阿昔洛韦联合泼尼松治疗46例贝尔面瘫的疗效评价

目的：评价抗病毒药物阿昔洛韦（aciclovir）联合糖皮质激素泼尼松（prednisone）治疗贝尔面瘫的疗效。方法：46例贝尔面瘫病者被随机分成阿昔洛韦联合泼尼松组（A＋P组，n=23）和泼尼松治疗组（P组，n=23）。A＋P组口服阿昔洛韦每日3次，每次0．4g和泼尼松每日一次，每次50mg，P组口服泼尼松每日一次，每次50mg，连续5d，接着各组均将泼尼松减量为隔日一次，每次20mg。面神经功能指数（facial nerve functional index，FNFI）作为评判疗效指标。结果：治疗后第3周A＋P组中有12例（52.1％）面神经完全恢复（FNFI=1），P组为5例（21.7％）两者有显著性差异（P〈0．05）；而治疗后第4周，A＋P组2l例（91．3％）和P组18例（78．3％）面神经完全恢复（P〉0．05）。结论：阿昔洛韦联合泼尼松治疗贝尔面瘫疗效确切，无明显副作用；疗程比单纯用泼尼松治疗有明显缩短。

Outcome of treatment 46 patients with Bell's palsy with aciclovir and prednisone

PURPOSE: To evaluate the outcome of treatment with an antiviral drug in combination with corticosteroids in patients with Bell's palsy. METHODS: 46 patients with Bell's palsy were randomly divided into two groups, aciclovir and prednisone group (A+P group, n=23) and prednisone group (P group, n=23). The patients in A+P group were treated with 0.4g of aciclovir tablets 3 times per day for 5 days and 50 mg of prednisone daily for 5 days, and the patients in P group were treated with 50 mg of prednisone daily for 5 days, and then the dosage of prednisone was reduced by 20 mg per two days for the next 10 days. Facial nerve function index (FNFI)was used as a evaluating method of the outcome. RESULTS: 12 patients (52.1%) in the A+P group recovered completely (FNFI=1), as compared with 5 patients (21.7%) in the P group (P<0.05) after treatment three weeks, and 21 patients (91.3%) in the A+P group comparing with 18 patients (78.3%) in the P group (P>0.05) after treatment four weeks. CONCLUSIONS: The study showed a significantly better outcome in the patients with Bell's palsy treated with aciclovir and predisone as compared with the patient given prednisone treatment without serious complications.