温针灸配合康复功能训练治疗周围性面瘫40例疗效观察

目的:观察温针灸配合康复功能训练治疗周围性面瘫的临床疗效。方法:将符合纳入标准的80例受试者随机分成治疗组、对照组各40例,治疗组用温针灸配合康复功能训练进行治疗,对照组采用康复功能训练进行治疗,运用Portmann评分法及House-Brackman(H-B)面神经功能分级评价效果。结果:经过2个疗程治疗后,2组Portmann评分均较治疗前明显提高(P0.05);治疗组提高幅度高于对照组(P0.05);治疗组痊愈率、总有效率均优于对照组,2组比较有显著性差异(P0.01、P0.05)。结论:温针灸配合康复功能训练治疗周围性面瘫有较好临床疗效,较单纯康复功能训练治疗具有优势,值得临床推广应用。     

浅刺法治疗急性期周围型面瘫的疗效观察

目的 观察应用浅刺法治疗面瘫急性期的临床疗效。方法 将116例患者随机分成两组,治疗组和对照组各58例,两组在急性期均用药无治疗,治疗组在药物治疗基础之上加用浅刺法针刺治疗,急性期后则用常规针刺治疗;对照组急性期仅用西药,至急性期之后开始针灸治疗,穴位、方法同治疗组。结果 治疗组总有效率明显优于对照组,且两组病程比较差异有统计学意义(P<0.05) 。结论 面瘫急性期可进行浅刺法治疗可以提高疗效。     

Ortner's syndrome in association with mitral valve prolapse

The case of an 83-year-old woman with a history of hypertension, valvular heart disease, atrial fibrillation, and cardiomegaly is presented. The patient also had progressive hoarseness of her voice and intermittent dysphagia. Ear, nose, and throat examination revealed left vocal cord paralysis. Echocardiography revealed severely dilated left (LA) and right atria (RA), moderate mitral regurgitation, severe tricuspid regurgitation, and prolapse of both these valves. A review of literature of Ortner's or cardiovocal syndrome is presented. Ortner's syndrome due to mitral valve prolapse has not been reported previously.     

甩针挂钩法联合麦粒灸治疗顽固性周围性面瘫的临床效果观察

目的：探讨甩针挂钩法联合麦粒灸治疗顽固性周围性面瘫的临床效果。方法选取本院2013年2月~2014年10月收治的60例顽固性周围性面瘫患者作为研究对象,随机分为治疗组与对照组,各30例。治疗组采用甩针挂钩法结合麦粒灸治疗,对照组采用传统针刺治疗。比较两组的临床效果及治疗后的H-B功能评分。结果治疗组的总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗4疗程后,治疗组治疗后的H-B功能评分显著高于对照组,差异有统计学意义(P<0.05)。结论甩针挂钩法结合麦粒灸治疗顽固性周围性面瘫效果显著,既改善了患者面容的美观度,提高了患者的生存质量,又降低了面部后遗症发生率,值得临床推广应用。     

Snake and Spider Toxins Induce a Rapid Recovery of Function of Botulinum Neurotoxin Paralysed Neuromuscular Junction

Botulinum neurotoxins (BoNTs) and some animal neurotoxins (β-Bungarotoxin, β-Btx, from elapid snakes and α-Latrotoxin, α-Ltx, from black widow spiders) are pre-synaptic neurotoxins that paralyse motor axon terminals with similar clinical outcomes in patients. However, their mechanism of action is different, leading to a largely-different duration of neuromuscular junction (NMJ) blockade. BoNTs induce a long-lasting paralysis without nerve terminal degeneration acting via proteolytic cleavage of SNARE proteins, whereas animal neurotoxins cause an acute and complete degeneration of motor axon terminals, followed by a rapid recovery. In this study, the injection of animal neurotoxins in mice muscles previously paralyzed by BoNT/A or /B accelerates the recovery of neurotransmission, as assessed by electrophysiology and morphological analysis. This result provides a proof of principle that, by causing the complete degeneration, reabsorption, and regeneration of a paralysed nerve terminal, one could favour the recovery of function of a biochemically- or genetically-altered motor axon terminal. These observations might be relevant to dying-back neuropathies, where pathological changes first occur at the neuromuscular junction and then progress proximally toward the cell body.     

双银纠正汤联合针灸治疗风热证周围性面瘫54例

目的:探讨双银纠正汤联合针刺治疗周围性面瘫(风热证)的临床观察及疗程报道。方法:108例周围性面瘫(风热证)患者随机按数字表分为针灸组和治疗组各54例。针灸组采用针刺穴位治疗,1次/d,每周休息1 d;治疗组在针灸组治疗的基础上采用双银纠正汤内服治疗,1剂/d,分3次口服。两组疗程均为4周。进行治疗前后面部残疾躯体功能指数(FDIP),社会生活功能(FDIS),面神经功能分级(H-B)量表和中医证候评分。结果:治疗组的临床总有效率为90.74%,高于针灸组的75.93%(P<0.05);治疗组临床治愈率50%,针灸组为24.07%,治疗组优于针灸组(P<0.05),治疗后第2周治疗组治愈例数多于针灸组(P<0.05);治疗后治疗组FDIP量表评分高于针灸组(P<0.05),FDIS评分较低于针灸组(P<0.05);治疗后治疗组H-B评分和中医证候评分较均低于针灸组(P<0.05)。结论:与单纯针刺治疗比较,双银纠正汤联合针刺治疗周围性面瘫(风热型)能明显提高临床总有效率和缩短治疗疗程。     

推抹捏擦扳五步推拿法为主治疗周围性面瘫临床观察

目的观察推抹捏擦扳五步推拿法为主治疗周围性面瘫的临床疗效。方法将72例周围性面瘫患者随机分为治疗组与对照组,每组36例。在均使用红外线照射治疗的基础上,对照组加用常规针刺疗法,治疗组加用推抹捏擦扳五步推拿法。两组疗程均为10天,观察临床疗效,比较面神经功能分级的变化情况。结果 1治疗组、对照组总有效率分别为94.44%和83.33%,组间临床疗效比较差异有统计学意义(P0.05)。2治疗前后组内比较,两组面神经功能分级差异均有统计学意义(P0.05);组间治疗后比较,面神经功能分级差异有统计学意义(P0.05)。结论推抹捏擦扳五步推拿法为主治疗周围性面瘫疗效满意。     

Scales of degree of facial paralysis: analysis of agreement

IntroductionIt has become common to use scales to measure the degree of involvement of facial paralysis in phonoaudiological clinics.ObjectiveTo analyze the inter- and intra-rater agreement of the scales of degree of facial paralysis and to elicit point of view of the appraisers regarding their use.MethodsCross-sectional observational clinical study of the Chevalier and House & Brackmann scales performed by five speech therapists with clinical experience, who analyzed the facial expression of 30 adult subjects with impaired facial movements two times, with a one week interval between evaluations. The kappa analysis was employed.ResultsThere was excellent inter-rater agreement for both scales (kappa > 0.80), and on the Chevalier scale a substantial intra-rater agreement in the first assessment (kappa = 0.792) and an excellent agreement in the second assessment (kappa = 0.928). The House & Brackmann scale showed excellent agreement at both assessments (kappa = 0.850 and 0.857). As for the appraisers’ point of view, one appraiser thought prior training is necessary for the Chevalier scale and, four appraisers felt that training is important for the House & Brackmann scale.ConclusionBoth scales have good inter- and intra-rater agreement and most of the appraisers agree on the ease and relevance of the application of these scales.     

Efficiency and durability of hyaluronic acid of different particle sizes as an injectable material for VF augmentation

Conclusion: The results of the present investigation suggest that modification of HA could improve efficiency and durability in augmentation laryngoplasty. Objectives: Injection laryngoplasty (IL) is one of the most suitable options for treatment of glottic insufficiency, which is caused by vocal fold (VF) paralysis, atrophy, or scarring. Hyaluronic acid (HA) is a widely used material for VF injection. This study was intended to evaluate the durability and efficiency of HA of different particle sizes for VF augmentation. Methods: Three types of HA, Restylane®, monophasic low-viscosity, and unequal particle-sized middle-viscosity HA were injected into the left VF of three groups with eight rabbits each. Results: After 6 and 10 weeks, the injected site was evaluated endoscopically, histologically, radiologically, and functionally. None of the 24 rabbits showed any signs of respiratory distress. Computed tomography (CT) images and endoscopic evaluation revealed sufficient augmented volume of the injected VF in all treated groups 6 weeks after the injection. Histological data at week 10 showed that unequal particle-sized HA did not migrate from its original injection site, while other HAs migrated to the periphery of the arytenoid cartilage. Videokymographic analysis showed more favorable vibrations of unequal particle-sized HA injected VF mucosa 10 weeks post-injection, compared to the other treatment groups.