finally, a third biopsy of a similar lesion, after spreading of the skin process, confirmed the diagnosis of Kaposi's sarcoma. He was treated with interferon α and later was seen in very satisfactory condition, with no clinical evidence of neuropathy, normal muscle strength, no headache, normal electrophysiologic nerve studies, involution of Kaposi's lesions and a normal ESR.
文摘目的:观察四物牵正散联合针刺治疗风寒袭络型急性期周围性面瘫的临床疗效。方法:将86例风寒袭络型急性期周围性面瘫患者按照随机数字表法分为对照组和试验组,每组各43例。对照组给予四物牵正散治疗,试验组在对照组治疗的基础上联合针刺疗法。比较两组患者的临床疗效、不良反应发生率及治疗前后面神经功能评分、面部残疾指数躯体功能(facial disability index physical function, FDIP)评分、面部残疾指数社会功能(facial disability index social function, FDIS)评分、中医证候积分、FaCE量表评分、免疫功能水平(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))变化情况。结果:对照组有效率为81.39%,试验组有效率为93.02%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后面神经功能评分、FDIP评分、FDIS评分高于本组治疗前,中医证候积分较低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后FaCE量表各项评分高于本组治疗前,且治疗后试验组高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)高于治疗前,CD8^(+)低于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。试验组不良反应发生率低于对照组,差异具有统计学意义(P<0.05)。结论:四物牵正散联合针刺治疗风寒袭络型急性期周围性面瘫患者,能够调节患者免疫功能,改善临床症状,且不良反应较低。
