面瘫共草稿.pptVIP

面瘫病针灸科共识草稿 为什么要有共识 1、病因未明 2、治疗方法未统一 3、针灸在治疗面瘫中的作用机制探讨,疗效分析 4、针灸介入时间 5、预后的判断 Etiology Classically, Bells palsy has been defined as idiopathic, and the cause of the inflammatory process in the facial nerve remains uncertain. Recently, attention has focused on infection with herpes simplex virus type 1 (HSV-1) as a possible cause because research has found elevated HSV-1 titers in affected patients. However, studies have failed to isolate viral DNA in biopsy specimens, leaving the causative role of HSV-1 in question. Etiology herpes simplex virus type 1 (HSV-1) Bell‘s palsy diabetes pregnant women Bells palsy has been described in patients of all ages, with peak incidence noted in the 40s. It occurs more commonly in patients with diabetes and in pregnant women. 关注面瘫与糖尿病和妊娠 面瘫的复发 Patients who have had one episode of Bells palsy have an 8 percent risk of recurrence Treatment ?spontaneous recovery?自愈 1、激素corticosteroids 2、抗病毒药antivirals 3、外科手术surgical decompression within three weeks of onset has 4、针灸acupuncture Some published studies have reported benefit with acupuncture versus steroids and placebo, but all had serious flaws in study design and reporting. spontaneous recovery?自愈Bell‘s palsy should be routinely indicated 常规治疗? The Copenhagen Facial Nerve Study evaluated 2,570 persons with untreated facial nerve palsy, including 1,701 with idiopathic (Bells) palsy and 869 with palsy from other causes; 70 percent had complete paralysis. Function returned within three weeks in 85 percent of patients, 85%自然开始恢复 with 71 percent of these patients recovering full function. 71%完全恢复 Of the 29 percent of patients with sequelae, 12 percent rated it slight, 13 percent rated it mild, and 4 percent rated it severe.29%遗留后遗症 suggesting 发病3天内的患者，若没有明确地药物禁忌症，需安全地给阿昔洛韦、伐昔洛韦，和短期的口服激素。完全性瘫痪的患者，自然恢复的可能性较小，他们或许能从药物治疗中获益。 Given the safety profile of acyclovir, valacyclovir, and short-course oral corticosteroids, patients who present within three days of the onset of symptoms