更昔洛韦联合地塞米松与单用更昔洛韦治疗急性特发性面神经炎的疗效比较

摘要

目的 比较更昔洛韦联合地塞米松与单用更昔洛韦治疗急性特发性面神经炎的临床效果.方法 对北大医疗鲁中医院神经内科2014年3月至2016年3月收治的急性特发性面神经炎患者80例按入院顺序随机分为治疗组、对照组,每组40例.两组均给以基础治疗(甲钴胺肌注+舒血宁静脉滴注,连续应用15 d),治疗组排除皮质类固醇应用禁忌,在此基础上应用更昔洛韦联合地塞米松,对照组应用更昔洛韦.两组疗程15d.对所有患者治疗前、治疗后7d、治疗后15 d均采用Portmann简易评分量表进行评分,采用SPSS 13.0软件统计评分的统计学意义.结果 组内比较:治疗组治疗7d评分(10.11 ±3.62)分,与治疗前评分(2.60±2.22)分,差异有统计学意义(t=1.432,P＜0.05);治疗组治疗7 d(10.11 ±3.62)分,与15 d评分[(11.82±3.02)分]差异无统计学意义(t=1.582,P＞0.05);对照组治疗7 d(3.22 ±3.12)分与治疗前评分[(2.70±2.30)分]差异无统计学意义(t =0.923,P＞0.05),对照组治疗15 d(10.98 ±3.50)分,与治疗7d[(3.22±3.12)分]及治疗前评分[(2.70±2.30)分]差异有统计学意义(t=1.492,P＜0.05).组间比较:两组治疗前评分差异无统计学意义(P＞0.05);治疗7d治疗组评分(10.11±3.62)分,与对照组评分[(3.22±3.12)分]差异有统计学意义(t=1.633,P＜0.05);治疗15 d两组评分差异无统计学意义(P＞0.05).结论 更昔洛韦联合地塞米松与单用更昔洛韦治疗急性特发性面神经炎效果显著,虽然联合应用在治疗过程中改善效果较单用起效更早,但两种治疗总有效率无明显差异.%Objective To compare the clinical effects of ganciclovir combined with dexamethasone and ganciclovir alone in the treatment of acute idiopathic facial neuritis.Methods From March 2014 to March 2016,80 patients with acute idiopathic facial neuritis admitted in the department of neurology of Luzhong Hospital were randomly divided into treatment group and control group according to the admission sequence,with 40 cases in each group.The two groups were given basic treatment (mecobalamine intramuscular injection + clonazepam and continuous application for 15d),and the treatment group was excluded from the corticosteroid application.On this basis,ganciclovir combined with dexamethasone was applied in the treatment group,and ganciclovir was applied in the control group.Both two groups had a course of 15 days.All the patients were graded by Portmann simple scale before treatment and at 7 days and 15 days after treatment,and statistical significance of SPSS13.0 software was adopted.Results Intra-group comparison:after treatment of 7d,the score of the treatment group was (10.11 ± 3.62) points,which was significantly higher than (2.60 ± 2.22) points before treatment (t =1.432,P ＜ 0.05).The score had no statistically significant difference between 7d after treatment [(10.11 ± 3.62)points] and 15d after treatment [(11.82 ±3.02) points] in the treatment group (t =1.582,P ＞ 0.05).In the control group,the score had no statistically significant difference between 7 d after treatment [(3.22 ± 3.12) points] and before treatment [(2.70 ± 2.30) points](t =0.923,P ＞0.05).Comparison between the two groups:there was no statistically significant difference in pretreatment score between the two groups (P ＞ 0.05).The score of the treatment group at 7d after treatment [(10.11 ±3.62) points] was significantly different from that of the control group[(3.22 ± 3.12)points] (t =1.633,P ＜ 0.05).There was no statistically significant difference in scores between the two groups at 15d after treatment (P ＞ 0.05).Conclusion Ganciclovir combined with dexamethasone and ganciclovir alone are effective in the treatment of acute idiopathic facial neuritis.Although the improvement effect of the combined treatment is earlier than that of single use,there is no significant difference in the total effective rate between the two treatments.