面瘫神经损伤定位和治疗方法选择相关关系的临床随机对照研究

目的:研究面瘫神经损伤定位和治疗方法之间的相关关系,为临床选择最佳治疗方案.采用随机、按神经损伤定位分层对照的方法,将199例符合纳入标准的患者分为针刺治疗组(A组)、西药治疗组(B组)、中西医结合治疗组(C组).结合临床和肌电图作出准确神经损伤定位,用House-Brachmann面神经功能分级标准,结合临床症状、体征进行疗效分析,并作6个月随访.结果表明面神经管内损伤,中西医结合疗法优于针刺组和西药组(P<0.05),后遗症少;面神经管外损伤,3组之间疗效差异无显著性意义(P>0.05).说明定位在面神经管内的面瘫,以中西医结合治疗方案为最佳选择;定位在面神经管外的面瘫,有明显的自然痊愈趋向.

Clinical research on correlation between the location of the nervous injury and therapeuticmethods for peripheral facial paralysis

Objective To explore the correlation between the location of the nervous injury and the therapeutic methods to select the best therapeutic methods for peripheral facial paralysis. Methods One hundred and ninety nine cases of peripheral facial paralysis were randomly divided into three groups according to different segments of injuried facial nerves. Group A were treated by acupuncture, group B by western medicine and group C by acupuncture combined with western medicine. The location of the nervous injury was based on the clinical symptoms and EMG. The therapeutic effects were analyzed according to clinical symptoms and signs and House-Brachmann criterion. They were followed up for six months and the sequelae were investigated. Results Acupuncture combined with western medicine had a better therapeutic effect on the injury within the facial canal than other two groups (P<0.05) with a few sequelae. There was no significant difference among the three groups on the facial nervous injury out of the facial canal (P>0.05). Conclusion Acupuncture combined with western medicine is the best choice for the cases of facial nerve injury within the facial canal. There is an obvious tendency of natural recovery for the nerve injury out of the facial canal.