泼尼松龙和泼尼松龙联合伐昔洛韦治疗不同程度Bell’s面瘫的疗效比较  

A comparison between prednisolone and prednisolone combined with valacyclovir in treating bell's palsy

作　　者：牛春生[1] 

机构地区：[1]天津市宝坻区人民医院耳鼻喉科,天津市01800

出　　处：《中华耳科学杂志》2015年第3期519-521,共3页Chinese Journal of Otology

摘　　要：目的评价泼尼松龙和泼尼松龙联合伐昔洛韦在不同程度Bell’s面瘫患者中的疗效。方法将2010年1月-2013年1月于我院门诊就诊280例Bell’s面瘫患者(年龄18-75岁、面瘫起病72小时内的患者)随机分为两组:泼尼松龙组(140人),联合治疗组(140人),分别给予泼尼松龙单药、泼尼松龙+伐昔洛韦治疗。随访持续12个月,254例患者完成了12个月的随访。根据Sunnybrook评分系统评价起病及12个月时的面神经功能。完全恢复为Sunnybrook评分100分。结果在重度面瘫患者中,12月内痊愈率分别为52%(泼尼松龙治疗组)和53.8%(联合治疗组)(P>0.05);中度面瘫患者痊愈率分别为69.8%和68.3%(P>0.05),轻度面瘫患者痊愈率分别为83.3%和84.7%(P>0.05)。12个月时,在重度面瘫患者中,连带运动出现比列分别为40%(泼尼松龙治疗组)和42.3%(联合治疗组)(P>0.05);中度面瘫患者连带运动比例分别为23.3%和22%(P>0.05),轻度面瘫患者连带运动比列分别为5%和5.1%(P>0.05)。结论无论Bell’s面瘫起病程度如何,与单独使用泼尼松龙相比,泼尼松龙联合伐昔洛韦治疗并未增加面瘫痊愈率,也未减少连带运动比例。因此,在Bell’s面瘫患者的治疗中,不推荐泼尼松龙联合伐昔洛韦治疗。Objectives To compare the efficacy of prednisolone and prednisolone combined with valaciclovir in treating Bell＇s palsy. Methods Patients（n=280） seen in our outpatient clinic between January 2010 and January 2013（aged 18–75 years and treated within 72 h of palsy onset） were divided randomly to receive prednisolone alone（n=140） or prednisolone combined with valacyclovir（n=140）. Of them, 254 patients completed a 12-month follow-up. Facial nerve function was assessed using the Sunnybrook grading scale at baseline and at12 months. Complete recovery was defined as Sunnybrook score = 100. Results In patients with severe palsy, the rate of recovery at 12 months was 52% with prednisolone treatment versus 53.8% with the combined treatment（P〉0.05）. The rate was 69.8% versus 68.3%（P 〉0.05） for patients with moderate palsy, and83.3% versus 84.7%（P〉0.05） for those with mild palsy. For patients with severe palsy at baseline, the rate of synkinesis at 12 months was 40% in the prednisolone group and 42.3% in the combined treatment group, respectively, for patients with severe palsy（P〉0.05）; 23.3% and 22%, respectively, for patients with moderate palsy（P〉0.05）; and 5% and 5.1%, respectively, for those with mild palsy（P0.05）. Conclusions Compared to prednisolone treatment alone, combined treatment with prednisolone and valaciclovir does not appear to increase recovery of palsy or to reduce the rate of synkinesis regardless of palsy severity at baseline.

关 键 词：Bell’s面瘫 泼尼松龙 伐昔洛韦 Sunnybrook评分 联合治疗 

分 类 号：R745.12[医药卫生—神经病学与精神病学]